Questions and Answers
Explain the difference between a Class 3 chemical indicator and a Class 5 chemical indicator.
Class 3 Chemical Indicator refers to a single parameter of the sterilization process whereas a Class 5 Chemical Indicator refers to all the parameters of a sterilization process.
Provide an example of an item that falls into each of the Spaulding Classification categories and rationale for that classification: Critical, Semi-critical, Noncritical.
Define sterile.
Absence of all living microorganisms including spores.
Define aseptic.
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Define sterile field.
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Define sterile technique.
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Define aseptic practices.
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What are the goals of sterile technique and aseptic practices?
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Define surgical conscience.
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Risk factors which contribute to surgical site infections include: ______
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What is a clean wound?
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What is a clean-contaminated wound?
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What is a contaminated wound?
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What is a dirty wound?
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What are the three categories of the Spaulding Classification system?
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Compare and contrast sterilization, disinfection, and decontamination.
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What are the steps of sterilization?
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What are the three AORN guidelines for cleaning and care of surgical instruments?
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What are the objectives of cleaning?
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Name the four principles of decontamination.
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Name some types of sterilization techniques.
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Name some automated cleaning and decontamination devices.
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When is immediate-use steam sterilization used?
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Name the two basic types of steam sterilizers.
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What are the four parameters required that affect the steam sterilization process?
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After steam sterilization, how long should items not be moved or touched?
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Define IUSS.
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What is PCD?
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What is biological monitoring?
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What is peracetic acid sterilization?
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What is ethylene oxide sterilization?
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What are the primary variables dependent on complete ethylene oxide sterilization?
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What is low-temperature hydrogen peroxide gas plasma sterilization?
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What are the six classes of chemical indicators?
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What class chemical integrating indicator should be run with the load including a surgical implant?
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Perioperative documentation of implants should include:
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What is the FDA time definition for implants?
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What is FIFO?
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What are the conditions that are important considerations in maintaining the sterility of an item?
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Define disinfection.
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Define decontamination.
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Define sterilization.
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Define high-level disinfection.
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The length of time an item is considered sterile depends on factors that include:
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Study Notes
Chemical Indicators
- Class 3 indicators: Measure a single parameter of the sterilization process.
- Class 5 indicators: Evaluate all parameters of the sterilization process.
Spaulding Classification
- Critical Items: Instruments like forceps that enter sterile areas; require sterilization.
- Semi-Critical Items: Scopes that contact mucous membranes; require high-level disinfection.
- Non-Critical Items: BP cuffs that contact intact skin; require intermediate to low-level disinfection.
Definitions
- Sterile: Complete absence of all living microorganisms, including spores.
- Aseptic: Absence of pathogenic microorganisms.
- Sterile Field: Area ready for invasive procedures, covered by sterile drapes and attended by sterile-clad personnel.
- Sterile Technique: Actions to prevent contamination and maintain sterility during procedures.
- Aseptic Practices: Protocols to prevent microbial contamination.
Goals of Techniques
- Prevent Surgical Site Infections (SSI).
- Optimize primary wound healing.
- Minimize recovery time from surgery.
Surgical Conscience
- Adherence to aseptic principles is crucial; any compromise increases infection risk.
Risk Factors for Infections
- Pre-existing infections, surgical technique, duration/type of surgery, and overall patient condition.
Wound Classification
- Class I (Clean Wound): No inflammation; respiratory/alimentary tracts not entered; examples include eye surgery and hernia repairs.
- Class II (Clean-Contaminated Wound): Controlled entry into the respiratory/alimentary tracts; examples include D&C and laparoscopic surgeries.
- Class III (Contaminated Wound): Open wounds with major sterile technique breaks; examples include traumatic wounds and surgeries that encounter acute inflammation.
- Class IV (Dirty/Infected Wound): Old wounds with infected tissue and existing clinical infections.
Sterilization and Disinfection
- Sterilization: Destroys all microorganisms.
- Disinfection: Destroys pathogenic microorganisms, not spores.
- Decontamination: Reduces bioburden and contaminants.
Steps of Sterilization
- Cleaning, Decontamination, Assembly, Packaging, Sterilization, Storage, Transportation.
Cleaning Objectives
- Removal of visible and invisible soil, preparation for sterilization, and ensuring safety.
Decontamination Principles
- Enzymatic wash, appropriate detergents, cool water rinses, and disassembly of instruments.
Sterilization Techniques
- Methods include saturated steam, chemical sterilization, ethylene oxide, and low-temperature hydrogen peroxide.
Biological Monitoring
- Confirms sterilization effectiveness; no growth indicates appropriate parameters met.
Peracetic Acid Sterilization
- Environmentally safe, low-temperature of liquid chemical sterilization agent; similar efficacy to steam.
Ethylene Oxide Sterilization
- Effective on moisture/heat-sensitive items, but requires aeration and poses significant health risks.
Immediate Use Steam Sterilization (IUSS)
- Used when there isn't enough time for the preferred sterilization method; requires adherence to strict conditions.
Equipment for Sterilization and Cleaning
- Automated devices like ultrasonic cleaners and washer-disinfectors ensure efficient decontamination.
Chemical Indicators Classes
- Range from Class 1 (package exposure) to Class 6 (specific cycle parameters).
FDA Definitions and Guidelines
- Implants: Remain in the body over one year; documentation must include extensive details.
Environmental Considerations for Sterility
- Cleanliness, temperature (72-78°F), air exchange (min. 4/hour), and humidity (60-70%) critical for maintaining sterility.
First in, First Out (FIFO)
- Stock rotation method for maintaining sterile item integrity.
High-Level Disinfection
- Destroys all vegetative microorganisms with some resistance to bacterial spores.
Factors Affecting Sterility Duration
- Includes the type of packaging, handling frequency, storage conditions, and transport situations.
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Description
This quiz covers essential concepts related to sterilization and infection control, including chemical indicators, the Spaulding classification, and definitions relevant to aseptic practices. It will test your understanding of critical, semi-critical, and non-critical items in healthcare settings, as well as techniques to maintain a sterile environment. Get ready to enhance your knowledge of surgical safety and infection prevention.