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Questions and Answers
What is the primary purpose of the assembly area in the CSSD?
What is the primary purpose of the assembly area in the CSSD?
Who should carry out the job in the inspection, assembly, and packaging area?
Who should carry out the job in the inspection, assembly, and packaging area?
What is the primary purpose of maintaining a positive pressure in the IAP?
What is the primary purpose of maintaining a positive pressure in the IAP?
What is the required temperature range for the IAP?
What is the required temperature range for the IAP?
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What is the purpose of environmental cleaning in the IAP?
What is the purpose of environmental cleaning in the IAP?
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What type of materials should furniture in the IAP be made of?
What type of materials should furniture in the IAP be made of?
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What is the required ventilation standard for the IAP?
What is the required ventilation standard for the IAP?
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What is the relative humidity range required for the IAP?
What is the relative humidity range required for the IAP?
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Why is it recommended to inspect devices under magnification?
Why is it recommended to inspect devices under magnification?
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What should be checked in devices with hinges, such as artery forceps and clamps?
What should be checked in devices with hinges, such as artery forceps and clamps?
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What is the purpose of checking cannulated devices?
What is the purpose of checking cannulated devices?
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Why is it essential to inspect devices with outer insulation coatings?
Why is it essential to inspect devices with outer insulation coatings?
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What is the recommended method for inspecting insulated devices?
What is the recommended method for inspecting insulated devices?
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What is the purpose of function checking telescopes and light cables?
What is the purpose of function checking telescopes and light cables?
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What is the consequence of damaged surfaces on insulated devices?
What is the consequence of damaged surfaces on insulated devices?
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What is the main purpose of checking the devices for free movement of all parts and non-sticking joints?
What is the main purpose of checking the devices for free movement of all parts and non-sticking joints?
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What is the recommended lubricant to use on devices if required?
What is the recommended lubricant to use on devices if required?
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Why is it important to check the edges of clamping RMD for overlap?
Why is it important to check the edges of clamping RMD for overlap?
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What is the purpose of checking all screws on jointed RMD for tightness?
What is the purpose of checking all screws on jointed RMD for tightness?
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What is the purpose of the track and trace system in CSSD?
What is the purpose of the track and trace system in CSSD?
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What is produced each time a new processing cycle begins in the track and trace system?
What is produced each time a new processing cycle begins in the track and trace system?
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What is scanned by the specialist preparing the tray in the track and trace system?
What is scanned by the specialist preparing the tray in the track and trace system?
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What is used in CSSDs that do not have a computerized track and trace system?
What is used in CSSDs that do not have a computerized track and trace system?
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What is a potential consequence of introducing lint to the sterile field?
What is a potential consequence of introducing lint to the sterile field?
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Why is daily environmental cleaning essential in the hospital?
Why is daily environmental cleaning essential in the hospital?
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What is the purpose of microbiological monitoring in the IAP room?
What is the purpose of microbiological monitoring in the IAP room?
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What is the significance of comparing testing results to baseline counts?
What is the significance of comparing testing results to baseline counts?
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Why is it essential to conduct part of the sampling program when the facility is unoccupied?
Why is it essential to conduct part of the sampling program when the facility is unoccupied?
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What is the purpose of using contact or settle plates in microbiological monitoring?
What is the purpose of using contact or settle plates in microbiological monitoring?
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What is the significance of having a dedicated cleaning room within the IAP room?
What is the significance of having a dedicated cleaning room within the IAP room?
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Who determines the accepted levels of contamination in the IAP room?
Who determines the accepted levels of contamination in the IAP room?
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What is the primary purpose of wearing shoes cover in the department?
What is the primary purpose of wearing shoes cover in the department?
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What is the maximum temperature that can be reached inside the washer-disinfector chamber?
What is the maximum temperature that can be reached inside the washer-disinfector chamber?
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Why is it necessary to wear heat-resistant gloves when unloading the washer-disinfector?
Why is it necessary to wear heat-resistant gloves when unloading the washer-disinfector?
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What is the purpose of quality checks during the unloading process?
What is the purpose of quality checks during the unloading process?
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What should be done if the utensils show soil or staining during visual inspection?
What should be done if the utensils show soil or staining during visual inspection?
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What happens if the spray arms were blocked by RMD during the cycle?
What happens if the spray arms were blocked by RMD during the cycle?
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What should be done if a container cycle was inadvertently used for instruments?
What should be done if a container cycle was inadvertently used for instruments?
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Why should utensils like gallipots or kidney dishes be handled carefully during unloading?
Why should utensils like gallipots or kidney dishes be handled carefully during unloading?
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What could be the cause of excessive wetness during the WD process?
What could be the cause of excessive wetness during the WD process?
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What should be done if a device was not properly disassembled in the wash area?
What should be done if a device was not properly disassembled in the wash area?
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What should be reported to the line manager in case of nonconformances?
What should be reported to the line manager in case of nonconformances?
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Why should the specialist document nonconformances?
Why should the specialist document nonconformances?
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What determines what happens to the load next after unloading?
What determines what happens to the load next after unloading?
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What should be checked during the unloading process?
What should be checked during the unloading process?
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What is the consequence of a blockage in the spray arm rotation?
What is the consequence of a blockage in the spray arm rotation?
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Why is it necessary to document nonconformances and rejected loads?
Why is it necessary to document nonconformances and rejected loads?
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Why is it necessary to make a visual inspection of the load after the washing cycle?
Why is it necessary to make a visual inspection of the load after the washing cycle?
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What should be done if a small percentage of RMD in a load were not cleaned and/or dried effectively?
What should be done if a small percentage of RMD in a load were not cleaned and/or dried effectively?
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What is the purpose of manually cleaning and inspecting devices that were not processed in a WD?
What is the purpose of manually cleaning and inspecting devices that were not processed in a WD?
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What should be reported immediately to the line manager?
What should be reported immediately to the line manager?
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Why is it necessary to document manually cleaned items and any nonconformances?
Why is it necessary to document manually cleaned items and any nonconformances?
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What is the consequence of not properly disassembling devices?
What is the consequence of not properly disassembling devices?
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What should be done if items were not processed in a WD?
What should be done if items were not processed in a WD?
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What is the purpose of checking items for excessive wetness?
What is the purpose of checking items for excessive wetness?
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What is the primary purpose of maintaining a controlled environment in the IAP?
What is the primary purpose of maintaining a controlled environment in the IAP?
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What is the primary consequence of introducing lint to the sterile field in the IAP room?
What is the primary consequence of introducing lint to the sterile field in the IAP room?
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What is the significance of using smooth non-porous easy to clean materials for furniture in the IAP?
What is the significance of using smooth non-porous easy to clean materials for furniture in the IAP?
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What is the purpose of ventilation in the IAP?
What is the purpose of ventilation in the IAP?
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Why is it essential to carry out environmental cleaning on a daily basis in the IAP room?
Why is it essential to carry out environmental cleaning on a daily basis in the IAP room?
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What is the primary purpose of microbiological monitoring in the IAP room?
What is the primary purpose of microbiological monitoring in the IAP room?
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What is the requirement for environmental cleaning in the IAP?
What is the requirement for environmental cleaning in the IAP?
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What is the significance of maintaining a positive pressure in the IAP?
What is the significance of maintaining a positive pressure in the IAP?
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What is the significance of comparing testing results to baseline counts in microbiological monitoring?
What is the significance of comparing testing results to baseline counts in microbiological monitoring?
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Why is it essential to conduct part of the sampling program when the facility is unoccupied?
Why is it essential to conduct part of the sampling program when the facility is unoccupied?
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What is the requirement for the inspection area in the IAP?
What is the requirement for the inspection area in the IAP?
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What is the purpose of using contact or settle plates in microbiological monitoring?
What is the purpose of using contact or settle plates in microbiological monitoring?
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What is the purpose of having a controlled temperature range in the IAP?
What is the purpose of having a controlled temperature range in the IAP?
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What is the requirement for the relative humidity range in the IAP?
What is the requirement for the relative humidity range in the IAP?
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What is the significance of having a dedicated cleaning room within the IAP room?
What is the significance of having a dedicated cleaning room within the IAP room?
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Who determines the accepted levels of contamination in the IAP room?
Who determines the accepted levels of contamination in the IAP room?
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What is the primary consideration when arranging devices in a tray?
What is the primary consideration when arranging devices in a tray?
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Why should forceps be placed on instrument pins?
Why should forceps be placed on instrument pins?
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What should be done with devices that have ratchets after assembly?
What should be done with devices that have ratchets after assembly?
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Why is it important to follow the manufacturer's IFU for devices?
Why is it important to follow the manufacturer's IFU for devices?
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What is the primary purpose of the checklist in a tray?
What is the primary purpose of the checklist in a tray?
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How should devices be arranged in a tray according to the surgeon's preference?
How should devices be arranged in a tray according to the surgeon's preference?
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Why should devices be arranged in a specific order in a tray?
Why should devices be arranged in a specific order in a tray?
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What is the purpose of verifying the contents of a tray against the checklist?
What is the purpose of verifying the contents of a tray against the checklist?
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Study Notes
Inspection, Assembly, and Packaging (IAP)
- IAP area is a clean area in CSSD where surgical instruments are inspected for intactness, cleanliness, and functionality.
- The job in this area is critical as surgical instruments will be handled for the last time before being dispensed to OR rooms or clinics.
- The area where inspection takes place is designated and controlled to optimize the effect of sterilization process and minimize the risk of contamination.
Environmental Requirements for IAP
- Ventilation for the inspection, assembly, and packing room meets clean room standards according to ISO 14644-1: 1999 Class 8 or other internationally accepted equivalent standard.
- The room must be maintained under positive pressure to ensure that air flows outward instead of into the work area whenever the doors are opened.
- All rooms in the department are ventilated and controlled to provide a comfortable working environment of 20-23°C and a relative humidity within the range 30-60%.
- Environmental cleaning must follow policies and procedures approved by the hospital infection control committee.
- Furniture in this area must be made of smooth, non-porous, easy-to-clean materials.
Inspection and Function Testing
- All surgical devices unloaded from the washer-disinfector must be inspected for cleanliness, stains, corrosion, cracks, breakage, and stiffness of movable parts before being placed in device sets.
- Devices should be checked under magnification to detect small pieces of bioburden or debris.
- Each RMD from a set should be inspected separately.
- Critically inspect all areas of devices, including box joints, serrations, and crevices, for cleanliness.
- Check hinges, jaws, and teeth for ease of movement and alignment.
- Report any damaged, incomplete, or malfunctioning devices immediately to the supervisor.
Assembly and Checking
- Once devices have been inspected and function-tested, they are ready to be assembled into their respective trays.
- A track and trace system allows for accurate tracking of devices and device trays through the decontamination process.
- The system consists of handheld barcode readers connected to PCs that log and store information for each tray.
Microbiological Monitoring
- Microbiological monitoring is carried out in the IAP room according to hospital infection control policies.
- Monitoring is used as an early warning system to alert staff when environmental quality is drifting out of control.
- One method of monitoring involves placing contact or settle plates in pre-planned locations in the room and sending them to the lab for culturing and analysis.
Washer-Disinfector (WD) to Sterilizer
- Quality checks are carried out when unloading the washer-disinfector, including correct cycle, spray arms not blocked, and no soil or staining.
- Fine fibers that compose lint can be carried by air currents and settle on clean surgical instruments, causing infection to patients' wounds.
Manually Cleaned Device Acceptance
- Quality checks must also be carried out when accepting items that were not processed in a WD, including soil or staining, excessive wetness, damage, and correctly disassembled devices.
- Documentation must be completed for manually cleaned items, including non-conformances and rejected items.
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Description
Test your knowledge of the CSSD's critical inspection, assembly, and packaging area where surgical instruments are prepared for use in OR rooms and clinics. Learn about the importance of trained specialists and adherence to manufacturer's instructions.