CBSPD Exam Flashcards
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Questions and Answers

What should the sterilizer access area pressure be?

Negative with 10 air exchanges per hour

What two steps are involved in decontamination?

  1. Manual and/or automated mechanical cleaning, 2. Application of a thermal or chemical disinfection process

Define cleaning.

The removal of contamination from an item to the extent necessary for further processing or for the intended use.

Nosocomial infections are well documented and caused by?

<p>Poor or ineffective decontamination of instruments</p> Signup and view all the answers

What are employee hazards in the decontamination process?

<ol> <li>Unidentified bioburden 2) Wet environment 3) Handling contaminated sharps 4) Must know procedures for proper handling, equipment, cleaning/sterilization agents</li> </ol> Signup and view all the answers

How do you properly clean a device?

<p>Follow the device manufacturer's written instructions</p> Signup and view all the answers

What is the starting point in sterilization?

<p>Cleaning</p> Signup and view all the answers

Define decontamination.

<p>The process of cleaning surgical instruments, patient care devices, and all involved surfaces to render areas and items safe for handling and/or further processing.</p> Signup and view all the answers

What are physical safety hazards?

<p>Good body mechanics, correct body techniques, being alert to potential injuries, using lifts for heavy supplies, proper clothing.</p> Signup and view all the answers

What is the weakest point of an instrument?

<p>Box lock and jaws</p> Signup and view all the answers

What does the ABC system stand for?

<p>A: Large dollar amount items not used frequently, B: Moderately priced and used frequently, C: Items with low dollar value</p> Signup and view all the answers

What is just in time distribution?

<p>Items are distributed to departments by vendor with no need for sterile storage or inventory control.</p> Signup and view all the answers

What are specialty/procedure carts?

<p>Carts placed in specific departments based on procedures and personalized to the needs of departments.</p> Signup and view all the answers

What is case cart distribution?

<p>Case carts are delivered to departments specialized to their needs.</p> Signup and view all the answers

What is the exchange cart distribution?

<p>Two identical carts are made; one is out in the department and the other stays in SPD.</p> Signup and view all the answers

What is par level distribution?

<p>There is fixed inventory, and when items become low, they are replenished from the stockroom per department/specialty.</p> Signup and view all the answers

What is demand distribution?

<p>An instrument/cart must be ordered in order to get it.</p> Signup and view all the answers

What are the most common distribution systems?

<ol> <li>Demand 2) Par-level 3) Exchange 4) Case carts 5) Specialty 6) Just in time</li> </ol> Signup and view all the answers

What is the air pressure of the sterile storage area?

<p>Positive air flows out</p> Signup and view all the answers

What is shelf life?

<p>Period of time which a sterile item is considered safe to use, event related not time related.</p> Signup and view all the answers

When are packs most vulnerable to contamination?

<p>Immediately after sterilization</p> Signup and view all the answers

What is it when a sterilizer's ability is tested under worst case conditions?

<p>Small load testing</p> Signup and view all the answers

What is it called when a sterilizer is tested for sterilization under actual use conditions?

<p>Max load testing</p> Signup and view all the answers

How often is a Bowie Dick test ran?

<p>Daily for dynamic air removal sterilizers</p> Signup and view all the answers

How much space should be between packages and the chamber wall?

<p>One inch</p> Signup and view all the answers

How should paper-plastic pouches be placed in a sterilizer?

<p>Plastic to paper or paper to plastic, tilted on side.</p> Signup and view all the answers

How should basins be placed in a sterilizer?

<p>On tilted side same direction.</p> Signup and view all the answers

What should be placed on the bottom of the rack in a mixed load?

<p>Metal instruments, basin, other metal items.</p> Signup and view all the answers

What should be placed on the top shelf?

<p>Textile packs and paper/plastic pouches.</p> Signup and view all the answers

Textile packs should be placed how in a sterilizer?

<p>Sides.</p> Signup and view all the answers

Solid bottom trays should be loaded how?

<p>Tilted on sides.</p> Signup and view all the answers

How should mesh bottom containers be loaded into the sterilizer?

<p>Flat on rack.</p> Signup and view all the answers

If packages are still moist when the sterilizer doors are opened, bacteria can do what?

<p>Wick through the package.</p> Signup and view all the answers

How does steam sterilization occur?

<p>By condensation.</p> Signup and view all the answers

What cases are proven to have prions?

<ol> <li>Neurosurgery 2. Ophthalmology (eye)</li> </ol> Signup and view all the answers

When should a flash sterilizer be monitored?

<p>Weekly with a biological and a class 5 or class 6 indicator.</p> Signup and view all the answers

What cannot be processed in an express cycle?

<p>Porous items and items with lumens.</p> Signup and view all the answers

When should a flash sterilizer be used?

<p>In an emergency; a one-of-a-kind instrument is dropped.</p> Signup and view all the answers

How are liquids sterilized?

<p>Only through gravity displacement liquid cycles.</p> Signup and view all the answers

What occurs during the drying phase?

<p>Dynamic air removal: Filtered air is drawn in to achieve drying; Gravity: Heat in the chamber evaporates moisture. Approx. 30 min. for both.</p> Signup and view all the answers

What occurs during the exhaust phase?

<p>Steam is exhausted from the chamber drain line.</p> Signup and view all the answers

What occurs during the sterilization/exposure/holding phase?

<p>Exposure temperature is maintained for the prescribed amount of time.</p> Signup and view all the answers

What occurs during the conditioning phase of steam sterilizers?

<p>Air is removed and steam is injected.</p> Signup and view all the answers

Where should the Bowie Dick test be placed in a steam sterilizer?

<p>Drain line.</p> Signup and view all the answers

Where is the sterilizer's heat-sensing thermometer located?

<p>Drain line.</p> Signup and view all the answers

What provides heat inside the chamber and prevents condensation in a steam sterilizer?

<p>The jacket.</p> Signup and view all the answers

Where is the dedicated steam supply made?

<p>A boiler.</p> Signup and view all the answers

Steam kills microorganisms by _______ the protein.

<p>denaturing (coagulation).</p> Signup and view all the answers

Removing as many microorganisms as possible before sterilization enhances the probability of microbial kill.

<p>True</p> Signup and view all the answers

What is the air exchange in sterile storage?

<p>4 per hour.</p> Signup and view all the answers

What is the suggested release temperature of packs?

<p>70 to 80 degrees Fahrenheit.</p> Signup and view all the answers

How far from the floor should medical devices be stored?

<p>8-10 inches from the floor.</p> Signup and view all the answers

How far should shelving be from outside walls?

<p>2 inches.</p> Signup and view all the answers

What kind of pressure should the sterilization area be under?

<p>Positive.</p> Signup and view all the answers

What is the coldest area of the sterilizer?

<p>Drain line.</p> Signup and view all the answers

What are the three parameters of steam sterilization?

<ol> <li>Steam under pressure, 2) Time, 3) Exposure/Temperature.</li> </ol> Signup and view all the answers

What are the two types of cycles in steam sterilization?

<ol> <li>Dynamic air removal (pre-vac), 2) Gravity Displacement (immediate use).</li> </ol> Signup and view all the answers

What are the phases of the cycle?

<ol> <li>Conditioning (air is removed), 2) Sterilization/Exposure/Hold (temperature is held), 3) Exhaust (steam out drain line), 4) Drying (approx. 30 min.).</li> </ol> Signup and view all the answers

It takes a certain ______ to reach a certain ____________.

<p>Pressure, temperature.</p> Signup and view all the answers

What are the types of sterilization processes used?

<ol> <li>Steam, 2) EtO, 3) Dry Heat, 4) Gas plasma, 5) Ozone, 6) Liquid chemical.</li> </ol> Signup and view all the answers

What does a class on indicator respond to?

<p>Only one parameter of the process (ex.: autoclave tape).</p> Signup and view all the answers

Geobacillus stearothermophilus must be incubated at what temp?

<p>132 degrees Fahrenheit.</p> Signup and view all the answers

What should the incoming saturated steam dryness be?

<p>Ideally 97% to 100% saturated steam.</p> Signup and view all the answers

What should the sterility assurance level be?

<p>10^-6.</p> Signup and view all the answers

When a new sterilizer comes in or is relocated how many consecutive biologicals must be ran in an empty sterilizer?

<p>Three.</p> Signup and view all the answers

How many air exchanges should there be in the sterilization area?

<p>Ten.</p> Signup and view all the answers

Class five responds to?

<p>All critical parameters.</p> Signup and view all the answers

Class three responds to?

<p>Single parameter responds to one chemical parameter.</p> Signup and view all the answers

Biological monitors contain?

<p>Spores Geobacillus stearothermophilus.</p> Signup and view all the answers

The biological used for steam, ozone, and peracetic sterilization contains?

<p>Geobacillus stearothermophilus.</p> Signup and view all the answers

The biological used for EtO, gas plasma, and dry heat contains?

<p>Bacillus atrophaeus.</p> Signup and view all the answers

Adequate cleaning will lead to easier sterilization because it reduces present bioburden.

<p>True</p> Signup and view all the answers

When must a control biological be run?

<p>Daily or when a new lot number is present.</p> Signup and view all the answers

When are biologicals placed for steam sterilization?

<p>Coldest point (drain line).</p> Signup and view all the answers

Where do you place biologicals for EtO sterilization?

<p>Approximately the center of the load.</p> Signup and view all the answers

Where are biologicals placed for gas plasma sterilization?

<p>First shelf back of chamber.</p> Signup and view all the answers

If no microorganisms survived, the biological test is positive or negative?

<p>False</p> Signup and view all the answers

If microorganisms survive, the biological test is considered positive or negative?

<p>False</p> Signup and view all the answers

If bacteria live what color does the biological turn?

<p>Yellow.</p> Signup and view all the answers

When a BI tests positive you must?

<p>Determine why it failed and recall everything from that cycle and reprocess it.</p> Signup and view all the answers

Steam sterilizers should be monitored at a minimum of?

<p>Weekly.</p> Signup and view all the answers

Each package run through sterilizers should be labeled with what?

<ol> <li>Lot number 2) Date 3) Cycle number.</li> </ol> Signup and view all the answers

What must CSD comply with?

<p>Local and state regulations.</p> Signup and view all the answers

What is decontamination?

<p>Contaminated items are rendered safe for handling by personnel who are not wearing protective attire.</p> Signup and view all the answers

What does the EPA regulate?

<p>EtO manufacturing and emissions, and labeling.</p> Signup and view all the answers

What agencies govern central sterile departments?

<p>Joint commission (JC), Occupational safety (OSHA), Environmental (EPA), Food and Drug (FDA).</p> Signup and view all the answers

Is JCAHO a government agency?

<p>False</p> Signup and view all the answers

The standards of __________ affect most areas of the health care facility.

<p>Joint Commission.</p> Signup and view all the answers

What should large items be lifted with?

<p>If too large, then a lift must be used; if can be lifted with body use legs not back/arms.</p> Signup and view all the answers

What can an incident report lead to?

<p>Work practices that need improvement.</p> Signup and view all the answers

What should be in an incident report?

<p>How the accident happened, where/when it occurred, any witnesses, medical treatment given, any work time lost due to the accident, description of corrective actions to prevent the recurrence of the accident.</p> Signup and view all the answers

When should an incident report for an accident/injury be reported?

<p>Immediately.</p> Signup and view all the answers

What items can be disinfected?

<p>Surgical instrumentation, patient care equipment, other medical devices from all areas of the institution.</p> Signup and view all the answers

When is disinfection used?

<p>When cleaning alone might not be enough to make an item safe for reuse or further handling without transmitting disease.</p> Signup and view all the answers

Decontamination activities should not take place when?

<p>Clean activities are being performed (prep, packaging, and sterilization).</p> Signup and view all the answers

What kind of containers should sharps be kept in?

<p>Impervious (puncture proof) and leak proof containers.</p> Signup and view all the answers

Acrylic nails are prohibited because they support the growth of microorganisms.

<p>False</p> Signup and view all the answers

How long should fingernails be kept?

<p>Short.</p> Signup and view all the answers

Why should jewelry not be worn?

<p>Cannot be easily cleaned, can catch on equipment causing injury.</p> Signup and view all the answers

Eyewash stations must be available in the decontam area and in areas where disinfectants are being used and have hands-free operation.

<p>False</p> Signup and view all the answers

Study Notes

Sterilization and Decontamination

  • Sterilizer Access Area Pressure: Should be negative with 10 air exchanges per hour.
  • Decontamination Steps: Involves manual/automated mechanical cleaning and application of thermal or chemical disinfection.
  • Cleaning Definition: Removal of contamination sufficient for further processing or intended use.
  • Nosocomial Infections: Often result from poor/inadequate decontamination processes.
  • Employee Hazards: Include exposure to unidentified bioburden, wet environments, handling contaminated sharps, and necessity of knowing proper procedures.

Sterilization Process

  • Starting Point in Sterilization: Cleaning is the foundational step.
  • Decontamination Process: Involves cleaning surgical instruments and patient care devices to ensure safe handling.
  • Physical Safety Hazards: Proper body mechanics, alertness, and right ergonomics are crucial to prevent injuries.

Distribution Systems

  • ABC System Classification: A for high-value infrequently used items, B is moderately priced frequently used items, C is low-value items.
  • Just in Time Distribution: Eliminates need for sterile storage by having items supplied directly by vendors.
  • Case Cart Distribution: Involves delivering specialized carts to specific departments based on needs.
  • Exchange Cart Distribution: Utilizes two identical carts—one in use, one in SPD.

Sterilization Conditions

  • Sterile Storage Area Pressure: Should be positive to prevent contamination.
  • Shelf Life of Sterile Items: Defined as event-related and not time-related.
  • Vulnerability to Contamination: Packs are most at risk immediately after sterilization.

Steam Sterilization

  • Steam Sterilization Mechanism: Achieved through condensation.
  • Biological Testing: Required to confirm sterilization effectiveness; includes max and small load testing.
  • Bowie Dick Test Frequency: Conducted daily for dynamic air removal sterilizers.
  • Space Guidelines in Sterilizer: Packages should have at least one inch of space from chamber walls.

Loading Sterilizers

  • Positioning of Various Materials:
    • Basins: Should be placed on their tilted side.
    • Metal Instruments: Load on the bottom of the rack.
    • Textile Packs: Positioned on the top shelf with sides facing out.
  • Moist Packages: If packages are wet upon sterilizer door opening, bacteria can wick through.

Monitoring and Labels

  • Frequency of Monitoring: Flash sterilizers need weekly monitoring with biological and indicators.
  • Indicators: Class 5 indicators respond to all critical parameters, Class 3 responds to single parameters.
  • Label Requirements: Each sterilized package should be labeled with lot number, date, and cycle number.

Biological Monitoring

  • Biological Indicators: Contain spores of Geobacillus stearothermophilus for steam, ozone, and peracetic sterilization; Bacillus atrophaeus for EtO, plasma, and dry heat.
  • Positive vs. Negative Tests:
    • Negative test: No microorganisms survived.
    • Positive test: Microorganisms survived, indicating failure.

Regulatory Compliance and Safety

  • CSD Compliance: Must adhere to local and state regulations, including those from OSHA, EPA, and FDA.
  • Incident Reporting: Must include all details of the accident/injury immediately after it happens.

Personal Protective Measures

  • Sharp Containers: Must be puncture-proof and leak-proof.
  • Prohibited Items: Acrylic nails and jewelry are not allowed in sterile environments due to hygiene concerns.
  • Fingernail Length: Should be kept short to minimize contamination risk.

Miscellaneous

  • Eyewash Stations: Should be readily available in decontamination areas with hands-free operation.

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Prepare for the CBSPD exam with these flashcards covering key concepts in sterilization and decontamination. Each card succinctly defines important terms and processes vital for sterile processing technicians. Enhance your knowledge and readiness for the certification exam.

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