Questions and Answers
How does one determine what type of physical or chemical agent to use to destroy microorganisms on an article?
Agent to be employed depends on the intended use of the article.
List two diseases that are caused by bacteria that produce spores.
Botulism and tetanus.
What are the characteristics of bacterial spores?
Spores represent a resting and protective stage of the bacterial cell and are more resistant to drying, sunlight, heat, and disinfectants.
What is the purpose of the Hazard Communication Standard?
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What is the difference between a health hazard and a physical hazard?
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What is the purpose of the Globally Harmonized System of Classification and Labeling of Chemicals (GHS)?
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List four examples of hazardous chemicals that may be used in the medical office.
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What information must be included on a hazardous chemical label?
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What is the purpose of a GHS signal word?
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What is the meaning of the following GHS signal words: Danger and Warning?
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What is the difference between a GHS hazard statement and a GHS precautionary statement?
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What is a GHS hazard pictogram and what is its purpose?
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List and briefly describe the information that must be included in a Safety Data Sheet.
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What is the purpose of sanitizing an article?
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What is the advantage of using the ultrasound method to clean instruments?
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Why should gloves be worn during the sanitization procedure?
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Why should instruments be handled carefully?
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Why should a chemical not be used past its expiration date?
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Why must a cleaning agent with a neutral pH be used to sanitize instruments?
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What type of brush should be used to clean the surface of an instrument?
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What type of brush should be used to clean grooves, crevices, or serrations?
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How should each of the following be checked for defects and proper working condition?
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What is the purpose of lubricating an instrument?
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What is the definition of high-level disinfection?
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List one example of an item that requires high-level disinfection and one example of a high-level disinfectant.
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List two examples of items that can be disinfected through intermediate-level disinfection.
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What is the purpose of sterilization?
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What is a critical item? List examples of critical items.
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What is the purpose of the pressure used in the autoclaving process?
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Why is it important that all air be removed from the autoclave during the sterilization process?
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What temperature and pressure are the most commonly used to sterilize materials with the autoclave?
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What information does the CDC recommend be recorded in an autoclave log regarding each cycle?
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What is the purpose of a sterilization indicator?
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What should be done if a sterilization indicator does not change properly?
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How should sterilization indicators be stored?
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What are the advantages and disadvantages of autoclave tape?
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How should a sterilization strip be placed in a wrapped pack?
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How often should a biological indicator be used to monitor an autoclave?
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What is the purpose of wrapping articles to be autoclaved?
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List two properties of a good wrapper for use in autoclaving.
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List three examples of wrapping materials used for the autoclave and identify an advantage of each type.
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Why shouldn't tap water be used to fill the water reservoir of an autoclave?
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How should small packs be positioned in the autoclave?
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How should large packs be positioned in the autoclave?
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How should jars and glassware be positioned in the autoclave?
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How should sterilization pouches be positioned in the autoclave?
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Why is more time needed to autoclave a large minor office surgery pack?
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What determines the amount of time required to sterilize articles in the autoclave?
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Why must a sterilized load be allowed to dry before it is removed from the autoclave?
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What is event-related sterility?
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How should sterilized packs be stored?
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Describe the care an autoclave should receive on a daily basis.
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Why is a longer exposure period needed to ensure sterilization when using the dry-heat oven?
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What effect does moist heat have on instruments with sharp cutting edges?
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How does the medical manufacturing industry use ethylene oxide gas sterilization?
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What guidelines must be followed when using cold sterilization?
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Study Notes
Microorganism Destruction Methods
- Selection of agents for destroying microorganisms depends on the article’s intended use.
Bacterial Diseases
- Botulism and tetanus are diseases caused by spore-forming bacteria.
Characteristics of Bacterial Spores
- Bacterial spores are dormant and protective, exhibiting high resistance to harsh conditions such as drying, heat, sunlight, and disinfectants.
Hazard Communication Standard
- Promotes employee awareness of chemical hazards in the workplace and outlines necessary precautions.
Health Hazards vs. Physical Hazards
- Health hazards: Chemical potential for acute toxicity, skin corrosion, eye damage, respiratory sensitization, mutagenicity, carcinogenicity, reproductive toxicity.
- Physical hazards: Risk of fire, explosion, or reactive incidents with other materials.
Globally Harmonized System (GHS)
- GHS standardizes chemical classification and labeling globally using pictograms, hazard warnings, and signal words.
Hazardous Chemicals in Medical Offices
- Examples include chemical disinfectants, autoclave cleaners, laboratory reagents, and local anesthetics.
Hazardous Chemical Label Requirements
- Must include product identifier, supplier info, GHS signal word, hazard statements, pictograms, precautionary statements, and supplementary information.
GHS Signal Words
- Danger: Indicates severe hazard potential.
- Warning: Signifies less severe but potentially harmful hazards.
GHS Hazard vs. Precautionary Statements
- Hazard statement: Describes the chemical's hazards.
- Precautionary statement: Provides measures to minimize risks or injuries related to the chemical.
GHS Hazard Pictograms
- Standardized symbols for quick recognition of hazards associated with chemicals.
Safety Data Sheet (SDS) Information
- Covers identification, hazard assessments, first-aid measures, fire-fighting recommendations, handling/storage precautions, and disposal guidance.
Purpose of Sanitization
- Reduces microorganisms on an article to a safe level by removing organic matter.
Advantages of Ultrasound Cleaning
- Enhances safety by eliminating the need to handle instruments during cleaning, minimizing injury risks.
Importance of Gloves During Sanitization
- Protects hands from hazardous materials and sharp instruments.
Careful Instrument Handling
- Prevents damage and maintains functionality.
Expired Chemicals
- Using outdated chemicals may result in loss of effectiveness.
Neutral pH Cleaning Agents
- Essential to prevent staining on instruments.
Instrument Cleaning Brushes
- Nylon brush: For instrument surfaces.
- Stainless steel wire brush: For grooves and serrations.
Checking Instrument Condition
- Ensure blades are straight, tips approximate tightly, box locks function correctly, cutting edges are smooth, and scissors cut cleanly.
Purpose of Lubrication
- Enhances instrument performance and longevity.
High-Level Disinfection Definition
- Destroys all microorganisms except bacterial spores.
High-Level Disinfection Example
- Flexible fiberoptic sigmoidoscope requires high-level disinfection; glutaraldehyde is a common disinfectant.
Intermediate-Level Disinfection Items
- Stethoscopes and blood pressure cuffs can undergo intermediate-level disinfection; ethyl and isopropyl alcohol are examples.
Low-Level Disinfection Items
- Examining tables and lab countertops fall under low-level disinfection.
Purpose of Sterilization
- Completely eradicates all microbial life.
Critical Items
- Items contacting sterile tissue or the vascular system, like surgical instruments.
Autoclaving Process Pressure
- Higher pressure allows steam to reach higher temperatures for effective sterilization.
Importance of Air Removal in Autoclave
- Air presence reduces temperature and inhibits effective sterilization.
Common Autoclave Temperature and Pressure
- Standard conditions are 250°F at 15 psi.
CDC Recommendations for Autoclave Records
- Log includes date, load description, exposure conditions, sterilization indicators, and operator initials.
Sterilization Indicator Purpose
- Validates sterilization effectiveness and checks handling or equipment issues.
Actions for Unchanged Sterilization Indicators
- Review manufacturer's guidelines and reprocess items for sterilization.
Sterilization Indicator Storage
- Keep in a cool, dry environment.
Autoclave Tape Advantages/Disadvantages
- Advantages: Available in various colors and can be written on.
- Disadvantages: Does not guarantee steam penetration or item sterilization.
Sterilization Strip Placement
- Centered in wrapped packs, with dye-end positioned where steam penetration is hardest.
Biological Indicator Frequency
- Must be used weekly to monitor autoclave efficacy.
Article Wrapping Purpose for Autoclaving
- Protects against recontamination during handling and storage.
Good Wrapper Properties
- Not affected by sterilization and allows steam penetration while blocking contaminants.
Autoclave Wrapping Materials
- Sterilization paper: Disposable and inexpensive.
- Sterilization pouches: Provide visibility and include sterilization indicators.
- Muslin: Reusable and economical.
Avoiding Tap Water in Autoclave Reservoir
- Contains minerals that can corrode autoclave parts.
Autoclave Positioning for Items
- Small packs: 1-3 inches apart, large packs: 2-4 inches apart, jars: on sides without lids, pouches: paper-side up.
Larger Surgery Pack Autoclaving Time
- Increased time due to steam penetration challenges.
Factors Determining Autoclave Sterilization Time
- Dependent on the type of items being sterilized.
Drying Sterilized Loads
- Allowing drying prevents contamination via moisture.
Event-Related Sterility
- Packs considered sterile unless compromised by an event like crushing.
Sterilized Pack Storage
- Store in clean, dry areas, placing the latest sterilized items at the back.
Daily Autoclave Care
- Wipe exterior and interior with mild detergent, inspect rubber gaskets for damage.
Dry-Heat Oven Sterilization Time
- Longer exposure required due to heightened resistance of microorganisms to dry heat.
Effect of Moist Heat on Sharp Instruments
- Dulls sharp cutting edges during sterilization.
Ethylene Oxide Gas Sterilization in Manufacturing
- Utilized for disposable medical items like syringes and catheters.
Cold Sterilization Guidelines
- Use EPA-designated sterilants, submerge for 6-24 hours, restart timing with each new instrument.
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Test your knowledge on the characteristics of bacterial spores, the diseases they can cause, and the appropriate agents for their destruction. This quiz will cover crucial concepts in microbiology related to spore-forming bacteria.