Decontamination Zone and Spaulding Classifications

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Questions and Answers

What is the minimum acceptable level of reprocessing for semi-critical medical devices?

Low Level Disinfection

Sterilization after each use

Cleaning with soap and water

High Level Disinfection (correct)

Which type of medical device requires sterilization at the time of use?

Non-critical device

Critical device (correct)

Semi-critical device

Single-use device

In the Spaulding classification system, which device would be classified as non-critical?

Stethoscope (correct)

Parkes retractor

Thermometer

Travers retractor

Which step is not part of the surgical instrument processing steps?

Automated Disassembly Signup and view all the answers

What is required for reusable medical devices used in high-risk procedures?

Reprocessing to a validated level Signup and view all the answers

What is the primary purpose of sorting and disassembling reusable medical devices (RMD) after they are used?

To facilitate timely cleaning and minimize risks to the decontamination specialist Signup and view all the answers

Which of the following practices ensures that reusable medical devices are cleaned effectively after disassembly?

Arranging devices so that all surfaces are exposed during cleaning Signup and view all the answers

What is a critical aspect to remember when using automated cleaners for RMD?

Heavy medical devices should be loaded into a separate tray or at the bottom Signup and view all the answers

What should be done if extra mesh baskets are needed for cleaning a set of RMD?

Label the extra baskets with the set name and number for identification Signup and view all the answers

Which of the following statements regarding policies for handling RMD is correct?

Policies should be developed for the handling, sorting, and disassembly of all devices Signup and view all the answers

What is the preferred temperature range for the wash and rinse sinks in the immersion method?

Below 40C Signup and view all the answers

Why is it important to use brushes under water during the cleaning process?

To avoid splashing and aerosols Signup and view all the answers

Which of the following types of detergent should be avoided for manual cleaning of devices?

Household soap Signup and view all the answers

What should be done if single-use brushes are not utilized during the cleaning process?

They must be decontaminated at least daily Signup and view all the answers

Which of the following is crucial to ensure effective manual cleaning of devices?

Following written procedures and wearing PPE at all times Signup and view all the answers

Study Notes

Decontamination Zone Overview

This zone details decontamination zone and equipment required for thorough cleaning.
All reusable medical devices (RMDs) must be decontaminated after use.
Decontamination processes need validating and reprocessing for appropriate intended use.
The appropriate level depends on body sites and procedure risk.

Spaulding Classifications

A classification system for minimum processing levels based on three risk categories.
Risk categories, using examples, include:
- Non-critical (stethoscope)
- Semi-critical (Parkes retractor)
- Critical (Travers retractor)

Minimum Inactivation Levels

Skin surface (non-invasive): Non-critical, cleaned and/or low/intermediate level disinfection
Mucous membranes/non-intact skin: Semi-critical, high-level disinfection, sterile areas
Critical (blood contact): Sterilization

Surgical Instrument Processing Steps

Must follow established department protocol.
Pre-preparation: wiping and keeping moist.
Cleaning steps. (Cleaning, ultrasonic cleaning, sterilization care and washer).
Additional steps. (sorting and disassembly)
Specific actions for all medical device types. (Open locks and hinges, place in mesh basket appropriately).
Secure small items and heavy items in different places.

Disinfection

Two types: thermal and chemical
Thermal disinfection: Achieved in a thermal washer-disinfector by choosing appropriate cycle.
Chemical disinfection: Achieved using compatible RMD-grade disinfectant.
Adequate processes are validated microbiologically.
Disinfection eliminates many or all pathogenic micro-organisms.

Drying Procedures

Drying minimizes rusting, staining, and recontamination risk
RMDs should be dried in a sloping position in a drying cabinet
Use a clean wipe if a cabinet is unavailable
Take care not to exceed manufacturer's temperature tolerances

Process Chemicals

Choice of process chemicals must be compatible. (device, equipment, intended use).
Chemicals should be non-abrasive, low-foaming, free-rinsing, biodegradable, non-toxic, easily dissolving/dispersing soil, and economical.
Dosage should be determined and validated during commissioning.

Water Quality

Water quality critical and must meet device and process requirements
Periodic tests required for washer-disinfectors.
Daily, weekly, and quarterly tests required for various checks, calibration and other assessments.

Cleaning Efficacy Tests

Tests ensure the cycle can adequately clean heavily soiled loads.
Tests must use correct process challenge device (PCD) as recommended by manufacturer
Tests include (examples): TOSI-protein test, Hemo-check test, Brownes test, Ninhydrin test, and Foil test.

Disposal Procedures

Important to follow manufacturer instructions for disposal, and proper certification of destruction for disposal.

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Description

Explore the essentials of the decontamination zone, including equipment and processes necessary for cleaning reusable medical devices. Learn about the Spaulding classifications and the required minimum inactivation levels based on risk categories. This quiz is crucial for understanding proper surgical instrument processing protocols.