chapter 5 review

Decontamination Area should also have what?

floors, walls and ceilings with non-porous surfaces that will withstand frequent cleaning and wet conditions.

If one person is responsible for cleaning the entire SPD, the work should

flow from clean to dirty areas, with the decontamination area being the last area cleaned.

Decontamination Area Should Provide

hand-hygiene facilities that are separate from the sinks used for cleaning, including conveniently located alcohol-based waterless hand hygiene solutions.

The staff works in a wet environment, is constantly doing what?

handling contaminated sharps, is working with potentially hazardous chemicals such as detergents and disinfectants and is using equipment that operates at high temperatures.

what is also recommended?

healthcare facilities should arrange for a healthcare professional with expertise in device reprocessing to immediately assess their reprocessing procedures.

Decontamination area should be set up to provide for efficient and effective cleaning and also to..

minimize and contain potential environmental contamination.

Items processed may include:

Surgical instrumentation Patient care equipment Other medical devices

Training should be required and provided when:

Upon hire or prior to provision of services at the facility At least once a year When new devices or protocols are introduced, including changes in the manufacturer's instructions for use during the device's life cycle

Cleaning is defined as the

"removal of contamination from an item to the extent necessary for further processing or for the intended use" (AAMI ST79).

Decontamination is defined as the

"use of physical or chemical means to remove, inactivate or destroy blood-borne pathogens on a surface or item, to the point where they are no longer capable of transmitting infectious particles and the surface is rendered safe to handle" (OSHA).

Decontamination involves two steps.

- The first (and most important) step is manual and/or automated, mechanical cleaning. - Second step is the application of a thermal or chemical disinfection process. (Used when cleaning alone may not be enough to make them safe to handle without transmitting disease.)

Training and competency verification was emphasized. Among the recommendations were the following:

- Training should be required and provided - personnel should be required to demonstrate competency with device processing - healthcare facilities should maintain current documentation of trainings and competencies - if the healthcare facility hires a contractor for device reprocessing, the facility should verify that the contractor has an appropriate training program and that the training program includes the specific devices the healthcare facility uses. - copies of manufacturers instructions for operating and reprocessing each type of reusable device should be readily available to staff and inspectors. This file should include instructions for use of chemical disinfectants.

why healthcare facilities that use reusable medical devices are urged to immediately review current reprocessing practices at their facility?

1- they are complying with all steps as directed by the device manufacturers 2- have in place appropriate policies and procedures that are consistent with current standards and guidelines.

Decontamination Area should Control and maintain the humidity in the range of what? A: 30% to 60% B: 40% to 70% C: 50% to 80% D: 60% to 90%

A: 30% to 60%

Temperature and humidity should be monitored and documented: A: Daily B: Weekly C: Monthly D: Yearly

A: Daily

The micro-organisms on a contaminated item are called what? A: bioburden B: organisms C: cells D: axons

A: bioburden

Because of the potentially high levels of contaminants in the decontamination area, the ventilation system should be designed to maintain A: negative air pressure B: positive air pressure

A: negative air pressure

Decontamination Area Should Accommodate

Accommodate disposal of hazardous substances and collection of sharps.

The Decontamination area should allow what?

Allow traffic control and efficient work flow

The Decontamination area should contain what?

Contain equipment needed for manual and automated, mechanical cleaning and disinfection

Decontamination Area should Control and maintain the temperature in the range of what? A: 50% to 65% B: 60% to 65% C: 30% to 45% D: 30% to 65%

B: 60°F to 65°F (16°C to 18°C)

Make sure that preventive maintenance is performed according to what? A: table B: schedule C: label D: stable

B: schedule

Decontamination Area Should Also Provide A: space for sleep B: space for workouts C: space for supply storage D: space for messing around

C: space for supply storage.

One method of promoting employee comfort A: the use of break room B: the use of restroom C: the use of netflix and chill D: the use of cooling vests

D: the use of cooling vests.

What Should be physically separated from all other areas of the department and Access should be from an outside corridor?

Decontamination Area

what is the root of the problem?

In virtually all cases, improper cleaning

The Decontamination area should include what?

Include a pass-through window through which manually cleaned items can be passed through to the clean area

what should be followed ?

It is essential that every step in the device manufacturer's current instructions for use (IFU) be followed each and every time

what in processing have been reported in the United States?

Numerous Breaches

The Decontamination area should provide what?

Provide space to accommodate type and quantity of supplies, equipment and instrumentation to be processed

The Decontamination area should also provide what?

Provide space to store, apply and remove PPE

what did the recent infection control lapses due to non-compliance with recommended reprocessing procedures highlighted?

a critical gap in patient safety

Decontamination Area should have what?

a ventilation system designed to maintain negative pressure to help contain contaminants inside the decontamination area.

To ensure that cleaning equipment is in good working order what must be done?

all equipment used for cleaning should be maintained with a preventive maintenance (PM) program.

The critical importance of thorough cleaning has been emphasized by what?

all standard-setting organizations as well as the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC)

Items received for decontamination are contaminated with what?

blood, body fluids, tissue and unknown micro-organisms that could be pathogenic.

whats the most important part of the disinfection or sterilization process?

cleaning

The health advisory urged healthcare facilities to review their practices to ensure what?

complete compliance with manufacturers' written instruction for use.

The process of decontaminating medical devices should be centralized in one location to accomplish what?

consistent, effective and efficient processing and containment of bioburden.

Healthcare facilities should maintain what?

current documentation of trainings and competencies.

Copies of manufacturers' instructions for operating and reprocessing each type of reusable device should be

readily available to staff and inspectors.

If the temperature or humidity levels are above or below the recommended levels, the discrepancies should be

reported to the SPD manager or supervisor.

what should this assessment ensure?

that processing is done correctly, including allowing enough time for reprocessing personnel to follow all steps recommended by the device manufacturer.

what does the health advisory also recommends ?

that the audits of the cleaning, disinfection, and sterilization processes be routinely performed to ensure compliance with IFUs and policies and procedures

If the healthcare facility hires a contractor for device reprocessing, the facility should verify what?

that the contractor has an appropriate training program and that the training program includes the specific devices the healthcare facility uses.

what happened on September 11, 2015?

the CDC and FDA issued a CDC Health Advisory entitled "Immediate Need for Healthcare Facilities to Review Procedures for Cleaning, Disinfecting, and Sterilizing Reusable Medical Devices."

what happen if even one step is omitted?

the entire disinfection or sterilization process can be ineffective

the national attention to cleaning and compliance with IFUs emphasizes what?

the importance of the cleaning process

cleaning is defined as what?

the removal of contamination from an item to the extent necessary for further processing or for the intended use

All items must be handled as if they represent a significant health risk, because ...

the type and level of contamination on items to be processed is generally unknown. This is known as Standard Precautions.

what was the purpose of the communication?

to alert "healthcare providers and facilities about the public health need to properly maintain, clean, and disinfect or sterilize reusable medical devices.

there should be what in decontamination area?

unobstructed access to eyewash facilities