AORN: sterilization process
the byproducts are water and oxygen
H2O2 vapor
why is hot water not. used for cleaning
it can denature blood proteins
Reacts to two or more critical parameters; Placed inside the compatible sterilization package
multi parameter indicator
the amount of time a processed package is considered to be sterile
shelf life
what is packaged in a peel pouch
small, lightweight, low profile items
the oldest, safest, most economical and most commonly used sterilization method
steam sterilization
T or F: A chemical indicator is placed on the inside of the container
true
Which of the following are examples of aseptic practice? Select all that apply a. Use of single use items for one patient b. The sterilization of a reusable medical device for use in a clean procedure c. Use of a clean instrument for a vascular procedure d. RN circulator using clean gloves to pick up a used sponge
a. Use of single use items for one patient b. The sterilization of a reusable medical device for use in a clean procedure d. RN circulator using clean gloves to pick up a used sponge
the absence of infectious organisms
asepsis
what does an air pocket prevent pressurized steam from doing
contacting the instruments and sterilizing the trays or equipment
if a wet pack is placed on a sterile field, what is the entire field considered
contaminated
where must sterilized instruments, equipment and supplies be stored
controlled environment
what water temperature is used for cleaning
cool water
Which statement about biological indicators is FALSE? a. In the event of a positive BI result, the sterilizer is not used until the cause of the BI failure has been determined b. The BI used must be specific to the sterilization method c. A BI is run with each sterilization load that contains one or more implants d. A BI test for EO sterilization should be performed one a week
d. A BI test for EO sterilization should be performed one a week
What is the first step of instrument processing? a. Chemical disinfection b. Decontaminator cycle on washer sterilizer c. Soaking d. Cleaning
d. Cleaning
a slow burning process that causes the coagulation of proteins in microbial cells
dry heat
used on items resistant to moist heat sterilization
dry heat
T or F: Sharp and delicate instruments are placed inside a peel pack pouch to protect the tips
false
what must an individual perform after removing PPE
hand hygiene
what are often reasons for immediate use steam sterilization
lack of equipment and time constraints
what should NOT be packaged in a peel pouch
large, sharp or heavy items
what do sets weighing more than 25 pounds require
longer drying times
what is chemical sterilization also referred to as
low temperature sterilization
what follows manual cleaning
mechanical cleaning
a BI is run with each sterilization load that contained ____ implants
one or more
Reacts to one critical sterilization parameter; Placed inside the compatible sterilization package
single parameter indicator
Individual vials contain solutions that test for specific contaminants
solution vial test
Tests for the presence of air in steam sterilizing chambers
speciality indicator
the most common method of sterilization
steam
complete elimination or destruction of all forms of microbial life
sterility
T or F: The person who loaded the cart into the sterilizer is a part of the each loads documentation
true
combination of thermal and chemical actions for instrument cleaning
Washer disinfector/decontaminator
what is incubated for each BI that is run
a control BI
during surgery, what should the surfaces of instruments be wiped with
a sponge soaked in sterile water
6 required PPE
1. head cover 2. eye protection 3. mask 4. utility gown 5. fluid resistant gown 6. fluid resistant shoe covers
4 examples of chemical sterilization
1. hydrogen peroxide 2. per acetic acid 3. ethylene oxide 4. dry heat
5 aspects of sterilization cycle records
1. identification of items 2. load number 3. exposure parameters 4. operators identification 5. indicator results
10 steps to sterilization
1. point of use 2. transport to decontamination 3. cleaning 4. disinfection 5. verification of cleaning 6. inspection 7. instrument tray assembly 8. packaging 9. sterilization 10. storage
2 main types of steam sterilizers
1. pre vacuum 2 gravity displacement
6 classes of chemical indicators
1. process indicator 2. specialty indicators 3. single parameter indicator 4. multi parameter indicator 5. integrating indicators/ integrators 6. emulating indicator
4 causes of wet packs
1. sterilizer malfunction 2. storage conditions 3. incorrect loading 4. packaging errors
three physical parameters for steam sterilization
1. time 2. temperature 3. pressure
What is an appropriate action before transporting contaminated instruments from the point of use to the decontamination area? a. Keep instruments that can be disassembled in one piece b. Discard sharps into a sharps container c. Place a dry towel over instruments d. Place sharp instruments with delicate instruments
b. Discard sharps into a sharps container
What is NOT included in the record of each sterilization cycle? a. Physical, chemical and biological indicator results b. General description of the sterilization load c. Operators identification d. Exposure parameters for the sterilization method
b. General description of the sterilization load
Geobacillus stearothermophilus is a biological indicator used for ____ a. Ethylene oxide sterilizers b. Liquid peracetic acid sterilizer c. Dry heat sterilizers d. All of the above
b. Liquid peracetic acid sterilizer
Which step precedes the others? a. Disinfection b. Point of use cleaning c. Transport d. Packaging
b. Point of use cleaning
Which of the following PPE is necessary for health care workers in the decontamination area? Select all that apply a. N95 respirator b. Utility gloves c. Fluid resistant shoe covers d. Eye protection or a full face shield
b. Utility gloves c. Fluid resistant shoe covers d. Eye protection or a full face shield
The accumulation of bacteria and other biological elements
bioburden
the amount of microbial contamination on an instrument
bioburden
The accumulation of bacteria and other biological elements creates a tight adhesion to the instruments surface
biofilm
a coating of biological organisms and material tightly adhered to the surface of an instrument
biofilm
used to monitor the efficacy of the sterilizer
biological indicator
designed to detect any residual air that has been not removed during the mechanical air removal step
bowie dick test
What type of monitor is an external strip or tape? a. Physical b. Ultrasonic c. Chemical d. Biological
c. Chemical
sound waves that create vacuums that remove debris from crevices
cavitation
what type of action are cleaning solutions
chemical action
devices that test sterilization equipment or monitor the presence or attainment of one or more sterilization parameters
chemical indicators
if an item cannot tolerate high heat and moisture from steam, what are they processed through
chemical sterilization
the removal of organic and inorganic soil from equipment and instruments and the first step in the decontamination process
cleaning
what does cool water prevent
coagulation of blood on instruments
Which statement about completely submerging an instrument into the cleaning solution is TRUE? a. It increases the potential of contamination to the worker b. It increases the risk of splashes and sprays to the worker c. It reduces the need for instrument disassembly d. It reduces the risk of chemical and contaminant aerosolization
d. It reduces the risk of chemical and contaminant aerosolization
Which of the following statements about sterilization packages is TRUE? a. Large items can be peel packed as long as it fits into the pouch b. Write information on the porous side of the peel pack c. It is important to allow for billowing or gaping of the sterilization wrap d. Sterilization wraps can be reusable, woven materials or single use nonwoven materials
d. Sterilization wraps can be reusable, woven materials or single use nonwoven materials
if the IFUs for the device, sterilizer or packaging conflict or are vague, what should you follow
device manufactures IFU
when should a biological indicator test be run
each day the sterilizer is used
Reacts to all critical parameters for specified sterilization cycles
emulating indicator
is shelf life event or time related
event
verify that the package has been exposed to the sterilization process
external chemical indicators
T or F: All sterilized items should be cooled for 30 minutes before being handled
false
T or F: An items sterility is based on how long it is on the shelf
false
T or F: Cupped instruments are placed with the cup portion up
false
T or F: If one wet pack is found on a sterilization load, all packages are considered to be wet packs
false
T or F: Instruments are to be closed when placing them on a stringer
false
Designed to react to all critical elements over a range of sterilization cycles
integrating indicators/integrators
verify that one or more of the conditions required for sterilization have been met
internal chemical indicators
an item must be fully immersible to undergo this process
per acetic acid
a paper or digital readout that records the time the sterilizer reached the chosen cycles temperature, pressure and content exposure time
physical parameters
what is used in steam sterilization
pressurized, saturated steam
External indicator that distinguishes between processed and non processed items
process indicator
the complete elimination or destruction of all forms of microbial life
sterilization
what does a negative biological indicator indicate
sterilization conditions were met
Individual swabs or strips test for specific contaminants: protein, blood or carbohydrates
swab or strip test
what does biofilm inhibit
the ability of cleaning solutions and disinfectants to effectively decontaminate the instrument
what type of action is water temperature
thermal action
why is steam completely exhausted from the chamber
to avoid condensation
T or F: Documentation is necessary for each sterilization cycle
true
T or F: Instruments must be completely dry before instrument tray assembly and sterilization
true
T or F: Tray weight should be evenly distributed
true
is wet pack sterile or unsterile
unsterile
reusable, woven materials or single use, non woven material that are specific to the sterilization method and cycle; ensures that the instrument or set is completely covered and does not allow for gapping or billowing
wraps
Which of the following CIs are placed on the outside of a package or container? a. Class 1: process indicator b. Class 2: specialty indicator c. Class 3: single parameter indicator d. Class 4: multi parameter indicator
a. Class 1: process indicator
Which of the following is NOT done when assembling an instrument tray? a. Instruments are damp when placed in a container or wrapped b. Instruments are counted as they are placed in a tray c. Instruments are opened when being placed on a stringer d. Instruments are placed with heavier instruments on the bottom
a. Instruments are damp when placed in a container or wrapped
Inspection and testing evaluates an instrument for ____. Select all that apply a. Integrity of cables and cords b. Sharpness c. Cleanliness d. Alignment
a. Integrity of cables and cords b. Sharpness c. Cleanliness d. Alignment
Which of the following cleaning and decontamination tests reports on blood, protein and carbohydrates? a. Specific strips or swabs b. Specific solution vials c. ATP test d. All of the above
a. Specific strips or swabs
methods by which microbial contamination is prevented
aseptic technique
Which IFU is followed if there is conflicting or vague information about the sterilization of an item? a. Sterilizer manufacturers IFU b. Device manufacturers IFU c. Packaging manufacturers IFU d. Assembly manufacturers IFU
b. Device manufacturers IFU
aeration is a critical step
ethylene oxide
Tests for ATP, which is present in all organic material
ATP test
absence of pathogenic microorganisms
asepsis
what must an instrument set not weigh more than
25 pounds
cooling times for trays
30 minutes to 2 hours
