Sterilization in Medical Device Reprocessing

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Questions and Answers

What is the first step in the sterilization process?

Instrument Inspection

Sterilization

Decontamination (correct)

Packaging

Which method of sterilization is known for being the oldest and most economical?

Chemical Sterilization Methods

Steam Sterilization (correct)

Immediate-Use Steam Sterilization

Gas Plasma Sterilization

What is one critical factor in steam sterilization that is necessary for destroying microorganisms?

Humidity

Cooling

Time (correct)

Air Pressure

Which sterilization method would be chosen based on item type and required equipment?

Chemical Sterilization Methods Signup and view all the answers

What is the main differentiator between the various types of steam sterilizers?

How air is removed from the chamber Signup and view all the answers

Which of the following steps occurs after decontamination in the sterilization process?

Instrument Inspection Signup and view all the answers

What type of rinsing is typically included in the mechanical decontamination process?

Hot water rinse Signup and view all the answers

Which of the following is a consideration when choosing a sterilization method?

Packaging of the item Signup and view all the answers

What is the primary goal of sterilization in a medical setting?

Freedom from infection Signup and view all the answers

Which of the following definitions accurately describes sterility?

Complete elimination of all forms of microbial life Signup and view all the answers

Which method is NOT a part of the sterilization process?

Thermal Disinfection Signup and view all the answers

Why is it critical to minimize bioburden on surgical instruments before sterilization?

Because it affects cleaning efficacy Signup and view all the answers

Which of the following best describes the roles of the Medical Device Reprocessing Department (MDRD)?

To ensure instruments are sterilized and safe for use Signup and view all the answers

Which test is used to monitor the effectiveness of sterilization processes?

Bowie Dick Leak Test Signup and view all the answers

What is the primary factor that determines how items are reprocessed in the Spaulding Classification System?

The intended use and associated risk of infection Signup and view all the answers

Which of the following practices is NOT recommended during the instrument cleaning process after surgery?

Wiping instruments with unsterile fabric Signup and view all the answers

What is the primary purpose of the Bowie Dick Leak Test?

To ensure steam can penetrate items being sterilized Signup and view all the answers

Which phase in the sterilization process involves packing and loading the sterilizer?

Phase 1 Signup and view all the answers

What is a contraindication for immediate-use steam sterilization (IUSS)?

Implantable devices Signup and view all the answers

What is the required exposure time for destruction of spores at 270F (132C) with 27 lbs of pressure?

2-4 minutes Signup and view all the answers

What is a necessary step after sterilization cooling that ensures items do not become wet?

Packs must cool for at least 30-60 minutes on open racks Signup and view all the answers

Which of the following items is NOT suitable for use in steam sterilizers?

Heat-sensitive instruments Signup and view all the answers

Immediate-use steam sterilization is typically recognized in which of the following scenarios?

Emergency situations Signup and view all the answers

What type of indicators are packed in the Medical Device Reprocessing Department (MDRD)?

External and internal chemical indicators Signup and view all the answers

What does the Bowie Dick test specifically indicate?

It proves air removal sufficiency for steam penetration. Signup and view all the answers

Which option is NOT a characteristic of appropriate packaging for sterilization?

Waterproof and airtight Signup and view all the answers

What is a significant advantage of using ethylene oxide (EO) gas for sterilization?

It is safe for heat-sensitive items. Signup and view all the answers

What is a common disadvantage of chemical sterilization methods?

They can expose users to dangerous chemicals and gases. Signup and view all the answers

What is the maximum temperature for materials in chemical sterilization?

60C (140F) Signup and view all the answers

What is the minimum aeration time required after sterilization with ethylene oxide?

8-12 hours Signup and view all the answers

Which of the following statements about gas plasma sterilization (Sterrad) is true?

It utilizes a plasma cloud to sterilize items. Signup and view all the answers

Which sterilization method generally requires the longest exposure cycle?

Ethylene oxide gas sterilization Signup and view all the answers

What is the primary function of high-level disinfectants?

Kill all microorganisms except spores Signup and view all the answers

How long must glutaraldehyde be used for an item to be considered sterile?

10 hours Signup and view all the answers

What is the correct maximum size for textile packs during sterilization?

12x12x20 inches Signup and view all the answers

Which of the following statements is true regarding chemical indicators?

They should be on each item load and verified by both nurses. Signup and view all the answers

What is the primary challenge posed by prions, such as those causing Creutzfeldt-Jakob Disease (CJD)?

They are highly resistant to conventional sterilization methods. Signup and view all the answers

Which method requires the lumens of instruments to be flushed with water before sterilization?

Steam sterilization Signup and view all the answers

What is necessary for ensuring instruments with screws and stylets are properly prepared for sterilization?

They must be disassembled. Signup and view all the answers

What is a common method for preventing rubber items from sticking together during sterilization?

Separating them from instruments Signup and view all the answers

Study Notes

Sterilization Overview

Sterilization Terminology: Understanding terms related to sterilization, such as "sterile," "high-level disinfection," "bioburden," and "prion."
Study Goals: Aim for freedom from infection; sterilization practices align with infection control policies as per the Canadian Standards Association (CSA).
Critical Role: Medical Device Reprocessing Departments (MDRD) are essential for perioperative nursing care and require certified technicians.

Medical Device Reprocessing (MDRD)

Known as Central Sterilization Department (CSD) or Central Processing Department (CPD).
Responsible for the sterilization and disinfection of medical instruments to prevent infection.
Sterilization is the complete elimination of all microbial life.

Sterilization Process

Efficacy: Dependent on meticulous cleaning of instruments to minimize bioburden, impacting sterilization effectiveness.
Spaulding Classification: Items classified based on intended use and infection risk; influences reprocessing approaches.

Steps in Sterilization

Step 1 - Decontamination: Initial cleaning using manual or mechanical methods (ultrasonic washers).
Step 2 - Inspection: Instruments checked for accuracy and readiness for sterilization.
Step 3 - Testing: Instruments tested to confirm readiness.
Step 4 - Packaging: Items packaged in suitable materials to maintain sterility.
Step 5 - Sterilization: Final sterilization process occurs once items are clean and packed.

Sterilization Methods

Steam Sterilization (Autoclave):
- Most common and economical method.
- Effective under high pressure and temperature for microbial destruction.
Chemical Sterilization:
- Includes Ethylene Oxide (EO), Gas Plasma (Sterrad), Liquid Chemosterilizer (Peracetic Acid), and Irradiation.
- Used for heat-sensitive items; varies by exposure time and safety.

Steam Sterilization

Types: Gravity displacement, pre-vacuum, and immediate-use steam sterilization (IUSS).
Parameters: Depends on moisture, heat, and time; requires proper flushing of lumens for thorough sterilization.
Bowie Dick Leak Test: Daily test to ensure air removal and steam penetration in the autoclave.

Five Phases of Sterilization

Phase 1: Packing and loading autoclave with appropriate wrappers.
Phase 2 & 3: Heating for destruction of spores; printouts document pressure, temperature, and time.
Phase 4: Cooling and drying process to prevent condensation.
Phase 5: Post-sterilization testing with chemical and biological indicators.

Chemical Sterilization Insights

Advantages/Disadvantages:
- Effective for delicate items, but may have harmful exposure risks and lengthy aeration times.
- EO requires specialized handling due to explosiveness and toxicity.
Hydrogen Peroxide Gas Plasma: Non-toxic alternative effective at lower temperatures and faster cycle times.

High-Level Disinfection (HLD)

Kills most microorganisms except spores; important in cleaning semi-critical items.
Glutaraldehyde used for both sterilization and HLD, with varying exposure times determining efficacy.

Best Practices for OR Sterilization

Verification of chemical indicators and documentation of biological indicators by MDRD.
Proper handling of textile packs (size and weight limits) and instrument preparation (disassembly when required).
Lumens must be dry for EO or plasma sterilization; comprehensive training is vital for scrub nurses.

Creutzfeldt-Jakob Disease (CJD)

Fatal neurological disease caused by self-replicating prions impacting brain tissue.
Resistance to conventional sterilization methods necessitates special protocols.
Incubation period ranges from months to decades, emphasizing the need for stringent sterilization practices.

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Description

This quiz covers essential terminology and best practices related to sterilization methods and their importance in the medical device reprocessing department. Participants will compare sterilization with high-level disinfection techniques and learn about protocols to ensure sterility, particularly concerning CJD. Test your knowledge and understanding of these critical processes in perioperative nursing.