Sterilization & Disinfection

Question: An integrator is a multiparameter indicator designed to measure which of the following parameters: A. pressure, steam, temp B. Temp, time, presence of steam C. Pressure and sterility

Answer: B. Temp, time, presence of steam

Question: During the decontamination process, any soil left on an item will act as a barrier between the item and the sterilant. Coagulated protein may cover and protect bacteria from coming in contact with the sterilizing agent. Which of the following may help remove debris on items heavily soiled with dried-on protein? a. warm water rinse b. appropriate detergent c. automated wash d. enzymatic wash

Answer: d. enzymatic wash

Question: The use of peracetic acid on surgical items requires the following consideration: a. items can be stored for future use b. items must be aerated c. items must be isolated for 7 days d. items must be immersible

Answer: d. items must be immersible

Question: A packaging system for items undergoing sterilization should possess which of the following characteristics? a. compatible with all sterilization processes b made of only disposable materials c. maintain sterility of the items for a specified length of time d. permits aseptic delivery of contents to the sterile field.

Answer: d. permits aseptic delivery of contents to the sterile field

Complete sterilization in EO is dependent on four primary variables: proper time, humidity, temperature and : a. proper packaging b. aeration c. gas concentration d. pressure

Answer: c. gas concentration

When steam is placed under pressure, its temperature rises and the moist heat that is produced destroys the protein within the cell, rendering it harmless. Direct contact with the steam is required to ensure sterility. Steam does not leave a toxic reside and remains the fastest method of sterilization. Heat sensitive items cannot be steam sterilized.

Parameters that affect the steam sterilization process: Steam saturation Pressure Temperature Time-temperature is maintained for a prescribed length of time to achieve elimination of microorganisms.

Aseptic

The absence of all pathogenic (capable of causing disease) microorganisms.

Sterile technique

The use of specific actions to prevent contamination and maintain sterility of identified areas during operative and other invasive procedures.

Disinfection

a chemical or physical process of destroying all pathogenic microorganisms except spores or inanimate objects/surfaces.

Select all that apply: Packaging systems should: a. permit sterilization to take place b. maintain sterility for a limited period c. be structured to provide for aseptic delivery of the contents to the sterile field. d. be compatible with the sterilization process e. be used according to the manufacturer's written instructions.

a. permit sterilization to take place c. be structured to provide for aseptic delivery of the contents to the sterile field. d. be compatible with the sterilization process e. be used according to the manufacturer's written instructions.

Sterilization:

process of destroying all microorganisms on a substance by exposure to physical or chemical agents. The complete elimination of all forms of microorganisms,

decontamination

the use of physical or chemical means to remove, inactivate or destroy blood borne or other pathogens on a surface or item.

Class IV Dirty or infected wounds

Old traumatic wounds with: retained devitalized tissue, existing clinical infection of perforated viscera and/or delayed primary closure of wounds. Suggests infectious process was present before surgery.

Class II Clean contaminated wound

Operative wound in which: The respiratory, alimentary or genitourinary tract is entered under controlled conditions without contamination of surrounding tissue. There is no evidence of infection and no major break in aseptic technique.

Class I Clean wound

Operative wound in which: no inflammation is encountered. Respiratory, alimentary and genitourinary tracts no entered.

Class III Contaminated wounds

Operative wound involves: Open, fresh, traumatic wounds. Major breaks in sterile technique. Gross spillage from the GI tract. Incisions in which acute, non-purulent inflammation is encountered.

Sterile

Absence f all living microorganisms

Select all that are true about prions: -Prions are not bacteria or viruses but rather malformed proteins -Creutzfeldt-Jakob disease (CJD) is a degenerative neurologic disease that appears to be caused by prions -Prions appear to be resistant to most forms of sterilization used in health care settings. -Prions appear to have marked vulnerability towards moist heat.

Answer: -Prions are not bacteria or viruses but rather malformed proteins -Creutzfeldt-Jakob disease (CJD) is a degenerative neurologic disease that appears to be caused by prions -Prions appear to be resistant to most forms of sterilization used in health care settings.

Match: 1. Ultrasonic cleaner 2. Washer decontaminator/disinfector 3. Washer/sterilizer A. Process instruments through several cycles. Instruments are not considered prepared for subsequent use. B. Allows hands-free processing, renders instruments safe for handling C. Removed fine debris through cavitation

Answer: 1. Ultrasonic cleaner-removed fine debris through cavitation 2. Washer decontaminator/disinfector-allows hands-free processing, renders instruments safe for handling 3. Washer/sterilizer-process instruments through several cycles. Instruments are not considered prepared for subsequent use.

Match: Disinfection Decontamination Sterilization High-level disinfection 1. The use of physical or chemical means to remove, inactivate or destroy bloodborne or other pathogens on a surface or item. 2. The process of destroying all microorganisms on a substance by exposure to physical and chemical agents, the complete elimination of all forms of microorganisms. 3. A process that destroys all microorganisms with the exception of high numbers of bacterial spores. 4. A chemical or physical process of destroying all pathogenic microorganisms, except spores, on inanimate objects

Answer: Disinfection 4 Decontamination 1 Sterilization 2 High-level disinfection 3

During the assembly process, instruments should be placed in a specifically designed container that restricts penetration of the sterilizing agent and prevents trapping of air. True or False

Answer: False

Question: All instruments opened in the operating procedure room should be decontaminated except for those that were not used. True or False?

Answer: False

Question: Items that enter sterile tissue of the vascular system are categorized as __________and should be sterile when used. a. Critical b. Noncritical c. Semicritical

Answer: a. Critical

Question: What is true about ethylene oxide (EO) sterilization? a. EO exposure is potentially carcinogenic and mutagenic to personnel and patients b. It cannot be used for heat sensitive items c. it is effective against prions d. items processed by EO sterilization may be used immediately.

Answer: a. EO exposure is potentially carcinogenic and mutagenic to personnel and patients

Question: According to AORN, which of the following work areas requires all of the following attire: scrubs, head covers, gloves, gown, eye protection and masks or face shields? a. decontamination b sterilization process c. preparation and packaging d. sterile storage

Answer: a. decontamination

Question: Disassembly, cool water rinse, enzymatic wash and use of appropriate detergent are principles used in: a. decontamination b. steam sterilization c. high level disinfection d. gas plasma sterilization

Answer: a. decontamination

Select all that apply: Select the truths regarding peracetic acid sterilization: a. it is a liquid chemical sterilization method. b. it uses low temperatures c. Equal in efficacy to steam and ethylene oxide sterilization d. it requires the use of a special unit designed for this type of sterilization e. it can be used for all surgical items.

Answer: a. it is a liquid chemical sterilization method. b. it uses low temperatures c. Equal in efficacy to steam and ethylene oxide sterilization d. it requires the use of a special unit designed for this type of sterilization

Question: What wound a total abdominal hysterectomy surgical wound be classified as? a. clean b. clean contaminated c. contaminated e. dirty

Answer: b. clean contaminated

Question: Which of the following is NOT a goal of sterile technique and aseptic practices? a. minimize the length of recovery from surgery b. create a sterile conscience c. optimize primary wound healing d. prevent SSI

Answer: b. create a sterile conscience

Question: Appropriate methods for function testing of devices should be obtained from the__________ a. biomedical department b. device manufacturer c. recommended practices d. Person in charge

Answer: b. device manufacturer

Question: Immediate use steam sterilization can be used: a. for implants b. in urgent situations c. under no circumstances d. for all items

Answer: b. in urgent situations

Question: While all prion diseases are infections, infectivity is based primarily on laboratory studies of different prion diseases in humans and animals. CNS tissue has been shown to be highly infectious. Which has also been shown to be highly infections? a. heart muscle b. optic nerve c. feces d. skeletal muscle

Answer: b. optic nerve

In order to achieve environmental and microbial control between decontamination and sterilization areas functional workflow patterns should establish______________ and vented airflow to the outside that will minimize potential contamination of processed items. a. elevated room temperature b. physical separation c. traffic patterns d. the amount of bioburden

Answer: b. physical separation

Acute appendicitis or cholecystitis would be classified as: a. Class I- clean wound b. Class II- clean contaminated wound c. Class III-contaminated wounds d. Class IV- dirty or infected wounds

Answer: c. Class III-contaminated wounds Acute inflammation of any organ without frank pus

Question: Complete sterilization in ethylene oxide is dependent on four primary variables: proper time, gas concentration, temperature and: a. proper packaging b. aeration c. chamber humidity d. pressure

Answer: c. chamber humidity Complete sterilization in EO requires chamber humidity of 45-75%

Question: Per the Spaulding classification system, critical items include instruments or objects that are: a. in contact with mucous membranes b. in contact with the patient's unbroken skin c. introduced into the human body d. out of the sterile field.

Answer: c. introduced into the human body either into or in contact with the blood stream or normally sterile areas of the body.

Question: After completion of the steam sterilization cycle, wrapped, sterilized items should be: a. Placed on a metal table until cooled b. used immediately c. left untouched to cool for 30-60minutes d. left untouched to cool for 15-30minutes

Answer: c. left untouched to cool for 30-60minutes

Question: Ineffective cleaning and the amount of bioburden negatively affect the process of sterilization. The process of sterilization is also negatively affected by ____________ a. an instrument tray weighing 20lbs. b. soaking of instruments in cleaning solution prior to decontamination c. the number, type and resistance of microorganisms d. all of the above

Answer: c. the number, type and resistance of microorganisms

Question: Scrub attire, head cover, gloves, gown, eye protection and masks or face shields must be worn in which of the following areas? a. sterile processing b. preparation and packaging c. sterile storage d. decontamination

Answer: d. decontamination

Chemical Indicators: Class 1-demonstrates that the package has been exposed to the sterilization process to distinguish between processed and unprocessed packages Class 2- Bowie-Dick-detects air leaks, ineffective air removal and presence of non-condensable gases, used in dynamic air-removal sterilizers. Class 3-Process indicator that reacts to a single parameter of the sterilization process.

Class 4-reacts to two or more of the critical parameters of sterilization Class 5- Integrating reacts to all critical parameters over a specified range of sterilization cycles, performance has been correlated to the performance of the stated test organism under the labeled conditions of use. Class 6 - Emulating-reacts to all of the critical parameters of a specific cycle.

Match the wound class with the appropriate example: Gastrectomy Compound fracture Perforated viscera Hernia surgery

Class I-hernia surgery Class II-gastrectomy Class III-compound fracture Class IV-perforated viscera