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is decontamination safe for patient use?
big fat negative
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are CS personnel required to become certified?
- yes ma'am
- 2 years from the date of hire to attain credential
- recommended by Association for Advancement of Medical Instrumentation (AAMI)
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sterile processing certification program accredited by NCCA
Certification Board of Sterile Processing and Disinfection (CBSPD)
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5 levels of certification from CBSPD
- technician
- supervisor
- manager
- surgical instrument processor
- ambulatory surgery
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what can be applied to the instruments to prevent debris from drying during transport?
enzymatic foam or solution
-
what should be worn when using chemical disinfecting agents?
PPE
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what is the purpose of prerinsing or presoaking?
to prevent blood and debris from drying on instruments or to soften and remove dried blood and debris
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how long should instruments soak in chlorine compound?
no more than 1 hour
-
most reliable solution in reducing the prior titer within 1 hour
chlorine bleach
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alkaline prion-inactivating and removal detergent that is corrosive potassium hydroxide solution
Hamo 100
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what is Hamo 100 not used for?
- soft metal or anodized aluminum
- rigid or flexible endoscopes
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purpose of manual cleaning
remove residual blood and debris before terminal sterilization or high-level disinfection
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how are microsurgical and ophthalmic instruments cleaned?
- cleaned and dried by hand
- not to be put in washer-sterilizer
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what kind of detergent is used when manual cleaning?
- noncorrosive, neutral pH, low-sudsing, free-rinsing detergent
- should be compatible with local water supply
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what should temp of water be for manual cleaning?
should not exceed 140 degrees F to prevent burns of the skin
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what does washer-sterilizer require?
require instruments to be prewashed by hand in germicidal solution at 110 degrees F
-
temp of washer-sterilizer
250-280 degrees F
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washer-decontaminator temp
140-180 degrees F
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arranging instruments in washer-decontaminator
- heavy instruments in separate tray or in body of tray
- concave surfaces with bowl side down
- open box locks and pivots of hinged instruments
- disassemble complex instruments
- position sharp or pointed instruments carefully
- do not randomly pile on top of one another
-
ultrasonic cleaning
- uses high-frequency sound waves
- process of cavitation
- generates tiny bubbles small enough to get into serrations, crevices, etc.
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how deep should ultrasonic tank be filled
to a level of 1 inch above top of instrument tray
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temp of water for ultrasonic cleaning
100-140 degrees F
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types of instruments recommended to be cleaned by ultrasonic method
ophthalmic, microinstruments, glassware, rubber goods, thermoplastics
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what type of water are instruments rinsed in for ultrasonic cleaning?
hot deionized water
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what types of instruments should be lubricated after cleaning?
instruments with moving parts
-
how are instruments lubricated?
immersed in antimicrobial water-soluble lubricant that is steam penetrable
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what should not be used to lubricate?
- mineral oils
- silicones
- machine oils
-
how long are instruments lubricated?
30-45 seconds
-
what is done if box locks are frozen?
leave instruments in water-soluble lubricant overnight
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how are instruments marked for identification?
- NOT etched
- some affix specialized heat-stable tape to instruments to color code them by sets or specialty, wrapped around circumference of handle but not overlapped
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are OR personnel qualified to sharpen or repair surgical instruments?
negative batman
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expected life of instruments
at least 10 years
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why does disinfection differ from sterilization?
by its lack of sporicidal power
-
developed classification system in 1968 to determine appropriate method to attain desired level of processing
Earle H. Spaulding
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Spaulding's classifications
- critical items must be sterilized because they enter sterile tissue
- semicritical items require high-level decontamination but also may be sterilized
- noncritical items adequately cleaned by intermediate or low-level disinfection
-
process of destroying or inhibiting growth of pathogenic microorganisms on inanimate objects
disinfection
-
high-level disinfection
kills all bacteria, viruses, and fungi
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after high-level disinfection, what is item rinsed in?
sterile distilled water
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intermediate-level disinfection
- kills most bacteria, viruses and fungi on noncritical items
- inactivates Mycobacterium tuberculosis
-
low-level disinfection
kills most vegetative bacteria, fungi and least resistant viruses on noncritical items
-
chemical agents for disinfection registered with?
Pesticide Regulation Division of Environmental Protection Agency (EPA)
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what is required as a rinse with sterile and high-level disinfected items?
sterile water
-
what is used as a rinse with semicritical and noncritical disinfected items?
tap water
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level of disinfection for ethyl and isopropyl alcohol
intermediate level
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timing of disinfection for ethyl and isopropyl alcohol
10-30 min
-
effectiveness of ethyl and isopropyl alcohol
bactericidal but not bacteriostatic or sporicidal
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level of disinfection for glutaraldehyde
sterile/high-level
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timing of disinfection for glutaraldehyde
- sterile - 10 hours at 25 C
- high-level - 45 minutes at 25 C
-
effectiveness of glutaraldehyde
virucidal, fungicidal, sporicidal
-
level of disinfection of Cidex-activated alkaline 2.4%
sterile/high-level
-
timing of disinfection of Cidex-activated alkaline 2.4%
- sterile - 10 hours at 25 C
- high-level - 45 minutes at 25 C
-
effectiveness of Cidex-activated alkaline 2.4%
virucidal, fungicidal and sporicidal
-
level of disinfection of Iodophors
low at wide range of pH
-
timing of disinfection of Iodophors
10-30 minutes
-
effectiveness of Iodophors
not sporicidal
-
level of disinfection of peracetic acid (STERIS 0.2%)
sterile
-
timing of disinfection of peracetic acid (STERIS 0.2%)
12-30 minutes
-
effectiveness of peracetic acid (STERIS 0.2%)
virucidal, fungicidal and sporicidal
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how does alcohol kill microorganisms?
coagulation of cell proteins
-
what is added to alcohol to prevent corrosion of metal?
0.2% sodium nitrite
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should alcohol be used to clean up blood or body fluid spills?
nope
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