Chapter 7: Preventing Perioperative Disease Transmission; Short Answer: Disinfection and Sterilization

Analyze and compare the differences between disinfection and sterilization; antiseptics and disinfectants.

Disinfection: Chemical agent is used on inanimate objects to reduce the number of microbes. Sterilization: Process of destroying all microorganisms, including spores. Also only performed on inanimate objects. Antiseptics: Used to reduce/remove microbes from living objects.

Glutaraldehyde: (A) Compare the sterilization times for glutaraldehyde and peracetic acid. (B) What is the usual time for glutaraldehyde high-level disinfection of an item? (C) Why is it necessary to rinse the glutaraldehyde completely from an item prior to use on the patient with sterile saline?

(A) Peracetic acid requires an exposure time of 6 mins of a 23 mins cycle for sterilization to occur; Glutaraldehyde requires immersion time of 10 hours. (B) The usual time for high-level disinfectant is 20 mins (C) Thoroughly rinsing with saline prevents chemical burns from the glutaraldehyde.

Terminal cleaning: (A) Does terminal cleaning take place at the end of the day or at the end of the case? (B) What principles are used are in the terminal cleaning process? (C) What type of disinfectant is most likely to be used for terminal cleaning? (D) What is the preferred method of floor cleaning?

(A) The end of the day. (B) It begins from top to bottom and from cleanest areas to the dirtiest areas using the principles of confine and contain. May include wiping down walls, floors and ceilings, cabinet doors and handles, and all furniture and equipment in each room down to the wheels. (C) Phenols (D) Clean with disinfectant and wet vacuum.

Summarize the three essential components of monitoring the sterilization process.

1) Chemical -> Detect failure sterilization: machine failure, assembly 2) Biological -> Only way to ensure sterilization has occurred 3) Mechanical ->Time and Temperature readings

List three steps of instrument preparation for sterilization and explain what happens during each process.

1) Inspection: Inspect instruments for proper elements and function. 2) Reassembly: Some instruments may need to be reassembled before processing; though many instruments must remain unassembled to allow the sterilant to come in contact with all pieces. 3) Preparation: Instruments must be distributed into instrument trays evenly, making sure that all instruments come in contact with sterilant, basin are to be nested, and an absorbent towel should separate each basin.

Analyze the process of sterilization and describe the four methods of monitoring that are required for all loads containing an implantable.

1) Mechanical - monitor progress of the machine during sterilization. 2) Chemical - Used externally and internally to verify the items have been exposed to the sterilant. 3) Biological - Ensures sterilization has occurred. 4) Administrative - proper documentation.

Describe briefly the 5 general principles of packaging.

1) Woven fabrics should be stored at 64-72 degrees and at humidity of 35-70% for 2 hours to rehydrate the fabrics. 2) Linen packs should not weigh more than 12 pounds. 3) Linen packs should be packaged loosely to allow steam to contact all surfaces. 4) Double sequential wrapping is essential. 5) Commercial and facility-packaged items must be inspected for holds, perforations, and seal integrity.

2a) Wrapper instrument set at 250 degrees in a gravity sterilizer ____ 2b) Unwrapped single no-lumen instrument in a gravity sterilizer _____ 2c) Unwrapped lumened instrument set at 270 degrees in a gravity sterilizer ____ 2d) Wrapped instrument tray set, unwrapped instrument set, or lumened instrument set at 270 degrees in a prevacuum sterilizer _____

A- 30 minutes B- 3 minutes C- 10 minutes D- 4 minutes

Differentiate between the chemical indicator and biological methods of monitoring the sterilization process.

Chemical: The item has been exposed to the conditions of sterilization. Biological: Ensures the item is sterile and the conditions have been met.

Describe the difference between a prokaryote and eukaryote cell.

Prokaryote: Have no nucleus Eukaryote: Have a membrane bound nucleus

describe why a towel should be placed between metal basin sets before wrapping the basins for steam sterilization.

Steam needs to be able to penetrate all surface areas of the basins as it wicks between the basins.