CRCST Key Concepts and Decontamination Processes

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?

stainless steel Signup and view all the answers

What is the proper order of how work progresses through the CSPD?

Decontam, Prep and pack, sterilizer, sterile storage Signup and view all the answers

What is defined as microorganisms on a contaminated item?

bioburden Signup and view all the answers

What type of stainless steel is used to manufacture basins, bowls, and malleable retractors?

300 series Signup and view all the answers

What are the two steps in the process of decontamination?

manual cleaning and thermal process Signup and view all the answers

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'?

decontamination Signup and view all the answers

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?

Ask for written instructions Signup and view all the answers

What is the temperature range in the decontamination department?

60°-65° F Signup and view all the answers

Sharps in the decontamination department should be confined and contained in what type of leak proof container?

impervious Signup and view all the answers

After thoroughly cleaning a contaminated item, the most important step in the decontamination process is to _____________ the item.

rinse Signup and view all the answers

Humidity level in a CS department should be kept at what percent?

30-60% Signup and view all the answers

Instruments in the OR that are just opened but not used still have to go through the decontamination process, only when?

every time and always considered contaminated Signup and view all the answers

What is the groups or collections of microorganisms that adhere to the surface of any object that comes into contact with nonsterile water?

biofilms Signup and view all the answers

What is extremely corrosive to surgical instruments and its use in the decontamination process is prohibited?

bleach Signup and view all the answers

A pH level of 7 is considered?

neutral Signup and view all the answers

Instruments should never be stored _________________, and all instruments should be sterilized as soon as possible after cleaning.

wet Signup and view all the answers

What should be the air pressure in the decontamination department?

negative Signup and view all the answers

How many air exchanges per hour should the decontamination department have?

10 Signup and view all the answers

How often should the temperature and humidity levels be documented?

daily Signup and view all the answers

What forms a protective slimy film on top of water and on instruments during the decontamination process?

biofilms Signup and view all the answers

A pH level below 7 is considered?

acidic Signup and view all the answers

Items that have been presoaked or treated must be ____________ thoroughly before further cleaning.

rinsed Signup and view all the answers

A pH level above 7 is considered?

alkaline Signup and view all the answers

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?

lumens, serrated surfaces, difficult-to-reach surfaces Signup and view all the answers

What kind of detergents contain organic substances that assist in the breakdown of protein soils and blood?

enzymatic detergents Signup and view all the answers

When using enzymatic detergents, higher water temperatures are not to be used because it will break down or destroy the enzymes, making them?

less efficient Signup and view all the answers

Temperatures below ______________ all have adverse effects, making enzymes sluggish and reducing their effectiveness.

109° F Signup and view all the answers

Water temperatures of _________________ are best for enzyme-based products.

140°F Signup and view all the answers

Which enzymatic detergent breaks down blood, mucus, feces, and albumin?

protease Signup and view all the answers

Which enzymatic detergent breaks down fat (e.g., bone marrow and adipose tissue)?

lipase Signup and view all the answers

Which enzymatic detergent catalyzes starches and breaks down carbohydrates?

amylase Signup and view all the answers

What kind of detergents can be used to remove severe stains on stainless steel instruments?

organic acid Signup and view all the answers

What kind of cleaning agents are available for removing stubborn soils and stains but must be thoroughly rinsed away?

non-abrasive Signup and view all the answers

What are organic compounds, made from products found in nature, that are poor cleaners by themselves?

soaps Signup and view all the answers

There must be some type of action that enhances the cleaning process, such as ____________ on the surfaces.

friction Signup and view all the answers

What type of items must be opened during the cleaning process?

hinged Signup and view all the answers

What type of equipment cannot be immersed?

powered Signup and view all the answers

Manual cleaning may be the only effective method for certain instrumentation such as devices with?

lumens Signup and view all the answers

Detergents that are meant to bind with soils and keep them suspended in the solution are used for what type of cleaning?

manual Signup and view all the answers

Using more detergent than called for does not improve the cleaning action; in fact, it can impede the process by causing instruments to?

bind and/or corrode Signup and view all the answers

Detergent solutions must be changed frequently to reduce the bioburden (contamination) and to prevent?

recontamination Signup and view all the answers

Just as cleaning is the most important step in the decontamination process, what is the most important step in the cleaning process?

rinsing Signup and view all the answers

For either manual or mechanical cleaning, the final rinse should be performed with what type of water to prevent mineral deposits?

treated Signup and view all the answers

What kind of bristle brushes are not generally recommended because they can damage the protective layer of surgical instruments?

metal Signup and view all the answers

To maintain accreditation and receive payments from insurance companies, a healthcare facility must pass the?

JC inspection Signup and view all the answers

What kind of pads should not be used because they will scratch device surfaces?

abrasive Signup and view all the answers

What are not acceptable for use, because they harbor bacteria and break apart during use?

sponges Signup and view all the answers

To prevent the formations of __________________ all cleaning implements should be regularly cleaned and disinfected or sterilized.

biofilms Signup and view all the answers

This is an automated cleaning equipment that transmits sound waves through a cleaning solution.

ultrasonic Signup and view all the answers

This mechanical action is called ___________________ and is very effective in cleaning hard-to-reach areas.

cavitation Signup and view all the answers

This type of detergent has a pH level higher than 11.

highly alkaline Signup and view all the answers

To reduce the potential of corrosion, highly alkaline detergents are used in a multistep process: first the alkaline wash, then a ______________________.

neutralizing acid rinse Signup and view all the answers

What should not be placed over instruments?

bowls and emesis basins Signup and view all the answers

What type of chemicals are used to process endoscopes for immediate reuse?

high-level disinfectants Signup and view all the answers

Cart washers are mechanical cleaners that _________________ metal surgical case carts and supply carts.

sanitize Signup and view all the answers

What types of instruments present unique challenges for cleaning because of their design?

orthopedic Signup and view all the answers

All orthopedic sets should be soaked in what type of enzyme solution?

lipolytic Signup and view all the answers

All instruments and devices received from another facility or company must be considered contaminated and should be completely?

reprocessed Signup and view all the answers

Who is required to provide the instructions for cleaning and sterilization?

manufacturer Signup and view all the answers

Where is the first area to accept responsibilities into the healthcare facility?

receiving Signup and view all the answers

Loaner sets are often multi-level; if so, each level should be cleaned how?

separately Signup and view all the answers

When instruments are 'opened but not used' and returned to the CS/SPD, they are considered?

contaminated Signup and view all the answers

To prevent damage, powered equipment should never be immersed in a solution, or come in contact with what type of solution?

saline Signup and view all the answers

Instruments should never be placed on top of fiberoptic cables because of the _______ inside could be damaged.

glass rods Signup and view all the answers

What type of endoscopes are extremely difficult to clean because of their numerous small channels?

flexible Signup and view all the answers

Flexible endoscopes must always be _________________ before any manual pre-cleaning is performed.

leak-tested Signup and view all the answers

The scope should be flushed with ____________ isopropyl alcohol to facilitate drying.

70% Signup and view all the answers

Toxic anterior segment syndrome (TASS) is an acute inflammation after what type of surgery?

cataract Signup and view all the answers

A simple test for ultrasonic cleaners is to place a piece of what in the unit?

aluminum foil Signup and view all the answers

According to this organization, the efficacy of cleaning processes should be verified regularly.

JC Signup and view all the answers

What process kills most microorganisms but not necessarily bacterial spores?

disinfection Signup and view all the answers

What method of destruction is required to destroy prions?

extended sterilization Signup and view all the answers

What method of destruction is required for bacterial spores?

sterilization Signup and view all the answers

What method of destruction is required for mycobacteria (tuberculosis)?

high-level disinfection Signup and view all the answers

What level of disinfection is required for nonlipid, small viruses?

intermediate level disinfection Signup and view all the answers

What is the method of destruction required for fungi?

intermediate level disinfection Signup and view all the answers

What level of destruction is required for vegetative bacteria?

low level disinfection Signup and view all the answers

What level of destruction is required for lipid, medium-sized viruses?

low level disinfection Signup and view all the answers

In order for the disinfectant to enter the cell, there must be a balance that allows for the process of?

osmosis Signup and view all the answers

This type of disinfectant is a low-level, environmental disinfectant effective against gram-positive bacteria.

Quaternary ammonium compounds Signup and view all the answers

This solution is severely corrosive and should never be used on surgical instruments.

bleach Signup and view all the answers

What halogen is generally used as a skin antiseptic?

iodine Signup and view all the answers

What solution is used to prepare skin before surgery when mixed with detergents?

idophors Signup and view all the answers

What formulations can stain and cause burns if allowed to pool on the skin?

iodine Signup and view all the answers

This is a carbolic-acid-based product effective against vegetative bacteria, fungi, and TB:

phenolics Signup and view all the answers

This disinfectant should not be used for surgical instrumentation as it can irritate the skin?

phenolics Signup and view all the answers

This product is an effective antiseptic and sanitizer capable of killing a variety of bacteria, mycobacteria, and fungi.

glutaraldehyde Signup and view all the answers

This high-level disinfectant is used on immersible items such as flexible and rigid endoscopes.

glutaraldehyde Signup and view all the answers

Although compliance with AAMI standards are not legally required, AAMI standards for sterilization are recognized as what type of practice?

good practice Signup and view all the answers

What is an established norm determined by opinion, authority, research, and/or theory?

standard Signup and view all the answers

This type of flow is how people move through the department.

people flow Signup and view all the answers

What should you do if an instrument salesmen enters the CSPD area without proper attire?

Explain to the sales rep the policy and show him where the proper attire is located. Signup and view all the answers

HIPAA states that all patient information is confidential. Who has the right to confidential patient information?

The people responsible for providing direct patient care of the patient. Signup and view all the answers

This type of control limits access to the CS/SPD department.

traffic control Signup and view all the answers

These statements are based on sound principles of practice that are based upon scientific data and opinions of experts.

recommended practice Signup and view all the answers

American National Standards developed by the Association for the Advancement of Medical Instrumentation (AAMI) is an example of a?

standard Signup and view all the answers

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.
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

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

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.