CBSPD Exam Guide

CBSPD Exam What should the sterilizer access area pressure be? Negative w/10 air exchanges per hour What two steps are involved in decontamination? 1. Manual and/or automated mechanical cleaning 2. application of a thermal or chemical disinfection process Define Cleaning... The removal of contamination from an item to the extent necessary for further processing or for the intended use. nosocomial infections are well documented and caused by... poor or ineffective decontamination of instruments What are Employee hazards in the decontamination process? Technicians work with a large amount of 1) unidentified bioburden 2) wet enviornment 3) handling contaminated sharps 4) must know procedures for proper handling, equipment, cleaning/sterilization agents How do you properly clean a device? follow the device manufacturer's written instructions What is the starting point in sterilization? Cleaning Define decontamination The process of cleaning surgical instruments, patient care devices, and all involved surfaces in order to render areas and items safe for handling and/or further processing What are physical safety hazards? -good body mechanics -correct body techniques and posture for lifting, pushing, pulling, and reaching -should be alert and correct anything that is a potential injury -lifts to lift heavy supplies, available work material, adjustable chairs, padding on sharp edges, correct height tables -proper clothing can prevent injury What is the weakest point of an instrument? Box lock and jaws What does the ABC system stand for? A: large dollar amount items not used frequently B: moderately priced and used frequently C: items w/ low dollar value What is just in time distribution? Items are distributed to department by vendor no need for sterile storage or inventory control. What are specialty/ procedure carts? Carts placed in specific departments based on procedures personalized to needs of departments easily accessible. What is case cart distribution? visually in specialty areas case carts are delivered to department case cart is specialized to departments needs What is the exchange cart distribution? Two identical carts are made one is out in the department and other stays in SPD What is par level distribution? There is fixed inventory and when items become low they are replenished from the stockroom per department/specialty What is demand distribution? An instrument/cart must be ordered in order to get it What are the most common distribution systems? 1) demand 2)par-level 3)Exchange 4)case carts 5) Specialty 6) Just in time What is the air pressure of the sterile storage area? positive air flows out What is shelf life period of time which a sterile item is considered safe to use event related not time related When are packs most vulnerable to contamination? Immediately after sterilization What is it when a sterilizer's ability is tested under worst case conditions? Small load testing What is it called when a sterilizer is tested for sterilization under actual use conditions? Max load testing How often is a Bowie Dick test ran? Daily for dynamic air removal sterilizers How much space should be between packages and chamber wall? one inch How should paper-plastic pouches be placed in a sterilizer? plastic to paper or paper to plastic tilted on side How should basins be placed in a sterilizer? on tilted side same direction 1/5 What should be placed on the bottom of the rack in a mixed load? metal instruments basin other metal items What should be placed on the top shelf? textile packs and paper/plastic pouches Textile packs should be placed how in a sterilizer? sides Solid bottom trays should be loaded now? tilted on sides How should mesh bottom containers be loaded into the sterilizer? flat on rack If packages are still moist when the sterilizer doors are open bacteria can do what? wick through the package How does steam sterilization occur? by condensation What cases are proven to have prions? 1) neurosurgery 2) opthamology (eye) When should a flash sterilizer be monitored? Weekly with a biological and a class 5 or class 6 indicator What can not be processed in an express cycle? porous items items with lumens When should a flash sterilizer be used? In an emergency; a one of a kind instrument is dropped How are liquids sterilized? only through gravity displacement liquid cycles What occurs during the drying phase? Dynamic Air Removal: Filtered air is drawn in achieve drying Gravity: Heat in chamber evaporates moisture *Approx.: 30 min. for both What occurs during the exhaust phase? steam is exhausted from the chamber drain line What occurs during he sterilization/exposure/"holding phase"? exposure temperature is maintained for the prescribed amount of time What occurs during the conditioning phase of steam sterilizers? Air is removed and steam is injected Where should the bowie dick test be placed in a steam sterilizer drain line Where is the sterilizers heat-sensing thermometer located? Drain- line What provides heat inside the chamber and prevents condensation in a steam sterilizer? the jacket where is the dedicated steam supply made? a boiler Steam kills microorganisms by_______ the protein denaturing (coagulation) True/false Removing as many microorganisms as possible before sterilization enhances the probability of microbial kill true What is the air exchange in sterile storage 4 per hour What is the suggested release temperature of packs? 70 to 80 degree farenheit How far from the floor should medical devices be stored? 8-10 inches from the floor How far should shelving be from outside walls? 2 inches What kind of pressure should the sterilization area be under? positive What is the coldest area of the sterilizer? drain line What are the three parameters of steam sterilization? 1) Steam under pressure 2) time 3) Exposure/temperature What are the two types of cycles in steam sterilization? 1) dynamic air removal (pre-vac) 2) Gravity Displacement (immediate use) What are the phases of the cycle? 1)conditioning (air is removed) 2)sterilization/Exposure/ Hold (temperature is held) 3) Exhaust (steam out drain line) 4) drying (approx. 30 min.) 2/5 It takes a certain ______ to reach a certain ____________ Pressure temperature What are the types of sterilization processes used? 1) steam 2) EtO 3) Dry Heat 4) Gas plasma 5) Ozone 6) liquid chemical What does a class on indicator respond to? Only one parameter of the process (ex.: autoclave tape) Geobacillus steurothermophilus must be incubated at what temp.? 132 degrees farenheit What should the incoming saturated steam dryness be? ideally 97% to 100% saturated steam What should the sterility assurance level be? 10^-6 When a new sterilizer comes in or relocated how many consecutive biologicals be ran in an empty sterilizer? three How many air exchanges should there be in the sterilization area? ten Class five responds to all critical parameters Class three responds to single parameter respond to one chemical parameter Biological monitors contain... spores geobacillus stearothermophilus The biological used for team, ozone, and pareacetic sterilization contains.... Geobacillus Stearothermophilus The biological used for EtO, gas plasma, and dry heat contains... Bacillus atrophaeus True/False Adequate cleaning will lead to easier sterilization b/c it reduces present bioburden true When must a control biological be ran? Daily or when a new lot number is present When are biologicals placed for steam sterilization? Coldest point (drain line) Where do you place biologicals for EtO sterilization? Approximately the center of the load Where are biologicals placed for gas plasma sterilization? First shelf back of chamber If no microorganisms survived, the biological test is the positive or negative? Negative If microorganisms survive the biological test is considered positive or negative? posititve If bacteria lives what color does the biological turn? yellow When a BI tests positive you must... Determine why it failed and recall everything from that cycle and reprocess it Steam sterilizers should be monitors at a minimum of... weekly Each package ran through sterilizers should be labeled with what? 1)lot number 2)date 3)cycle number What must CSD comply with? local and state regulations What is decontamination? contaminated items are rendered safe for handling by personnel who are not wearing protective attire What does the EPA regulate? EtO manufacturing and emissions, and labeling What agencies govern central sterile departments? -joint commission (JC) -occupational safety (OSHA) -Environmental (EPA) -Food and Drug (FDA) Is JCAHO a government agency? no it is a volunteer organization 3/5 The standards of _____________ affect most areas of the health care facility. Joint Commision What should large items be lifted with? If too large, then a lift must be used; if can be lifted with body use legs not back/arms What can an incident report lead to? Work practices that need improvement What should be in an incident report? -how the accident happened -where/ when it occurred -any witnesses -medical treatment given -any work time lost due to accident -description of corrective actions to prevent the recurrence of the accident When should an incident report for an accident/injury be reported? immediately What items can be disinfected? -surgical instrumentation -patient care equipment -other medical devices from all areas of the institution When is disinfection used? When cleaning alone might not be enough to make an item safe for reuse or further handling without transmitting disease Decontamination activites should not take place when clean activities are being performed (prep, packaging, and sterilization) What kind of containers should sharps be kept in? impervious (puncture proof), and leak proof containers Acrylic nails are... prohibited because the support the growth of microorganisms How long should fingernails be kept? Short Why should jewelry not be worn? cannot be easily cleaned can catch on equipment causing injury True/false eyewash stations must be available in the decontam area and in areas where disinfectants are being used and a hands free operation True Is the use of PPE optional? no PPE must not... permit blood or other potentially infectious materials to pass through or reach the employees work clothes, street clothes, undergarments, skin, eyes, mouth, or mucous membrane during the time of use Individuals entering the area must... wear PPE traffic in the decontamination area must be restricted to? individuals with job responsibilities in the area Provisions for the cleaning of walls, vents, and drains should be to inhibit he growth of microorganisms in the traps, prevent insects, made because... prevent emission of noxious odors How should the work flow in decontamination? clean to dirty areas with decontamination being the last area cleaned Floors and work surfaces should be cleaned? daily in accordance to the policies and procedures How many air exchanges should there be in the decontamination area? 10 per hour Air should be exhausted where? directly to the outside not recirculated temp. and humidity should be monitored and documented daily, when it reaches above/below those standards what should you do? the discrepancies should be reported to the SPD manager or supervisor Negative air pressure should... be drawn into the room what helps control biofilm in pipes Chlorination of water ad flushing of delivery systems What are biofilms Biofilms are microbial communities that are tightly attached to surfaces and cannot be easily removed; Bacteria is 1000x more resistant than bacteria in suspension 4/5 Soaking items for too long should be avoided. Why? because of the potential for biofilms Items with multiple parts should be disassembled according to what? Manufacturer's IFU What are the basic steps in the cleaning process? -sorting -disposing of single-use items -prerinsing/presoaking reusable items -washing -rinsing -drying True/False disinfection and/or sterilization will not compensate for poor cleaning True a sterilized instrument is opened but not used what should happen? treat as contaminated and completely reprocess it What is a pyrogen? fever reducing substances What does cleaning and rinsing do? remove rather than kill microorganisms What is the most important step in the decontamination process? cleaning followed by thorough rinsing Before an instrument is cleaned what must be obtained? The manufacturer's IFU What is the objective of decontamination? To make an item safe for reuse and/or further handing 1) Placing a towel moisteneed with water (not saline) over the instruments Organic soils should not be able to dry on instruments, how can 2) Using an instrument spray designed for pre treatment (enzyyou accomplish this? matic foam/ gel that adheres to the surface to begin breaking down soils) When should sharps containers be changed? 2/3 full to help prevent sharps injuries What can the quality of water affect? 1) how the detergent will work 2) how much detergent is needed 5/5