Infection Control - Chapter 13 & 14
Which of the following is a housekeeping surface rather that a clinical contact surface and does not have to be covered or routinely cleaned and disinfected between each patient?
Wall next to the dental chair
According to CDC how often is one to perform chemical monitoring of the sterilization process?
With every package in every load
How should a cotton roll or other items be retrieved from a bulk container at chairside?
With sterile cotton pliers or forceps
Which of the following protective barriers are to be worn when disinfecting a surface?
Utility gloves, mask, protective clothing, protective eyewear
The goal of instrument processing is to:
provide sterile instruments at chairside for use on a subsequent patient.
When designing a sterilization facility and purchasing a new sterilizer, one should look for clearance of the desired sterilizer by what Federal agency?
FDA
Proper steam sterilization involves placing the instruments in a completely closed container before processing them through the sterilizer.
False
Which bacterial spore is used to spore test a steam sterilizer and the unsaturated chemical vapor sterilizer?
Geobacillus stearothermophilus
Which of the following is a high-level disinfectant/sterilant?
Glutaraldehyde
Why should ultrasonic cleaners or automatic instrument washers be used instead of routine hand-scrubbing to clean contaminated dental instruments?
Hand-scrubbing increases the chances of sharps injuries.
According to the CDC how should critical instruments be prepared for use?
Heat sterilized.
According to the CDC how should non heat sensitive semicritical instruments be prepared for use?
Heat sterilized.
What is the correct sequence of the instrument processing steps?
Holding, precleaning, corrosion control, packaging, sterilization, monitoring, handling
How would you sterilize burs made of carbon steel?
In a dry heat sterilizer
Gloves need not be worn during which of the following activities?
Placing new surface covers between patients.
If you are using a disinfectant wipe (a paper towelette saturated with a disinfectant) rather than a spray disinfectant, how many wipes should be used to achieve proper cleaning and disinfection of a surface?
Two
Why should heavy and/or sharp instruments not be packaged in paper bags for steam sterilization?
The bags will get wet during sterilization and the instruments may puncture the bag or the bag may easily tear.
What should be done before disinfecting a contaminated operatory surface?
Preclean the surface.
According to the CDC how heat sensitive semicritical instruments be prepared for use?
Processed with high-level disinfection.
According to the CDC how should noncritical instruments be prepared for use?
Processed with intermediate-level or low-level disinfection.
What is the first step to be taken after a sterilization failure is detected through spore testing?
Take the sterilizer out of service.
When using surface disinfectants in the office one cannot verify whether the microbes on the surface have been removed or killed.
True
Which of the following statements is true about ultrasonic cleaning of dental instruments?
Used cleaning solution contains live microbes.
What equipment should not be used as an instrument sterilizer?
A bead sterilizer
What type of containers should be used to transport contaminated instruments from the operatory to the sterilizing room?
A covered, leak-proof, puncture-proof, container marked with a biohazard symbol.
Which of the following should never be used as a surface disinfectant?
A high-level disinfectant.
Which of the following terms indicate the strongest microbial killing power?
A sporicidal agent
What is a Bowie-Dick test?
A test for air removal in vacuum and prevacuum steam sterilizers.
Which of the following best describes an intermediate-level disinfectant?
A tuberculocidal agent
Which of the following is the strongest (kills the most microbes)?
A tuberculocidal disinfectant
How often should a surface cover on a dental light handle or light switch be replaced?
After every patient
What does the test solution contain that is used to evaluate the efficiency of medical/dental instrument cleaning equipment in the TOSI test?
Albumin, fibrin, and hemoglobin
Which of the following germicidal agents is least desirable as a surface disinfectant?
Alcohols
Which of the following is used to kill microbes on the skin just before an injection?
Antiseptic
What microbe is not killed by low-level disinfectants nor intermediate-level disinfectants?
Bacterial spore
Why should handpieces be heat sterilized rather than wiped off with a disinfectant between patients?
Because wiping off the outside will not kill the microbes that were retracted up inside the handpiece.
"Autoclave" tape is used for which type of sterilization monitoring?
Chemical
Which of the following types of disinfectants can contain the same active ingredient as bleach?
Chlorines
If you properly use surface covers on clinical contact surfaces at chairside for each patient, which of the following is not necessary?
Clean and disinfect those surfaces between patients.
If surface covers are properly used during patient treatment, which of the following procedures is not needed?
Cleaning and disinfecting covered surfaces after the appointment.
According to CDC how often is one to perform mechanical monitoring of a sterilizer?
Every load
What is the best approach for decontaminating high-tech equipment such as computers, cameras, and digital radiography equipment?
Contact the manufacturer for instructions.
What are the three main areas in a sterilizing facility?
Decontamination, packaging, sterilization and storage
How would one manage a piece of equipment marketed for use in patients' mouths but is not disposable, and cannot be heat sterilized, covered with a protective barrier, or contact a liquid disinfectant?
Don't use it.
Bacillus atrophaeus spores are used to monitor which of the following sterilizers?
Dry heat sterilizer and steam sterilizer
The labels of properly approved surface disinfectants contain a registration number from which Federal agency?
EPA
What is the main concern/precaution with using a dry heat oven-type sterilizer?
It has a long sterilization time
What is the main reason why cloth (e.g., terry cloth towels, denim) is not be used as a sterilization wrap?
It is not a good microbe barrier.
What is the most important property of a surface cover?
It must be impervious to water.
Choose an advantage of using instrument cassettes?
It reduces the risks of sharps injuries by reducing the direct handling of the instruments.
What is the main concern/precaution with using an unsaturated chemical vapor sterilizer?
It requires the purchase and use of a special chemical sterilizing solution.
How can you tell if a disinfectant has been registered with the EPA?
Its label displays a registration number
What should be done to the instruments at the end of a steam sterilization cycle?
Let the instrument packages dry inside the sterilizer before handling them.
How would you sterilize a plastic, reusable, rubber dam frame that melts at 100°C (212°F)?
Liquid chemical sterilant
What should be done to a clinical contact surface after its protective surface cover has been carefully removed at the end of a patient appointment?
Nothing—just add a fresh cover for the next patient.
How should instrument packages/cassettes be placed into the sterilizer chamber?
On their edges or in a single layer
According to CDC how often is one to perform biological monitoring of a sterilizer?
Once a week
Manufacturers have added alcohol to which of the following types of disinfectants to make it tuberculocidal?
Quaternary ammonium compounds
What type of disinfectants is not tuberculocidal?
Quaternary ammonium compounds
Your office just received a new disinfectant. What's the easiest way to find out how it should be used?
Read its label.
Why did the CDC and the FDA issue a Health Advisory in 2015 urging all healthcare facilities to immediately review current reprocessing practices at their facility to ensure they (1) are complying with all steps as directed by the device manufacturers, and (2) have in place appropriate policies and procedures that are consistent with current standards and guidelines?
Recent infection control lapses due to noncompliance with recommended medical device reprocessing procedures highlighted a critical gap in patient safety.
What is a housekeeping rather than clinical contact surface?
Sink
Which of the following surfaces is usually not involved in patient-to-patient spread of microbes?
Sink
Hospital disinfectants are low-level disinfectants that have been shown to kill:
Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa.
Which of the following sterilization methods lead to corrosion (e.g., rusting) of carbon steel instruments?
Steam
What is sterility assurance?
The correct performance of the proper instrument processing steps and monitoring of the sterilization step.
Why are two disinfecting towelettes used during the wipe-discard-wipe procedure?
The first one cleans the surface and the second one disinfects the surface.
Choose the meaning of a failed Bowie-Dick test.
There may be places in the sterilizer chamber that did not reach sterilizing temperature.
Which of the following is a problem when using a liquid chemical sterilant on heat-sensitive instruments?
These sterilants cannot be spore-tested.
What kinds of dental operatory surfaces best lend themselves to being covered with a surface barrier rather than being cleaned and disinfected between each patient?
Those that are difficult to clean and disinfect
What is the purpose of the second spray in the spray-wipe-spray procedure?
To disinfect the surface.
What's the rationale for the holding step as part of instrument processing?
To facilitate the cleaning process by keeping the debris on the instruments from drying.
What's the rationale for the packaging step as part of instrument processing?
To help maintain sterility of the instruments after instrument processing
During instrument processing, what is the reason for sterilizing instruments?
To kill all remaining microbes on the instruments after they have been cleaned.
Why is it important to dry instruments before dry heat or unsaturated chemical vapor sterilization?
To maintain the antirusting nature of these two methods of sterilization.
Why is it important to let instruments packaged in paper/plastic pouches, paper bags or sterilization wrap dry inside the steam sterilizer?
To minimize tearing of packaging materials when handling the sterilized items and to avoid wicking
What is the main reason for packaging instruments before they are placed in a sterilizer?
To protect the instrument from recontamination after sterilization.
What's the rationale for the precleaning step as part of instrument processing?
To remove as much of the bioburden as possible to give the sterilization step the best chance to work.
Storing supplies in drawers at chairside for retrieval during patient treatment can lend itself to cross-contamination of the drawer handle or of bulk items inside.
True
Disinfection is best defined as:
a process designed to kill all diseases-producing microns but not necessarily high level of bacterial spores.
Sterilization is best defined as:
a process intended to kill all microbes.
Supplying sterile forceps or cotton pliers with each instrument set-up to reach into containers of bulk supplies (e.g., cotton rolls, or cotton pledgets) is best referred to as:
aseptic retrieval.
The spray-wipe-spray procedure is a technique for:
disinfecting surfaces or objects.
Paper-plastic peel pouches cannot be used in a ________________ sterilizer.
dry heat
A system of storage of sterilized instrument packages that recognizes a package's contents should remain sterile until some event causes items inside to become contaminated is correctly referred to as:
event-related storage.
The reason for holding (presoaking) instruments prior to cleaning is to:
facilitate cleaning
Which microbe is the most susceptible to the environment and usually dies within seconds to minutes outside the human body:
herpes simplex virus.
According to the CDC low-level disinfectants can be use on clinical contact surfaces if they are EPA-registered as a hospital disinfectant and have been shown to kill:
human immunodeficiency virus and hepatitis B virus
Paper bags for steam sterilization are best used to package:
light weight nonsharp items.
There are two reasons why packages of instruments should be allowed to dry inside the steam sterilizer before they are handled. One reason is because wet paper can easily tear when handled. The other is because:
of wicking
According to the CDC semicritical instruments are those that:
partially penetrate soft tissue, contact bone, enters into or contacts the bloodstream or other normally sterile tissue.
According to the CDC critical instruments are those that:
penetrate soft tissue, contacts, bone, enters into or contacts the bloodstream or other normally sterile tissue.
Spores of Geobacillus stearothermophilus are used in biological indicators to monitor:
steam and unsaturated chemical vapor sterilizers.