Ch 11 Decontam and Sterilization

checking, recording, and reporting.

(Quality control) monitoring means

Detergent

A chemical that breaks down organic debris by emulsification to aid in cleaning.

Peraetic acid

A chemical used in the sterilization of critical items.

Antiseptic

A chemical used to remove microorganisms on skin or other tissue.

Reusable

A designation used by manufacturers to indicate that a medical device can be reprocessed for use on more than one patient.

Nonwoven

A fabric or material that is bonded together as opposed to a process of interweaving individual threads.

Material Safety Data Sheet (MSDS)

A government-mandated requirement for all chemicals used in the workplace. It describes the formulation, safe use, precautions, and emergency response. Must be available for each chemical an employee is required to handle in his or her work.

Ethylene oxide (EO)

A highly flammable gas that is capapble of sterilizing an object.

Cobalt-60 radiation

A method of institutional bulk sterilization used by manufacturers to sterilize prepackaged equipment using ionizing radiation.

Case cart system

A method of receiving clean and sterile equipment and preparing it for the transportation to a central decontamination area. All equipment is contained within a covered movable storage cart.

Chemical indicator

A method of testing a sterilization parameter. Chemical strips sensitive to physical conditions, such as temperature, are placed with the item being sterilized and change color when the parameter is reached.

Sanitation

A method that reduces the number of bacteria in the environment to a safe level.

Sterilization

A process by which all microorganisms, including spores, are destroyed.

Cavitation

A process in which air bubbles are imploded, releasing particles of soil or itssue debris.

Decontamination

A process in which recently used and soiled medical devices, including instruments, are rendered safe for personnel to handle.

Antisepsis

A process that greatly reduces the number of microorganisms on skin or other tissue.

High level disinfection (HLD)

A process that reduces the bioburden to an absolute minimum.

Cleaning

A process that removes organic and inorganic soil or debris using detergent and washing.

Chemical sterilization

A process that uses chemical agents to achieve sterilization.

Gas plasma sterilization

A process that uses the form of matter known as plasma to sterilize an item. Also referred to as plasma sterilization.

Biological indicator

A quality control mechanism used in the process of sterilization. It consists of a closed system containing harmlesss, spore-forming bacteria that can be rapidly cultured after the sterilization process.

Process challenge monitoring

A sealed, harmless bacteriological sample included in a load of goods to be sterilized. The sample is recovered following the sterilization process and cultured to test for viability. Also called biological monitoring.

Enzymatic cleaner

A specific chemical used in detergents and cleaners to penetrate and break down biological debris, such as blood and tissue.

-cidal

A suffix indicating death. Ex. bactericial- able to kill bacteria

Spaulding system

A system used to determine the level of microbial destruction required for medical devices and supplies based on the risk of infetion associated with the area of the body where the device is used. Categories include critical, semicritical, and noncritical.

High-vacuum sterilizer

A type of steam sterilizer that removes air in the chamber by vacuum and refills it with pressurized steam. Also known as a prevacuum sterilizer.

Gravity displacement sterilizer

A type of sterilizer that removes air by gravity

Event-related sterility

A wrapped sterile item may become contaminated by environmental conditions or events, such as a puncture in the wrapper.

Bactericidal

Able to kill bacteria

Fungicidal

Able to kill fungi

Germicidal

Able to kill germs (bacteria)

Sporicidal

Able to kill spores

Viricidal

Able to kill viruses.

Surgical instruments, vascular cannulas, hypodermic needles, and implants

According to the Spaulding system, critical items are those that come in contact with sterile body tissues and internal organ systems. What are examples of critical items?

Pneumatic tourniquet, pulse oximeter, external doppler, operating table accessories, Blood pressure cuffs and examination tables.

According to the Spaulding system, noncritical items are those that are used only on intact skin. What are examples of noncritical items?

Laryngoscope, vaginal retractor, Bronchoscope, thermometer, or otoscope.

According to the Spaulding system, semicritical devices are used on the mucous membrane or nonintact skin. What are examples of semicritical items?

Reprocessing

Activities or tasks that prepare used medical devices for use on another patient; these activities include cleaning, disinfection, decontamination, and sterilization.

sorting, inspection, and assembly

After decontamination, instruments are taken to the clean assembly area for _______________.

assembly and wrapping

After inspection, the instruments are ready for _______ and _______.

cold

After the instruments have been sorted, selected instruments are soaked and hand cleaned using _____ water and enzymatic detergent.

Batch number and date

All batches of goods processed together in a single load are identified by ______ and _____.

Woven wrappers

Also called linen or cloth wrappers, these are fabric cloths used to wrap clean, disinfected supplies in preparation for a sterilization process.

Association for the Advancement of Medical Instrumentation (AAMI)

An authoritative source of standards for sterilization and disinfection.

pop open

An instrument that is "sprung" will ______ when bumped.

Medical device

Any equipment, instrument, implant, material, or apparatus used for the diagnosis, treatment, or monitoring of patients.

repair

Any instrument found to be malfunctioning should not be packaged and sterilized, but should be sent for ______.

Sharps

Any objects used in health care that are capable of penetrating the skin, causing injury.

Personal protective equipment (PPE)

Approved attire worn during the reprocessing of medical devices and the cleaning of patient areas. Protects the wearer from contamination by microorganisms.

soil, stains, corrosion, proper function, and structural soundness.

Before instruments are assembled and wrapped for sterilization, they are inspected for ______________________.

Bacteriostatic

Chemical agent capable of inhibiting the growth of bacteria.

Implant

Defined by the FDA as a device that is placed into a surgically or naturally formed cavity of the human body if it is intended to remain there for a period of 30 days or more.

Biofilms

Dense colonies of bacteria that adhere tightly to surfaces. Resistant to chemical disinfectants and scrubbing, are a matrix of exracellular polymers produced by microorganisms.

Disinfection

Destruction of microorganisms by heat or chemical means. Spores usually are not destroyed by this.

Ultrasonic cleaner

Equipment that cleans instuments using ultrasonic waves.

Washer-sterilizer/disinfector

Equipment that washes and decontaminates instruments after an operative procedure.

bottom

Heavy instruments are placed on the _______ of the tray.

By hand, ultrasonic cleaner, and automated cleaner.

How is cleaning of instruments performed?

inanimate

If a chemical is labeled a disinfectant, it is intended for _______ surfaces only.

steam under pressure.

In the final stage of the washer-sterilizer/disinfector, the instruments are sterilized by ____________.

Nonliving

Inanimate

Single-use items

Instruments and devices intended for use on one patient only; sometimes called disposable items.

cleaned

Instruments and equipment must be ______ before they are disinfected or sterilized.

lubricated

Instruments are ________ to ensure smooth mechanical action.

International Association of Healthcare Central Service Material Management (IAHCSMM)

International organization that represents Central Service Technicians by providing opportunities for continuing education, professional development, and commnication among its members.

Noncritical items

Items that are not required to be sterile because they do not penetrate intact tissues. Patient care items such as a blood pressure cuff and a stethoscope.

Immediate-use sterilization

Items to be sterilized shortly before surgery must be processed so they are ready as close to the time of surgery as possible. This is referred to as immediate-use sterilization, previously called flash sterilization.

Centers for Disease Control and Prevention and Prevention-Healthcare Infection Control Practices Advisory Committee (CDC-HICPAC)

Joint federal agencies that provide research and protocols in all areas of public health and infection control, incluiding those in the professional environment.

Evidence-based practices

Methods and procedures proven to be valid by rigorous testing and professional research.

toxic anterior segment syndrome (TASS)

Ophthalmic instruments require special handling in order to prevent __________.

Prion

Proteinaceous infectious particle, a unique pathogenic substance that contains no nucleic acid. Transmitted by direct contact or ingestion and is resistant to all forms of disinfection and steriliation normally used in the health care setting.

Contaminated

Rendered nonsterile and unacceptable for use in critical areas of the body.

ECRI institute

Research and consulting organization that applies scientific research to determine which medical procedures, devices, drugs, and processes are best for patient care.

Single use device

SUD

Central Processing technicians

Skilled professionals who specialize in processing and maintenance of medical devices used in the health care facility.

ultrasonic cleaner

The _________ removes debris from instruments by a process called cavitation. High-frequency sound waves are generated through a water bath.

washer-sterilizer/disinfector

The __________ is used to process instruments that can tolerate water turbulence and high pressure steam.

The Joint Commission (TJC)

The accreditation agency for all health care organizations in the United States. It oversees compliance with environmental and patient safety regulations and enforces compliance with standards.

Central Processing (CP) department

The area of the hospital where medical devices and equipment are processed.

US Food and Drug Administration (FDA)

The federal agency responsible for regulation of medical devices, drugs, food, and cosmetics.

Centers for Disease Control and Prevention (CDC)

The federal agency that provides research and protocols in all areas of public health.

Shelf life

The length of time a wrapped item remains sterile after it has been subjected to a sterilization process.

Association of periOperative Registered Nurses (AORN)

The professional association for perioperative nurses that publishes standards and guidelines of practice for all areas of perioperative care.

Association of Surgical Technologists (AST)

The professional organization of surgical technologists that publishes guidelines for many practices in the perioperative setting.

event, time

The shelf life of a sterilized pack is _______ related, not _______ related.

freely, precisely

The tips of forceps should close ______ and align _______.

enzymatic cleaner

The ultrasonic cleaner has one or more recessed cavities that are filled with _________ intended for use in the system.

Exposure time

This is the amount of time goods are held at a specific time, temperature, and pressure during a sterilization process. Varies with the size of the load, type of materials being sterilized, and type of sterilizer. Is sometimes called "hold time".

Terminal decontamination

Thorough cleaning and disinfection of supplies or an environment such as the operating room suite after patient use. Specific protocols and procedures are used.

True

True or false: Instrument trays should not contain separate items wrapped in peel pouch packages.

False.

True or false: Ultrasound alone decontaminates and sterilizes instruments.

Goggles, face shield, gloves, gown, shoe covers

What do PPE's include?

A clean scrub suit with long sleeves and a surgical cap.

What is the attire for the clean assembly area?

Sorting

What is the first phase of reprocessing?

To control the spread of disease by eliminating or reducing the number of microbes and preventing their proliferation on the equipment used in patient care.

What is the purpose of decontamination, disinfection, and sterilization?

Mineral oil and silicone

_____ and ______ must not be used on surgical instruments because they can interfere with the sterilization process.

Oils

_____ are not used for lubrication of instruments because the sterilization cannot penetrate it.

Saline

______ is never used for cleaning or soaking instruments because it causes pitting, rusting, and corrosion.

Cavitation

_______ causes tiny air spaces trapped within debris to implode and this releases the debris from the surface of the instrument.

Microsurgical

________ instruments are very expensive to purchase, repair, and replace. These instruments should never be mixed with heavier ones.

Bioburden

number of live bacterial colonies on a surface before it is sterilized.