Sterile Processing Technician

Front 1

Who is credited with the birth of sterile processing?

Back 1

American College of Surgeons

Front 2

The sterile processing department is defined as

Back 2

That service area within the hospital which processes, issues, and controls professional supplies and equipment, both sterile and unsterile, for all departments and units of the hospital for the care and safety of the patients

Front 3

WB Underwood

Back 3

Performed extensive studies.

Established the philosophy of centralization of processing.

Front 4

Where were supplies sterilized, prepared, and distributed in the early days?

Back 4

The OR

Separate departments where they were used

Front 5

Dr. John Perkins

Back 5

From AMSCO

Advocated the centralization of processing in one department so that all procedures could be standardized.

Front 6

What is the Role of a SPT?

Back 6

Retrieves, receives, cleans, decontaminates, assembles, disinfects, sterilizes, distributes, and stores devices, and instruments.

Front 7

Other names for Sterile Processing Departments?

Back 7

Central Services, Central Supply, Central Sterile Supply, Sterile Processing Material Services

Front 8

Areas of the sterile processing department?

Back 8

Decon

Prep & Pack

High level disinfection

Sterilization

Sterile Storage

Sterile stores

Case Cart

Dispatch

Loaned Instrument

Patient Care Equipment clean-up

Front 9

Decon

Back 9

Soiled items are received and cleaned.

Must have a safe transport method to Decon.

Front 10

Prep & Pack

Back 10

Cleaned items are inspected, assembled, packaged

Front 11

High Level Disinfection

Back 11

Cleaned items are high-level disinfected. They go to Prep and Pack.

Front 12

Sterilization

Back 12

Terminal sterilization is performed.

May have additional areas for ethylene oxide sterilization and cart cooling.

Front 13

Sterile Storage Area

Back 13

Where sterile items are stored

Front 14

Case Cart

Back 14

Where sterile supplies are kept and picked.

Front 15

Sterile Stores

Back 15

Where items from outside manufacturers are stored.

Also called Medical Supply Distribution or Central Supply

Front 16

Dispatch

Back 16

Where sterile and clean items are dispensed

Front 17

Loaned Instrument

Back 17

Loaned instruments are returned here

Front 18

Patient Care Equipment

Back 18

Patient care equipment is cleaned and disinfected

Front 19

The SPD is said to be

Back 19

The heart of the hospital

Front 20

Work flow begins in the

Back 20

Decontamination area

Front 21

Describe the work flow progresses

Back 21

1. Items recieved in Decon >

Items cleaned > Prep & Pack: inspected and tested > Trays/sets assembled, labeled, and wrapped/packaged >

Sterilized > Items cooled/distributed

Front 22

What area would high level disinfection take place?

Back 22

Prep & Pack

Front 23

SPT's must do what when leaving the Decon area?

Back 23

Remove all PPE and wash hands

Front 24

Visitors to the SPD should start where and progress to where?

Back 24

Clean area > soiled area

Front 25

What is TJC? What do they do?

Back 25

The Joint Commission.

Establishes accrediting standards and conducts inspections for healthcare institutions.

Front 26

What two organizations offer SPD certification?

Back 26

CBSPD

Certification Board for Sterile Processing and Distribution

HSPA

Healthcare Sterile Processing Association

Front 27

Who would a SPT report to? Who would they report to?

Who would report to SPT?

Back 27

Lead Tech

SPD manager

Inventory Tech reports to SPT

Front 28

Anatomy is

Back 28

Structure of body parts

Front 29

Physiology is

Back 29

Functions of body parts

Front 30

Levels of organization in the body (4)

Back 30

Cellular: smallest structural unit

Tissue: similar cells from same part of body

Organ: a structure of several kinds of tissue

System: has many different organs that work together. 11 major systems.

Front 31

11 Major Body Systems

Back 31

Nervous

Endocrine

Muscular

Skeletal

Reproductive

Urinary

Lymphatic

Respiratory

Circulatory

Digestive

Integumentary

Front 32

What do cells need?

Back 32

Water

Food

Oxygen

Heat

Pressure

Front 33

AXIAL Skeleton

Back 33

BONY AND CARTILAGINOUS

PROTECTS ORGANS OF HEAD, NECK, TRUNK

Front 34

AXIAL Skeleton bones:

Back 34

SKULL

HYOID BONE

VERTEBRAL COLUMN

THORACIC CAGE

Front 35

How many vertebrae do we have?

Back 35

26

Front 36

How many ribs do we have?

Back 36

12

Front 37

What are the sections of vertebrae?

Back 37

Cervical

Thoracic

Lumbar

Sacral

Coccygeal

Front 38

Appendicular skeleton is:

Back 38

The bones of limbs and their anchor bones.

Front 39

Appendicular bones:

Back 39

PECTORAL GIRDLE

LIMB UPPER AND LOWER BONES

PELVIC GIRDLE

Front 40

Longest bone in the body:

Back 40

Femur

Front 41

Bone is a connective tissue composed of:

Back 41

Cells and protein fibers woven in gel of water, mineral salts, carbohydrates.

Front 42

Diseases of the bone:

Back 42

Bone cancer

Leukemia

Osteoarthritis

Front 43

Sets used for bone cases:

Back 43

Arthroscopes

Arthroscopic instruments

Total hip sets

Total knee sets

Open reduction/internal fixation sets

Cannulated screw sets

Front 44

Involuntary muscle:

Back 44

Cardiac muscle

Front 45

3 types of muscle tissues:

Back 45

Skeletal muscle

Smooth muscle

Cardiac muscle

Front 46

Diseases of the muscular system:

Back 46

Muscular dystrophy

Myasthenia Gravis

Front 47

Muscular System medical devices/instruments:

Back 47

Anterior cruciate ligament (ACL) set

Arthroscopes

Tenotomy set

Front 48

The 3 layers of integument (skin):

Back 48

Epidermis

Dermis

Hypodermis

Front 49

Diseases of the integument (skin):

Back 49

Skin cancer, psoriasis, eczema

Front 50

Skin grafts are harvested by this surgical device:

Back 50

Dermatome

Front 51

Functions of the circulatory system:

Back 51

Transportation

Regulation

Protection

Front 52

Substances transported by the circulatory system:

Back 52

Respiratory

Nutritive

Excretory

Front 53

Microorganisms include:

Back 53

Bacteria

Viruses

Fungi

Protozoa

Microscopic algae

Front 54

Biogenesis means:

Back 54

Living cells can only arise from pre-existing living cells

Front 55

Microorganisms are measured in:

Back 55

Microns

Front 56

One micron is this big:

Back 56

1/25 thousandths/ inch

Front 57

Most bacteria's size in microns:

Back 57

1-10 microns (length), and 0.2 - 1 micron (width)

Front 58

What is the Gram stain used for?

Back 58

Identifying different types of bacteria:

gram-negative and gram-positive

Front 59

Pathogenic means

Back 59

Disease producing

Front 60

Non pathogenic mean

Back 60

Non disease producing

Front 61

Round/spherical bacteria is called:

Back 61

Cocci

Front 62

Rod-shaped bacteria is called:

Back 62

Bacilli

Front 63

How many cells does bacteria have and what is the term for it?

Back 63

One,

Unicellular

Front 64

Bacteria reproduce by:

Back 64

Binary fission

(Asexual reproduction)

Front 65

Microorganisms that need oxygen are:

Back 65

Aerobic

Front 66

Microorganisms that don't need oxygen are called:

Back 66

Anaerobic

Front 67

"Facultative" microorganisms means:

Back 67

They are adaptive to environment

Front 68

"Obligate" microorganisms means:

Back 68

They can only survive in particular environments

Front 69

Gram-Positive Bacilli survival characteristics:

Back 69

Can become dormant

Shrinks

Front 70

Endospores (spores) facts:

Back 70

Is a gram-positive bacteria.

Durable.

Dehydrated.

Hard, thick cell walls.

Can survive extreme heat, lack of water, chemicals, and radiation.

Resistant to sterilization.Remains dormant for years.

Remains dormant for years.

Front 71

Gram-Positive rods species:

Back 71

Bacillus

Clostridium

Mycobacteria

Front 72

Clostridium diseases:

Back 72

C.diff (C.difficile)

Tetanus (C. tetani)

Botulism (C. botulinum)

Gas gangrene (C. perfringens)

(C. perfringens)

Front 73

Bacillus diseases:

Back 73

Anthrax (Bacillus anthracis)

Front 74

What spore is used to test sterilizers?

Back 74

Geobacillus stearothermophilus

Front 75

Mycobacteria characteristics:

Back 75

Non-spore

Aerobic

Non-moving

Front 76

"Myco" means:

Back 76

Fungus

Front 77

What is the microorganism responsible for TB?

Back 77

Mycobacterium tuberculosis

Front 78

Gram-Positive cocci family:

Back 78

Staphylococcus

Streptococcus

Enterococcus

Front 79

Staphylococci facts:

Back 79

Is on skin, nose, throat

Transferred through direct contact or contaminated surfaces.

Resistant to antibiotics.

Front 80

MRSA comes from what gram-positive cocci?

Back 80

Staphylococci

(specifically Staphylococcus aureus)

Front 81

Is Streptococci gram-negative or positive? Rod or sphere shaped?

Back 81

Gram-Positive

Sphere shaped

Front 82

Streptococci are responsible for these diseases:

Back 82

Scarlet fever

Pharyngitis

Pneumococcal pneumonia

Front 83

Enterococci facts:

Back 83

Gram-Positive cocci

Are intestinal bacteria

Found in feces, intestine, genitourinary tract

Transferred human to human or through food

Resistant to antibiotics

Front 84

Gram-negative bacilli:

Back 84

Pseudomonas

Escherichia coli

Salmonella

Klebsiella pneumoniae

Serratia marcescens

Legionella pneumophila

Front 85

Gram-negative cocci:

Back 85

Neisseria meningitidis

(meningococcal meningitis)

Front 86

Spirochetes causes:

Back 86

Syphilis (Treponema pallidum)

Front 87

Spirochetes facts:

Back 87

Gram-negative.

Found in humans and animals.

Found in water, sewage, soil, decaying organic matter.

Front 88

Some viruses are:

Back 88

Ebola virus

Zika virus

H1N1 Influenza virus

Front 89

Protozoa facts:

Back 89

Single-celled.

Variety of shapes.

Can be either free living or parasitic.

Classified by their means of locomotion.

Front 90

Some types of Fungi:

Back 90

Yeasts

Multi-cellular molds

Macroscopic species (mushrooms)

Front 91

Fungi facts:

Back 91

Lack flagella.

Develops from fungi spores or fragments.

Obsorbs organic matter to function.

Front 92

Immunocompromised people are at risk of these fungi diseases:

Back 92

Aspergillosis

Candidiasis

Cryptococcosis

Front 93

Prions are:

Back 93

Abnormal proteins

Front 94

Prion diseases are otherwise known as:

Back 94

Transmissible spongiform encephalopathies (TSE's)

Front 95

What is iatrogenic transmission?

Back 95

Transmission as a result of healthcare procedures

Front 96

One of the prion diseases:

Back 96

Creutzfeldt-Jakob disease

Front 97

Prion facts:

Back 97

Neurodegenerative disorder.

Fails to induce inflammatory response.

Causes brain/nerve damage.

Long incubation period.

Can remain dormant.

Always fatal.

Front 98

Human prion diseases include:

Back 98

CJD

variant CJD

Gerstmann-Straussler-Scheinker syndrome

fatal familial insomnia

kuru

Front 99

What are MDRO's?

Back 99

Multi-drug-resistant organisms

Front 100

MDRO facts:

Back 100

Mostly bacteria microorganisms

Resistant to one or more antimicrobial agents

Transmitted patient-to-patient via healthcare workers

Front 101

What are some MDRO's?

Back 101

MRSA

Staphylococcus aureus

CRE (carbapenum-resistant enterobacteriaceae

Vancomycin-resistant enterococcus

Front 102

VRE facts:

Back 102

Transmitted by direct contact.

Survives on hard surfaces for 5-7 days.

Survives on hands for hours.

Front 103

Microorganisms resistant to drugs:

Back 103

Salmonella

E. coli

M. tuberculosis

CRE

MRSA

VRE

Front 104

Carbapenum-resistant-enterobacteriaceae (CRE) facts:

Back 104

Transmitted by healthcare workers or medical equipment.

High mortality rate

Associated with GI endoscopes and duodenoscopes.

Front 105

Enterobacteriaceae is mostly found in:

Back 105

Gastrointestinal tract

Front 106

A pathogen is a:

Back 106

Disease-causing organism

Front 107

Most effective ways to reduce spread of C. difficile:

Back 107

Hand hygiene

Contact precautions

Front 108

How long can C. difficile spores survive on dry surfaces?

Back 108

Weeks or months

Front 109

What chemical is used to decrease C. difficile contamination in surfaces?

Back 109

Phosphate-buffered hypochlorite solution (bleach)

Front 110

What items have been implicated in C. diff outbreaks?

Back 110

Reusable electronic rectal thermometers

Bedside commode

IV machines

Overhead bedframes

High touch surfaces

Front 111

Ways bacteria can resist our defenses:

Back 111

Producing capsules

Producing enzymes

Releasing toxins

Front 112

Foreign organisms or substances invading the body are called:

Back 112

Antigens

Front 113

Immunity is the ability:

Back 113

Of the body to counteract antigens

Front 114

Active immunity:

Back 114

A person is exposed to microorganisms or foreign substances.

Front 115

Passive immunity:

Back 115

Antibodies are transferred person to person.

Lasts as long as antibodies are present. (weeks or months)

Front 116

Reservoirs of infection:

Back 116

Human (main reservoir)

Animal (rabies, Lyme, influenza)

Nonliving: water (gastrointestinal disease), soil (botulism and fungi)

Front 117

Modes of disease transmission:

Back 117

Contact

Droplet

Air

Vehicle

Vectors

Front 118

Contact transmission is:

Back 118

Person-to-person

Direct contact

Can be through body fluids or intact skin.

Front 119

What is a "fomite"?

Back 119

An inanimate object that transmits infection. (Eating utensils, syringes, rusty nail, etc.)

Front 120

Droplet Transmission facts:

Back 120

A form of contact transmission.

Droplets travel short distances.

Air handling/ventilation is not required.

Front 121

How does droplet transmission happen?

Back 121

Respiratory droplets travel from one person's respiratory tract to the other person's mucosal surfaces.

Front 122

How are respiratory droplets generated?

Back 122

Coughing, sneezing, talking.

Procedures: suctioning, intubation, cough induction by chest physiotherapy, CPR.

Front 123

Some pathogens spread by droplets:

Back 123

Influenza

SARS

Coronavirus

Group A streptococcus

Mycoplasma pneumoniae

Neisseria meningitidis

Bordetella pertussis

Front 124

Airborne transmission facts:

Back 124

From droplet nuclei or particles small enough to be be inhaled.

Disbursed by air currents.

Can carry pathogens over long distances and remain airborne for a long time.

Requires airborne infection isolation rooms (AIIRs)

Front 125

Vehicle transmission facts:

Back 125

Transmission occurs by water, air, food, body fluids, drugs, IV fluids.

Front 126

Vehicle transmission by air is:

Back 126

Droplet nuclei in dust that travels more than 3 feet.

Front 127

Pathogens spread through vehicle transmission by air:

Back 127

Measles

TB

Staphylococci

Streptococci

Front 128

Vector transmission happens when:

Back 128

Animals or insects transmit diseases to food or water or by biting/injesting blood.

Front 129

Vector transmitted diseases:

Back 129

Rocky Mountain spotted fever

Lyme disease

Front 130

What are the most common portals of exit?

Back 130

Respiratory tract

Gastrointestinal tract

Genitourinary tract

Front 131

What are the common portals of entry?

Back 131

Mucous membranes

Skin

Parenteral tissue

Front 132

What is the parenteral route?

Back 132

Skin or mucous membranes that have been penetrated or injured.

Front 133

What are the transmission based precautions?

Back 133

Contact

Droplet

Airborne

Front 134

How often should training in reprocessing be provided?

Back 134

Upon hire/before employee works

At least once a year

When new devices or protocols are introduced including changes in IFU's

Front 135

What two steps are the decontaminating process?

Back 135

Manual or mechanical cleaning

Thermal or chemical disinfection

Front 136

What is microorganisms on a contaminated item called?

Back 136

Bioburden

Front 137

How often should temperature and humidity be monitored and documented in the SPD?

Back 137

Daily

Front 138

If temperature or humidity levels are not at recommended levels what should we do?

Back 138

Report to SPD supervisor or manager

Front 139

Verification of a IFU's CLEANING process's effectiveness/useability consists of:

Back 139

Defining a cleaning process and it's steps.

Ensuring each step can be performed accurately, by adequately training and observing workers.

A verification system and methods to ensure cleaning process is performed adequately.

Front 140

Factors that impact cleaning:

Back 140

Water quality

Water temperature

Cleaning chemistries of the detergent

Type of action used to clean

Type of soil

Worker competence

Verification/documenting effectiveness

Quality assurance (monitoring compliance)

Front 141

Cleaning Process Steps:

Back 141

Sorting

Disposing

Pre-rinsing/presoaking

Washing

Rinsing

Drying

Inspecting

Front 142

What are pyrogens?

Back 142

Fever-producing substances

Front 143

How do you remove biofilm?

Back 143

Direct friction and/or oxidizing chemicals

Front 144

What factors should be considered in selecting a detergent for cleaning?

Back 144

The quality of the water

Water temperature

Type / amount of soil

What the item is made of

How the item will be cleaned

Front 145

Types of detergents:

Back 145

Enzymatic

Organic acid

High-alkaline

Non-abrasive cleaning agents

Soaps

Precleaning sprays/foams/gels

Front 146

Cart washers usually use what type of detergent?

Back 146

High-alkaline detergent

Front 147

High-alkaline detergents should not be used on what materials?

Back 147

Anodized aluminum rigid sterilization containers

Rubber

Some plastics

Front 148

Organic acid detergent is used for what material and why?

Back 148

Stainless steel for removing severe stains and rust

Front 149

Instruments cleaned with organic acid detergent should be neutralized afterward with what?

Back 149

Neutral pH detergent

Front 150

Instruments cleaned with high-alkaline detergent should be neutralized with what?

Back 150

Neutralizing acid rinse

Front 151

Non-abrasive cleaning agents are used for:

Back 151

Removing stubborn soil and stains.

Must be rinsed with detergent after.

Front 152

Non-abrasive cleaning agents are used for:

Back 152

Removing stubborn soil and stains.

Must be rinsed with detergent after.

Front 153

Instrument lumens should be precleaned by flushing with what?

Back 153

Sterile distilled water or other suitable agent.

Front 154

What are the types of enzymatic detergents? What are they for?

Back 154

Protease - blood, mucous, feces, albumin

Lipase - fat, bone marrow, adipose tissue

Amylase - starches, carbohydrates

Front 155

What should be done to instruments after using non-abrasive cleaning agents?

Back 155

Washed with a detergent afterwards.

Front 156

What soap is used when soap is recommended to clean instruments?

Back 156

Ivory Snow

Front 157

How should you CLEAN cannulated instruments?

Back 157

Soaked, flushed, and brushed

Front 158

During decontamination instruments should be rinsed when?

Back 158

After enzyme pre-soaking

Manual cleaning

Ultrasonic cleaning

Front 159

AAMI recommends sinks be how many inches from the floor? How many inches deep?

Back 159

36 inches from the floor

8 to 10 inches deep

Front 160

Cleaning solution pH should be:

Back 160

Between 7 and 9

Front 161

What is the most important step in the decontamination process?

Back 161

Cleaning

Front 162

What is the most important step in the cleaning process?

Back 162

Rinsing

Front 163

The final rinse should be performed with what kind of water?

Back 163

Critical water

Front 164

What is critical water?

Back 164

Deionized

Distilled

Reverse osmosis

Front 165

The detergents used in ultrasonic cleaners should be:

Back 165

Low-sudsing

Near neutral pH

Contain surfactants

Front 166

When using an ultrasonic cleaner remember:

Back 166

Ultrasonic cleaners can damage Chrome plated and ebonized instruments, and endoscopic telescopes.

Cork wood or glass should not be processed in an ultrasonic cleaner.

Plastics and soft metal should be avoided.

Cleaning solutions should be approved for use in ultrasonic cleaners.

Presoaking chemicals should first be removed.

Gross soil should be removed first.

The loading procedure described in the manufacturer's written IFU should be followed.

The ultrasonic cleaner IFU should be followed.

Devices with more than one part should be disassembled.

Cleaning solution should be changed after each use.

The ultrasonic cleaner should be cleaned each time it is drained.

The lid should remain closed.

The temperature of the water should be between 100° F and 140° F.

The water-detergent solution must be the gas before it is used.

Silicone mats should be removed and cleaned separately.

Trays should not be stacked.

Instruments should be open and items should be disassembled.

Instruments should be open and items should be disassembled.Mixing of metals should be avoided.Instruments in the basket should not be higher than 3 inches.

Mixing of metals should be avoided.

Instruments in the basket should not be higher than 3 inches.

Heavier items should be on the bottom.

In an ultrasonic cleaner without flushing capability lumens should first be cleaned with a brush and rinsed.

Lumens must be thoroughly rinsed after ultrasonic processing.

Must follow IFU for using the correct adapter.

Instruments must be rinsed after ultrasonic cleaning.

Instruments should be checked for any loose parts after ultrasonic cleaning.

The Ultrasonic cleaner should be located in the decontamination area.

Instruments should be processed through a mechanical washer-decontaminator after ultrasonic cleaning.

If not done, gloves should be worn when handling the instruments afterward.

Front 167

Gram-negative microorganisms stain what color?

Back 167

Red or pink

Front 168

Gram-Positive microorganisms stain what color?

Back 168

Purple or blue

Front 169

What should the detergent pH level for cleaning plastic, aluminum, or anodized aluminum?

Back 169

7 to 9 (neutral)

Front 170

What is the multi-step process when high-alkaline detergents are used?

Back 170

Alkaline wash

Neutralizing acid rinse

Regular enzyme-based rinse

Front 171

What is the pH for moderately alkaline?

Back 171

9-11

Front 172

What is the pH for highly alkaline?

Back 172

Higher than 11

Front 173

Moderately alkaline detergent can be corrosive to what kinds of materials?

Back 173

Aluminum

Copper

Brass

Front 174

What are the cycles washer - decontaminators provide?

Back 174

Pre cleaning

Cleaning

Rinsing

Sanitization or disinfection

Drying

Front 175

What kind of water does the pre cleaning cycle use in a mechanical washer?

Back 175

Cold water

Front 176

What kind of water do the wash cycles use in a mechanical washer? What is the temperature?

Back 176

Tap water

140° f to 180° f

Front 177

What kind of water is used in the first rinse cycle in a mechanical washer?

What is the water temperature?

Back 177

Tap water

140°F to 180°F

Front 178

What kind of water is used in the second rinse cycle in a mechanical washer?

What is the water temperature?

Back 178

Treated water

140° f to 180° f

Front 179

What kind of water is used for the last rinse in a mechanical washer?

What is the water temperature?

Back 179

Critical water

180° f to 230° f

Front 180

How long is the last rinse in a mechanical washer?

Back 180

Approximately 1 minute

Front 181

What are the different types of ultrasonic cleaners?

Back 181

Tabletop

Single chamber

Dual chamber

Three chamber

Single chamber with multiple trays

Lumen irrigator/flusher

Front 182

Other than the final sanitizing rinse, the water temperature for all cycles in a mechanical washer temperature is:

Back 182

Below 154° F

Front 183

A major contributor to cleaning failures is:

Back 183

Improper loading of mechanical washers

Front 184

Cart washers are used for cleaning:

Back 184

Case carts

Supply carts

Sterilization containers

Surgical instruments

Front 185

What are the cycles the cart washer provides?

Back 185

Wash cycle

Rinse cycle

Dry cycle

Front 186

What type of detergent is usually used in the cart washer?

Back 186

A high pH detergent

Front 187

What type of detergent should be used for anodized aluminum?

Back 187

Neutral pH

Front 188

How often should the cleaning process be verified for cart washers?

Back 188

Weekly

Front 189

What class of medical devices are rigid sterilization containers?

Back 189

Class II

Front 190

What is the process for receiving loaned instruments?

Back 190

Log in instruments

Record:

Weight of the each set

Weight of each set tray

Date and time of receipt

Company receiving from

Front 191

Powered equipment should never:

Back 191

Be immersed

Have contact with saline

Be processed in an ultrasonic cleaner

Front 192

Disposable instruments often used for CJD cases:

Back 192

Craniotomy sets

Brain biopsy set

Suction devices

Front 193

How should fiber optic light cables be cleaned?

Back 193

Soft cloth and detergent

Front 194

Fiberoptic light cable coils should be at least:

Back 194

8 inches

Front 195

Verification of a cleaning process consists of:

Back 195

Defining a cleaning process and it's critical aspects so that each step is fully verifiable through personnel training and observation to ensure that it can be followed completely accurately and without variation by all individuals who perform it.

Providing process controls along with verification methodologies that ensure adequate consistent cleaning levels.

Front 196

What testing device is used to verify the cleaning effectiveness of mechanical washers, ultrasonic cleaners, and car washers?

Back 196

Test Object Surgical Instrument (TOSI)

Front 197

What are some tests that are used to verify cleaning processes?

Back 197

Water quality tests

Water temperature tests

Flexible endoscope channel testing kits

Instrument surface tests

Front 198

What are the two key factors in testing cart washers?

Back 198

The water is reaching all surfaces of the cart.

The water temperature is accurately reached.

Front 199

Adequate cleaning requires an understanding of what?

Back 199

Composition of the soils.

The materials the items are made of.

What detergents are best suited.

Front 200

What is the first step in verifying the efficacy of a mechanical washer?

Back 200

Visual inspection

Front 201

What type of cleaning is usually recommended for lumens?

Back 201

Ultrasonic cleaning

Front 202

What is the first step to cleaning lumens?

Back 202

Manual cleaning using a brush &

visual inspection.

Front 203

Orthopedic and spinal sets should be soaked in what? Some manufacturers recommend soaking for how long?

Back 203

Lipolytic enzyme solution

20 to 45 minutes

Front 204

How should rigid endoscopes be cleaned?

Back 204

By hand.

Wiped with gauze or a soft cloth and detergent solution.

Separately from other instruments.

No chemicals.

Front 205

A high level disinfection process does not kill what?

Back 205

Bacterial spores

Front 206

Osmosis in disinfection means:

Back 206

The movement of a solvent through a cell membrane into a solution of higher solute concentration

Front 207

What can improve a disinfectants ability to kill microorganisms?

Back 207

A higher temperatures of solution

Front 208

Why is it important to determine whether disinfectants should be rinsed off?

Back 208

The residuals of some high level disinfectants can be toxic

Front 209

What kind of disinfectant leaves behind a film which inhibits the growth of microorganisms but does not destroy them?

Back 209

Bacteriostatic disinfectants

Front 210

What kind of disinfectant kills microorganisms but does not leave a protective film behind?

Back 210

Bacteriocidal disinfectants

Front 211

What type of disinfectant should not come into contact with patient's tissue? Why?

Back 211

Bacteriostatic

Leaves a residue

Front 212

Before using any chemical you should review all information available where?

Back 212

Labels

Product literature

Product SDS

Manufacturer's IFU

Front 213

What is the most important safety information to know before using any chemical?

Back 213

First aid recommendations.

The need for engineering controls such as ventilation.

An emergency plan in the event of spills.

Special PPE or attire required.

Front 214

What are some of the instruments that high level disinfectants are used on?

Back 214

Flexible gastrointestinal endoscopes

Transesophageal endocardiography probes

Ultrasound probes

Front 215

What is the minimum PPE required for working with environmental disinfectants?

Back 215

Gloves and protective eyewear

Front 216

Types of environmental disinfectants:

Back 216

Quaternary ammonium compounds (QUATS)

Halogens

Phenolics

Alcohols

Hydrogen peroxide

Ultraviolet light

Front 217

QUATS:

Back 217

Low level disinfectant.

Ineffective against lipid viruses and spores.

Effective against gram-negative and gram positive bacteria.

Can be corrosive to medical devices.

Used on non-critical surfaces.

Can be used for medical equipment that contacts intact skin.

Non-toxic.

Front 218

What kind of water should quats be mixed with?

Back 218

Distilled water

Front 219

What is the typical solution concentration for quats? Time required for disinfection?

Back 219

0.05 to 0.2%

10 minutes

Front 220

Are quats bacteriostatic or bactericidal?

Back 220

Bactericidal

Front 221

Bleach is what type of disinfectant?

Back 221

Halogen

Front 222

Iodine is what kind of disinfectant?

Back 222

Halogen

Front 223

Halogens:

Back 223

Not normally a high-level disinfectant.

Should not be used to disinfect medical devices that will be used in patients.

Do not leave toxic residues.

Removes dried or fixed organisms and biofilms.

Are not affected by hard water.

Chlorine and iodine.

Are environmental disinfectants or skin antiseptics.

Front 224

Phenolics are effective against:

Back 224

Vegetative bacteria

Fungi

Some mycobacteria

Front 225

Phenolics are not effective against:

Back 225

Bacterial spores

Some viruses

Front 226

Phenolics:

Back 226

An environmental disinfectant.

Can kill TB mycobacteria

Used in critical or high bioburden areas.

Bacteriostatic.

Not easily rinsed off.

Not recommended for food prep, nurseries, porous materials.

Should not be used for surgical instruments.

Can irritate and depigment skin.

Front 227

Alcohols:

Back 227

Not effective against spores and some hydrophilic viruses.

Skin antiseptic.

Kills mycobacteria, fungi, bacteria.

Is flammable.

Can damage latex rubber and plastic.

Is a solvent.

Impractical for large surfaces due to rapid evaporation.

Front 228

Are alcohols bactericidal or bacteriostatic?

Back 228

Bactericidal

Front 229

How long should alcohol remain on surfaces without evaporation to be effective?

Back 229

5 to 10 minutes

Front 230

What is the most effective concentration of alcohol for disinfecting?

Back 230

70%

Front 231

Accelerated hydrogen peroxide:

Back 231

Not irritating to skin eyes or respiratory system.

General environmental cleaner-disinfectant

Consistently remains wet for required period of time for effectiveness.

Front 232

UV-C light:

Back 232

Destroys cell DNA and prevents reproduction.

Effective against C. difficile, VRE, MRSA.

Can be used for air and environmental surfaces.

Front 233

Glutaraldehydes are:

Back 233

High level disinfectants for use on medical instrumentation.

Front 234

Glutaraldehydes are used in manual or automated processes?

Back 234

Both

Front 235

Are Glutaraldehydes used to disinfect non-critical semi critical or critical items?

Back 235

Semi critical

Front 236

The soaking time necessary for high-level disinfection with glutaraldehydes is:

At what temperatures?

Back 236

5 to 90 minutes

68° F to 95° F

Front 237

In 2% solutions glutaraldehydes are effective against what microorganisms?

Back 237

Mycobacteria, vegetative bacteria, viruses

Front 238

Items being disinfected manually with Ortho-phthalaldehydes should have an exposure time of how long?

At what temperature?

Back 238

12 minutes

68° F

Front 239

Items being disinfected with ortho-phthalaldehydes in an AER

should be exposed for how long?

At what temperature?

Back 239

5 minutes

77° F

Front 240

Items disinfected with ortho-phthalaldehydes should be rinsed how many times?

Back 240

3 separate times

Front 241

7 functions of surgical instruments:

Back 241

Cut/incise

Retract

Grasp/hold/occlude

Dilate/probe

Cannulate/drain

Aspirate/inject/infuse

Suture/ligate

Front 242

5 categories of surgical instruments:

Back 242

Handheld

Microsurgical

Powered

Endoscopic

Minimally invasive

Front 243

What kind of water is usually recommended for preparing instrument lubricant?

Back 243

Critical water

Front 244

Are laparoscopic instruments insulated or non-insulated?

Back 244

Both

Front 245

Inspection steps for laparoscopic instruments:

Back 245

Make sure handle and jaws are working.

Make sure jaw rotates.

Make sure slide lock graspers are working.

Check for debris in hinges of tips.

Make sure instruments with trumpet valves have been properly reassembled.

Front 246

What are the types of sterilization for wrapped items?

Back 246

Steam under pressure.

Ethylene oxide gas.

Low temperature gas plasma.

Low temperature hydrogen peroxide.

Dry heat.

Hydrogen peroxide - ozone.

Front 247

What are the types of sterilization for unwrapped items?

Back 247

Steam sterilization.

Liquid chemical sterilization.

Front 248

Where are sterilizers usually located in the SPD?

Back 248

Prep and packaging area

Front 249

1-log reduction means:

Back 249

90% of microorganisms have been killed

Front 250

Steam sterilization kills microorganisms how?

Back 250

By denaturing the protein.

Front 251

What is the most commonly used form of sterilization?

Back 251

Steam sterilization.

Front 252

How often must a Bowie Dick test be performed for sterilizers?

Back 252

Daily

Front 253

What is the required psi for steam sterilizers?

Back 253

60 to 80 psi

Front 254

What are the three perimeters for steam sterilization cycles?

Back 254

Saturated steam under pressure.

Time

Temperature

Front 255

What is the spore most resistant to steam sterilization?

Back 255

Geobacillus stearothermophilus

Front 256

Electrosurgery is also used in these surgeries:

Back 256

Urology

Colonoscopy

Front 257

What are the three types of endoscopes?

Back 257

Rigid

Flexible

Semi-rigid

Front 258

Endoscopes should be labeled with what information?

Back 258

Manufacturer

Service

Size

Visual field

Front 259

Virtually all problems with rigid endoscopes are caused by what?

Back 259

Mishandling or improper reprocessing

Front 260

Can rigid endoscopes be steam sterilized?

Back 260

Yes but some older ones require low temperature sterilization.

Front 261

Other names for clamps:

Back 261

Hemostats

Forceps