Questions and Answers
What states that all patient information is highly confidential and should NEVER be discussed with anyone at any time unless it is required for the direct care of the patient?
HIPAA
This process is defined by AAMI as the removal of contamination from an item to the extent necessary for further processing or for the intended use.
cleaning
What type of stainless steel is used to manufacture scissors, forceps, osteotomes, and chisels?
400 series
What type of material is used the most in the manufacturing of surgical instrumentation?
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What is the proper order of how work progresses through the CSPD?
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What is defined as microorganisms on a contaminated item?
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What type of stainless steel is used to manufacture basins, bowls, and malleable retractors?
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What are the two steps in the process of decontamination?
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As defined by OSHA, what is defined as 'the use of physical or chemical means to remove, inactivate or destroy blood borne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles'?
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What should be done first when a Sales Rep brings in a new Stryker Drill for Dr. Bridwell to try during a total hip procedure?
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What is the temperature range in the decontamination department?
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Sharps in the decontamination department should be confined and contained in what type of leak proof container?
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After thoroughly cleaning a contaminated item, the most important step in the decontamination process is to _____________ the item.
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Humidity level in a CS department should be kept at what percent?
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Instruments in the OR that are just opened but not used still have to go through the decontamination process, only when?
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What is the groups or collections of microorganisms that adhere to the surface of any object that comes into contact with nonsterile water?
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What is extremely corrosive to surgical instruments and its use in the decontamination process is prohibited?
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A pH level of 7 is considered?
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Instruments should never be stored _________________, and all instruments should be sterilized as soon as possible after cleaning.
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What should be the air pressure in the decontamination department?
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How many air exchanges per hour should the decontamination department have?
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How often should the temperature and humidity levels be documented?
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What forms a protective slimy film on top of water and on instruments during the decontamination process?
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A pH level below 7 is considered?
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Items that have been presoaked or treated must be ____________ thoroughly before further cleaning.
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A pH level above 7 is considered?
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Biofilms adhere to all surfaces, but they form more slowly on smooth surfaces than on rough surfaces. In healthcare settings, what items are most affected by biofilms?
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What kind of detergents contain organic substances that assist in the breakdown of protein soils and blood?
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When using enzymatic detergents, higher water temperatures are not to be used because it will break down or destroy the enzymes, making them?
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Temperatures below ______________ all have adverse effects, making enzymes sluggish and reducing their effectiveness.
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Water temperatures of _________________ are best for enzyme-based products.
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Which enzymatic detergent breaks down blood, mucus, feces, and albumin?
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Which enzymatic detergent breaks down fat (e.g., bone marrow and adipose tissue)?
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Which enzymatic detergent catalyzes starches and breaks down carbohydrates?
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What kind of detergents can be used to remove severe stains on stainless steel instruments?
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What kind of cleaning agents are available for removing stubborn soils and stains but must be thoroughly rinsed away?
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What are organic compounds, made from products found in nature, that are poor cleaners by themselves?
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There must be some type of action that enhances the cleaning process, such as ____________ on the surfaces.
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What type of items must be opened during the cleaning process?
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What type of equipment cannot be immersed?
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Manual cleaning may be the only effective method for certain instrumentation such as devices with?
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Detergents that are meant to bind with soils and keep them suspended in the solution are used for what type of cleaning?
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Using more detergent than called for does not improve the cleaning action; in fact, it can impede the process by causing instruments to?
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Detergent solutions must be changed frequently to reduce the bioburden (contamination) and to prevent?
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Just as cleaning is the most important step in the decontamination process, what is the most important step in the cleaning process?
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For either manual or mechanical cleaning, the final rinse should be performed with what type of water to prevent mineral deposits?
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What kind of bristle brushes are not generally recommended because they can damage the protective layer of surgical instruments?
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To maintain accreditation and receive payments from insurance companies, a healthcare facility must pass the?
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What kind of pads should not be used because they will scratch device surfaces?
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What are not acceptable for use, because they harbor bacteria and break apart during use?
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To prevent the formations of __________________ all cleaning implements should be regularly cleaned and disinfected or sterilized.
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This is an automated cleaning equipment that transmits sound waves through a cleaning solution.
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This mechanical action is called ___________________ and is very effective in cleaning hard-to-reach areas.
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This type of detergent has a pH level higher than 11.
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To reduce the potential of corrosion, highly alkaline detergents are used in a multistep process: first the alkaline wash, then a ______________________.
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What should not be placed over instruments?
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What type of chemicals are used to process endoscopes for immediate reuse?
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Cart washers are mechanical cleaners that _________________ metal surgical case carts and supply carts.
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What types of instruments present unique challenges for cleaning because of their design?
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All orthopedic sets should be soaked in what type of enzyme solution?
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All instruments and devices received from another facility or company must be considered contaminated and should be completely?
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Who is required to provide the instructions for cleaning and sterilization?
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Where is the first area to accept responsibilities into the healthcare facility?
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Loaner sets are often multi-level; if so, each level should be cleaned how?
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When instruments are 'opened but not used' and returned to the CS/SPD, they are considered?
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To prevent damage, powered equipment should never be immersed in a solution, or come in contact with what type of solution?
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Instruments should never be placed on top of fiberoptic cables because of the _______ inside could be damaged.
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What type of endoscopes are extremely difficult to clean because of their numerous small channels?
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Flexible endoscopes must always be _________________ before any manual pre-cleaning is performed.
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The scope should be flushed with ____________ isopropyl alcohol to facilitate drying.
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Toxic anterior segment syndrome (TASS) is an acute inflammation after what type of surgery?
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A simple test for ultrasonic cleaners is to place a piece of what in the unit?
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According to this organization, the efficacy of cleaning processes should be verified regularly.
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What process kills most microorganisms but not necessarily bacterial spores?
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What method of destruction is required to destroy prions?
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What method of destruction is required for bacterial spores?
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What method of destruction is required for mycobacteria (tuberculosis)?
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What level of disinfection is required for nonlipid, small viruses?
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What is the method of destruction required for fungi?
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What level of destruction is required for vegetative bacteria?
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What level of destruction is required for lipid, medium-sized viruses?
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In order for the disinfectant to enter the cell, there must be a balance that allows for the process of?
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This type of disinfectant is a low-level, environmental disinfectant effective against gram-positive bacteria.
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This solution is severely corrosive and should never be used on surgical instruments.
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What halogen is generally used as a skin antiseptic?
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What solution is used to prepare skin before surgery when mixed with detergents?
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What formulations can stain and cause burns if allowed to pool on the skin?
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This is a carbolic-acid-based product effective against vegetative bacteria, fungi, and TB:
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This disinfectant should not be used for surgical instrumentation as it can irritate the skin?
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This product is an effective antiseptic and sanitizer capable of killing a variety of bacteria, mycobacteria, and fungi.
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This high-level disinfectant is used on immersible items such as flexible and rigid endoscopes.
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Although compliance with AAMI standards are not legally required, AAMI standards for sterilization are recognized as what type of practice?
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What is an established norm determined by opinion, authority, research, and/or theory?
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This type of flow is how people move through the department.
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What should you do if an instrument salesmen enters the CSPD area without proper attire?
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HIPAA states that all patient information is confidential. Who has the right to confidential patient information?
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This type of control limits access to the CS/SPD department.
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These statements are based on sound principles of practice that are based upon scientific data and opinions of experts.
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American National Standards developed by the Association for the Advancement of Medical Instrumentation (AAMI) is an example of a?
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Study Notes
CRCST Key Concepts
- HIPAA: Protects patient information; confidentiality must be maintained, only disclosed for direct care needs.
- Cleaning: Defined by AAMI as removing contamination sufficiently for further processing or intended use.
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Stainless Steel Types:
- 400 Series: Used for scissors, forceps, and osteotomes.
- 300 Series: Used for basins, bowls, and malleable retractors.
- CSPD Workflow: Progression order is Decontam, Prep and Pack, Sterilizer, Sterile Storage.
- Bioburden: Refers to microorganisms present on contaminated items.
Decontamination Processes
- Decontamination Steps: Involves manual cleaning and a thermal process.
- Decontamination Temperature: Maintain at 60°-65° F with a negative air pressure and 10 air exchanges per hour.
- Humidity Levels: Should be kept between 30-60% to ensure optimal conditions.
- Cleaning Items: Should always be rinsed thoroughly after presoaking to prevent incompatibility with detergents.
Instrumentation Care
- Instruments: Open but unused instruments are always considered contaminated.
- Biofilms: Microbial communities that adhere to surfaces; form more slowly on smooth surfaces.
- Detergent Usage: Use enzymatic detergents for protein soils, avoid excessive detergent to prevent build-up.
Enzyme and Detergent Types
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Enzymatic Detergents:
- Protease: Breaks down proteins such as blood and mucus.
- Lipase: Effective against fats like bone marrow.
- Amylase: Breaks down carbohydrates.
- High Alkaline Detergents: Should be followed by a neutralizing rinse to reduce corrosion.
Cleaning Techniques
- Mechanical vs. Manual: Manual cleaning necessary for lumens or complex instruments.
- Final Rinse: Must be performed with treated water to avoid mineral deposits.
Sterilization & Disinfection
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Disinfection Levels: Range from low to high, depending on the type of pathogens:
- Low Level: Effective against vegetative bacteria and some viruses.
- Intermediate Level: Required for fungi and mycobacteria.
- High Level: Necessary for bacterial spores.
- Sterilization: Essential for killing all microorganisms, including prions.
Equipment and Safety Guidelines
- Ultrasonic Cleaners: Utilize cavitation to clean hard-to-reach areas effectively.
- Endoscopes: Must be leak-tested prior to cleaning, using high-level disinfectants for processing.
- Personal Protective Equipment: Required for staff and sales representatives entering CSPD areas.
Regulatory Standards
- AAMI Standards: Consulted for best practices in sterilization, although not legally enforced.
- JC Inspections: Healthcare facilities must comply with standards to maintain accreditation and insurance payments.
This structured overview highlights critical definitions, processes, and standards relevant to CRCST practice, ensuring efficient study and understanding for examination purposes.
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Description
This quiz covers essential concepts related to CRCST including HIPAA regulations, types of stainless steel, and the CSPD workflow. Additionally, it examines decontamination processes, steps, and optimal conditions necessary for effective cleaning and sterilization. Test your knowledge and understanding of these critical topics in surgical processing.