St. Mark's Cbspd Certification Training / Chapter 5- Decontamination

What does the acronym IFU stand for?

• Information For Us

• Instructions For Use

• Indications For Use

• Interface Unit

• It doesn't mean anything. It's a professional way of cursing out your coworkers. 

To ensure that cleaning equipment is in good working order, all equipment used for cleaning should be maintained with a ________ program

• Preventative Maintenance 

• Equipment Maintenance 

• Scheduled Service

• Equipment Refurbishment

According to the CDC, training and competency verification should be required:

• Every two years

• Every year

• Whenever a new device or instrument is introduced to the department. 

• Whenever an existing device or instrument manufacturer updates and/or changes a device or instrument's reprocessing procedures. 

• Upon initial hire

• Whenever a surgical site infection occurs

________ is defined as the "removal of contamination from an item to the extent necessary for further processing or for the intended use."

What are the two steps in the decontamination process?

• Inspection

• Manual or Automated Cleaning

• Ultrasonic Cleaning

• Thermal or Chemical Disinfection

• Sterilization

What should the temperature range in the decontamination area be? Note: For the purposes of this test the symbol (*) should be referred to as the degree symbol. Unfortunately I am not skilled enough to figure out how to put that fancy degree circle in this test. 

• 55*F - 60*F

• 60*F - 65*F

• 65*F - 70*F 

• 63*F - 68*F

What should the humidity range be in the decontamination area?

• 0% - 20%

• 25% - 40%

• 30% - 60%

• 35% - 65%

The decontamination area should be designed to maintain positive air pressure to help contain contaminants inside the decontamination area. 

• True

• False

How often should temperature and humidity be recorded and documented?

• Hourly

• 2x's a day

• Daily

• Weekly

How many air exchanges per hour should the decontamination area have?

• 4

• 10

• 14

• 20

The use of PPE (personal protective equipment) is NOT optional and is regulated by which government agency?

• OSHA / Occupational Safety and Health Administration

• CDC / Center for Disease Control

• APIC / Association for Professionals in Infection Control

• FDA / Food and Drug Administration

• Although PPE is mandatory, it is not regulated by a governing body. Rather, policies and procedures pertaining to PPE are created and enforced by the Hospital's "Standard Operating Procedure." 

Select all the appropriate PPE for the decontamination area

• Civilian Street Clothes

• Surgical scrub attire

• Eye and face shield

• Non-skid "decontamination area only" shoes

• Fluid resistant mask

• Head covering (surgical bonnet or scrub cap)

• Neck covering

• Heavy duty gloves

• Long-sleeved fluid resistant gown

• Fluid protective shoe covers

Wearing jewelry and having long fingernails is acceptable in the decontamination area because you are wearing gloves and therefore poses no risk of contamination

• True

• False

In 2001 OSHA (Occupational Safety and Health Administration) required that ________  be confined and contained in impervious, leak-proof container. 

• Enzymatic chemicals

• Sharps

• Acid based cleaning agents

• Discarded cleaning brushes 

When transporting contaminated items, what type of label should be used to alert personnel that they contain potentially biohazardous materials? 

• Biochemical

• Sharps

• Bioburden

• Biohazard

Soiled items should be transported immediately to the decontamination are  for processing to prevent blood, body fluids, and other contaminants from drying on the surfaces. 

• True

• False

What is the policy regarding the use of saline on surgical instruments for soaking?

• The use of saline is acceptable as long as instrumentation is removed from the solution and rinsed within 10 minutes.

• The use of saline is acceptable because the sodium will make it easier to remove blood, film, and proteins from the surface of the instrument. 

• The use of saline is not acceptable because the sodium will cause blood and tissue to harden on the instruments.

• The use of saline is not acceptable because it can damage the surface of the instrument. 

Soaking contaminated items in an enzyme solution at the point of use is discouraged because the solution must be discarded before transport. As each item is introduced into the solution, the contamination level increases, as does the potential for cross-contamination. 

• True

• False

If an instrument is discovered to be damaged in the decontamination area, it is permissible to skip the complete decontamination process because it will be sent out for repair and not used on a patient. 

• True

• False

________ is defined as "the use of physical or chemical means to remove, inactivate, or destry blood-borne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal"

What are the factors that affect cleaning? Select all that apply

• Water quality

• Water temperature

• Cleaning activity of detergents

• Mechanical action of the cleaning process

• Nature and design of the instruments or devices

• Type of soil

• Human factors

• Cleaning verification

• Quality assurance

What are the basic steps in the cleaning process? Select all that apply

• Pre-soaking

• Sorting

• Disposing single use only items

• Washing

• Repairing

• Tagging damaged instrumentation

• Rinsing

• Drying

• Inspecting

What is defined as "groups or collections of microorganisms and extracellular material that adhere to the surface of any object and are protected by a slimy film (polysaccharides)

• Biofilm

• Bioburden

• MRSA (Methicillin-resistant Staphylococcus aureus)

• Gram-Positive Bacteria

Why are biofilms so concerning as it pertains to sterile processing?

• Biofilms are extremely corrosive to surgical instruments

• Biofilms can affect water quality which therefore affects the cleaning process

• Biofilms can not be easily removed from instrumentation and are extremely resistant to many methods of cleaning and disinfection

• Biofilms can cause discoloration on instruments that are difficult to remove. 

The relative acidity or alkalinity of a solution is referred to as its 

• Water quality

• Neutral solution

• PH

• Acidity solution

What are the two types of water used in processing?

• Utility water

• Acidic water

• Alkaline water

• Critical water

If the water pH in decontamination is tested and the result is  "4" that means the water is

• Alkaline

• Neutral

• Acidic

• Corrosive

Water pH can affect the efficacy of the detergents and disinfectants used in processing

• True

• False

This is defined as a fever producing agent. Using critical water is recommended for the final rinse of all medical devices to reduce the potential for this to form and re-contaminate instruments

• Fire bacteria

• Pyrogen

• Thermal microorganism

• Saturday Night Fever bacterium

This is defined as cleaning agents that lower surface tension, dislodging soils and dissolving or suspending them in the solution so they can be removed by washing and rinsing. 

• Enzymatic solutions

• Soap

• Detergents

• Phosphate cleaners

What are the factors that must be considered in the selection of a detergent? Select all that apply

• Quality of the available water

• The cost of the detergent

• The water temperature

• The type and amount of soil on the item

• The materials the items are made of

• The amount of solution you will need to use

• The manner in which the item will be cleaned

What is the appropriate temperature range for water when used with enzymatic based detergents?

• 90*F - 110*F

• 70*F - 90*F

• 109*F - 140*F

• 123*F - 150*F

Water temperatures that exceed 140* F are recommended with the use of enzymatic detergents because the heat helps remove soils and inactivates proteins found on instruments. 

• True

• False

This type of detergent is not compatible with anodized aluminum rigid sterilization containers, rubber, some plastics, and other materials. It is, however safe and effective for stainless steel.

• Organic acid detergents

• High-alkaline detergents

• Enzymatic based detergents

• Non-abrasive cleaning agents

This type of cleaning agent is an organic compound that is made from products found in nature. These are generally considered difficult to rinse off however, some device manufacturers recommend the use of this to clean due to potential patient sensitivity. 

• Soaps

• High-alkaline detergents

• Organic acid detergents

• Non-abrasive cleaning agents

This type of cleaning agent is used for removing stubborn soils and stains, however these specially formulated agents can be difficult to remove and must be thoroughly rinsed away

• Enzymatic Detergents

• Organic acid detergents

• High-alkaline detergents

• Soaps

• Non-abrasive cleaning agents

To remove severe stains and rust from stainless steel instruments, soak in this type of cleaning agent for 5-10 minutes. After soaking, the instruments are treated with a neutral pH detergent, manually washed and thoroughly rinsed. 

• Enzyme based detergents

• Organic acid detergents

• High-alkaline detergents

• Non-abrasive cleaning agents

• Soaps

Only the parts of an instrument that come into direct contact with the patient must come into contact with a cleaning agent. Cleaning only the working part of an instrument is an acceptable way to save time during the cleaning process.  

• True

• False

Friction is one of the main principles of cleaning and is created by scrubbing an instrument in manual cleaning. 

• True

• False

To prevent damage to instruments, these types of instruments should always be placed on top of heavy items when they are being sorted into trays for cleaning

• Delicate

• Sharp

• Disposable

• Multi-part

Unless recommended otherwise by the manufacturer, items that can be disassembled should be assembled for cleaning to reduce the risk of damage to the instrument. 

• True

• False

How often should rigid sterilization container systems be cleaned?

• Daily

• Weekly

• Monthly

• After each use; before they are resterilized and reused.

Which of the following statements about manual cleaning water is correct?

• Change the detergent / water when the water is visibly soiled

• Change the detergent / water every hour

• Change the detergent/ water frequently

• Change the detergent / water after every tray

Because steam is known to leave residuals that build up over time, it is recommended that rigid containers are cleaned after every use according to manufacture recommendations

• True

• False

What are the AAMI (Association for the Advancement of Medical Instrumentation) recommendations for the sinks used for manual cleaning? Select all that apply

• 36 inches from the floor (height)

• 8 - 10 inches deep

• 4 inches larger than the biggest tray that will be placed into the sink (width and length)

• 5 gallon capacity

• There are no AMMI standards pertaining to the configuration of manual cleaning sinks

What are the functions of the three sinks used in manual cleaning? Select all that apply

• Pre-soaking/washing

• Preliminary Rinsing

• Secondary Rinsing

• Final Rinsing

The pH of cleaning solution should be between

• 4-7

• 5-8

• 7-9

• 9-10

Whenever the detergent solution is changed, the sink basin should be cleaned before it is refilled. 

• True

• False