St. Mark's Cbspd Certification Training / Chapter 6- Disinfection Processes

Employees should report their concerns about being exposed to hazardous levels of a particular chemical to their supervisor. Supervisors are responsible for ensuring the safety and well-being of their employees, and they have the authority and knowledge to address and resolve such concerns. Reporting to a supervisor is the most appropriate course of action as they can take immediate steps to investigate the situation, implement necessary safety measures, and involve relevant authorities if required. Peers may not have the authority or expertise to handle such situations, while a nurse may be consulted for medical advice but may not have the authority to address the issue directly. The OSHA whistle-blower hotline can be used if the supervisor fails to take appropriate action or if there is a need to report a violation of safety regulations.

Staff who use disinfectants regulated by OSHA should be monitored for exposure, advised of their exposure, and provided with a plan for reducing exposure. This statement is true because OSHA (Occupational Safety and Health Administration) sets regulations and standards for workplace safety, including the use of disinfectants. It is important to monitor staff for exposure to these chemicals to ensure their health and safety. Additionally, staff should be informed about their level of exposure and provided with a plan to minimize their exposure, which can help prevent any potential health risks associated with these disinfectants.

The statement is false because "shelf life" and "use life" do not mean the same thing. "Shelf life" refers to the amount of time that a product can be stored before it becomes unfit for use or consumption, while "use life" refers to the duration during which a product can be actively used or consumed after it is opened or activated. These terms have distinct meanings and should not be used interchangeably.

The explanation for the given correct answer is that disinfectants and antiseptics have different purposes and target different types of surfaces. Disinfectants are designed to kill microorganisms on inanimate objects, such as surfaces, tools, or equipment. They are commonly used in hospitals, homes, and other settings to prevent the spread of infections. On the other hand, antiseptics are used to prevent or stop the growth of microorganisms on living tissues, such as skin or wounds. They are typically used to clean and sterilize cuts, scrapes, or other injuries to prevent infection. Therefore, the statement that disinfectants are used on inanimate objects and antiseptics are used on living tissue is true.

The recommended humidity for the area designated for high-level disinfection is 30%-60%. This range provides an optimal environment for the disinfection process to be effective. Humidity levels below 30% can cause the disinfectant to evaporate too quickly, reducing its effectiveness. On the other hand, humidity levels above 60% can promote the growth of mold and bacteria, which can compromise the disinfection process. Therefore, maintaining a humidity level within the range of 30%-60% is crucial for ensuring the success of high-level disinfection.

According to the Spaulding Classification System, medical devices that come into contact with mucous membranes or non-intact skin, but do not penetrate body tissues, are considered semi-critical. These devices may carry a lower risk of infection compared to critical devices, but they still require a high level of disinfection to prevent the transmission of harmful microorganisms.

The area designated for high-level disinfection should have 10 air exchanges per hour. This is important to ensure that there is proper ventilation and circulation of air in the area, which helps in removing any airborne contaminants and maintaining a clean and safe environment. Having a sufficient number of air exchanges per hour is crucial in preventing the spread of infections and maintaining the effectiveness of the disinfection process.

The correct answer is Automated Endoscope Reprocessor. AER refers to a device used in healthcare facilities to clean, disinfect, and sterilize endoscopes. This automated system ensures that the endoscopes are properly cleaned and ready for the next use, reducing the risk of infections and cross-contamination.

The correct answer is "Use." The explanation for this answer is that the length of time for which the HLD (High-Level Disinfectant) can be used after it is opened indicates its "shelf use" or usability. This means that once the HLD is opened, it can be used for a certain period of time before it expires or becomes ineffective. Therefore, the answer "Use" is the most appropriate choice based on the given information.

According to the Spaulding Classification System, critical medical devices require sterilization because they come into direct contact with sterile tissues or the vascular system, posing a high risk of infection if not properly sterilized. Sterilization ensures the complete elimination of all microorganisms, including bacteria, viruses, and fungi, from these devices, reducing the risk of infection transmission to patients. This classification includes devices such as surgical instruments, implants, and catheters that are introduced into sterile body cavities or the bloodstream. Sterilization methods commonly used for critical devices include steam sterilization, ethylene oxide gas sterilization, and hydrogen peroxide plasma sterilization.

The CDC (Center for Disease Control) is not responsible for regulating chemical disinfectants. The CDC focuses on preventing and controlling the spread of diseases, including providing guidance on the use of disinfectants, but they do not have the authority to regulate these products. On the other hand, OSHA (Occupational and Safety Health Administration), FDA (Food and Drug Administration), and EPA (Environmental Protection Agency) all have roles in regulating chemical disinfectants. OSHA ensures workplace safety and may have regulations on the use of disinfectants in certain industries. The FDA regulates disinfectants used on medical devices and drugs, while the EPA regulates disinfectants used in environmental settings.

The statement is false because using more of a chemical disinfectant does not necessarily make it better. In fact, using too much of a chemical disinfectant can be harmful and ineffective. It is important to follow the instructions and recommended concentrations provided by the manufacturer to ensure proper disinfection without causing any harm to the surfaces or individuals being treated.

The effectiveness of disinfection is influenced by both the location and the number of microorganisms present. The location of the microorganisms determines the accessibility of the disinfectant, as some areas may be harder to reach or may provide more favorable conditions for microbial survival. Additionally, the number of microorganisms plays a role in disinfection efficacy, as higher concentrations may require stronger or longer exposure to the disinfectant in order to effectively eliminate them. Therefore, both factors are important considerations when assessing the effectiveness of disinfection.

The recommended temperature for the area designated for high-level disinfection is 60*F-65*F. This temperature range is ideal for ensuring the effectiveness of disinfection processes. Temperatures below this range may not provide sufficient heat to kill pathogens, while temperatures above this range may compromise the integrity of certain disinfectants. Therefore, maintaining a temperature between 60*F-65*F is crucial for effective high-level disinfection.

The recommended "ceiling threshold limit value" for glutaraldehyde is .05 PPM (parts per million). This means that the maximum concentration of glutaraldehyde in the air should not exceed .05 parts per million. This threshold limit value is set to ensure the safety of individuals who may be exposed to glutaraldehyde. Higher concentrations of glutaraldehyde can be harmful and may cause respiratory irritation, eye irritation, and other health effects. Therefore, it is important to monitor and control the concentration of glutaraldehyde in the air to maintain a safe working environment.

Using a liquid high-level disinfectant past its "reuse expiration date" is not acceptable and recommended, even if it passes the MEC test. The reuse expiration date indicates the point at which the disinfectant may no longer be effective or safe to use. Therefore, it is important to adhere to the expiration date and dispose of the disinfectant properly to ensure proper disinfection and safety.

The high-level disinfection room should have ventilation in place to ensure adequate airflow and prevent the buildup of harmful fumes or gases. Proper ventilation helps remove any potentially hazardous chemicals or vapors from the room, ensuring a safe environment for personnel working in the area. It also helps maintain air quality and prevents the accumulation of any odors or contaminants that may be present during the disinfection process.

Osmosis refers to the movement of a solvent, usually water, from an area of lower solute concentration to an area of higher solute concentration through a semi-permeable membrane. This process occurs in order to equalize the solute concentration on both sides of the membrane. In the given context, the movement of solvent through a semi-permeable membrane into a solution of higher solute concentration accurately describes osmosis. Infusion, invasion, and deionization do not involve the movement of solvent through a semi-permeable membrane and are therefore not appropriate explanations for the given statement.

The statement suggests that because the AER uses tubing irrigation HLD into a flexible endoscope, it is not necessary to clean the channels and lumens beforehand as the irrigation force will remove all debris and contaminants. However, this statement is false. It is still crucial to clean the channels and lumens before using the AER, as the irrigation force alone may not effectively remove all debris and contaminants. Proper cleaning and disinfection protocols are necessary to ensure patient safety and prevent the spread of infection.

High-level disinfection is a process that kills most microorganisms but may not necessarily eliminate bacterial spores. Sterilization, on the other hand, is a more rigorous process that aims to eliminate all forms of microbial life, including bacterial spores. Environmental disinfection and decontamination refer to processes that aim to reduce the number of microorganisms on surfaces or in the environment, but they may not be as effective as high-level disinfection in killing bacterial spores. Therefore, high-level disinfection is the most appropriate answer in this context.

Hydrogen peroxide is the correct answer because it is a versatile disinfecting chemical that can be used in different settings. It can be used as an environmental disinfectant, which means it can be used to disinfect surfaces and objects in the environment. It can also be used as a high-level disinfectant, which means it can be used to disinfect medical equipment and instruments that come into contact with mucous membranes. Additionally, it can be used as a sterilant, which means it can be used to kill all forms of microbial life, including spores. This makes hydrogen peroxide unique among the given options, as the other chemicals have more specific applications.

A bacteriostatic disinfectant is designed to inhibit the growth and reproduction of bacteria, rather than killing them outright. When applied directly to the patient's skin or mucous membranes, the disinfectant may disrupt the natural balance of bacteria in that area, potentially leading to tissue damage. This is because the disinfectant may not be able to completely eliminate harmful bacteria, allowing them to multiply and cause harm to the surrounding tissue. Therefore, it is true that a bacteriostatic disinfectant could cause tissue damage when used on an item that comes in direct contact with the patient's skin or mucous membranes.

Glutaraldehyde is the correct answer because it is a high-level disinfectant that is effective against all vegetative bacteria, mycobacteria, and viruses. It also has the ability to kill spores in some cases with extended exposure times. The soaking time required to achieve high-level disinfection with glutaraldehyde can range from 5 minutes to 90 minutes.

Alcohol is an effective environmental disinfectant because it has the ability to kill various types of bacteria, mycobacteria, and fungi. It is also known for its quick evaporation, which can make it challenging to achieve the recommended 5-10 minute wet contact time necessary for effective disinfection. However, despite this limitation, alcohol remains a popular choice for sanitizing surfaces due to its effectiveness in killing pathogens.

Glutaraldehyde is a disinfectant commonly used in healthcare settings. It is permissible to dispose of glutaraldehyde down a sink drain with water running continuously to dilute it because the water helps to dilute and flush away the chemical. However, due to the risk of fumes, it is recommended to use a flexible spout and shut off valve to reduce exposure to the fumes. This precaution helps to minimize the inhalation of potentially harmful fumes while disposing of glutaraldehyde. Therefore, the statement is true.

Disinfectant solutions, including glutaraldehyde, can become diluted if there is water on the items being immersed. Therefore, it is important to ensure that all items to be immersed in glutaraldehyde are first dried thoroughly. This is because water can dilute the concentration of the disinfectant, reducing its effectiveness in killing microorganisms. Therefore, the statement is true.

According to the Spaulding Classification System, medical devices are categorized into three levels based on the risk of infection associated with their use. Critical devices are those that come into contact with sterile tissue or the vascular system and require sterilization. Semi-critical devices come into contact with mucous membranes or non-intact skin and require high-level disinfection. Non-critical devices only come into contact with intact skin and require low-level disinfection or cleaning. Therefore, the correct answer is Non-Critical, indicating that this classification of medical devices requires sanitization rather than sterilization or high-level disinfection.

The type of PPE used when actively engaged in the disinfection process does not affect a disinfectant's effectiveness. PPE, or Personal Protective Equipment, is used to protect the person performing the disinfection process, but it does not directly impact the disinfectant's ability to kill or inactivate microorganisms. Factors such as temperature, pH, water hardness, contact time, and the presence of organic and inorganic matter can all influence the effectiveness of a disinfectant.

MEC stands for Minimum Effective Concentration, which refers to the lowest concentration of a drug or compound that is required to produce a therapeutic effect. It is an important parameter in pharmacology and is used to determine the dosage of a drug that will provide the desired therapeutic outcome. The term "minimum" implies that concentrations below this threshold would be ineffective, while "effective" indicates that the concentration is sufficient to produce the desired effect. Therefore, MEC is a crucial factor in determining the appropriate dosage of a drug for optimal therapeutic efficacy.

There are two categories of chemical disinfectants.

QUATS (Quaternary Ammonium Compounds) are a type of environmental disinfectant that is effective against both gram-positive and gram-negative bacteria. However, they are not effective against lipid viruses and spores. QUATS are commonly used for disinfecting environmental surfaces such as bedsides, tables, floors, and walls.

The correct answer is "Shelf" because the question mentions that the chemical "life" is indicated by the date in which the bottle must be used. This implies that the date on the bottle refers to the period of time that the chemical can be stored on the shelf before it expires or becomes unusable. Therefore, the term "Shelf" is the most appropriate answer as it relates to the storage duration of the chemical.

Patients with a history of bladder cancer should not be exposed repeatedly to devices processed in Cidex OPA. This is because Cidex OPA contains glutaraldehyde, which is a known carcinogen and can potentially increase the risk of developing bladder cancer or cancer recurrence in individuals with a history of the disease. Therefore, it is not recommended to use this high-level disinfectant on patients with a history of bladder cancer.

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Glutaraldehyde is a high-level disinfectant, but it is not a cleaning agent. Cleaning agents are used to remove dirt, debris, and organic material from surfaces, while disinfectants are used to kill or inactivate microorganisms. Glutaraldehyde is primarily used for disinfection purposes rather than cleaning.

Glutaraldehyde is not a popular choice for high-level disinfection because of its low toxicity and low residuals. In fact, glutaraldehyde is known to have high toxicity and can cause skin and respiratory irritation. It also leaves behind high levels of residuals, which can be harmful to humans and the environment. Therefore, the statement is false.

Air pockets in cannulated items do not assist with the disinfection process. In fact, air pockets can hinder the disinfection process as they can trap contaminants and prevent the disinfectant from reaching all surfaces of the item. It is important to ensure that cannulated items are properly cleaned and free of any air pockets to ensure effective disinfection.

Hydrogen peroxide is the correct answer because it is an environmental disinfectant that remains wet for a longer period than other disinfectants, making it effective in killing germs. It is also non-irritating to the skin, eyes, and respiratory system when used in low concentrations.

The given statement is false. The automated endoscope reprocessor is not designed specifically for the reprocessing of rigid endoscopes. It is a device used to clean and disinfect flexible endoscopes, which are used for procedures such as colonoscopy and bronchoscopy. Rigid endoscopes, on the other hand, are cleaned and sterilized using different methods, such as manual cleaning and steam sterilization.

Phenolics are a type of environmental disinfectant that is effective against vegetative bacteria, fungi, and certain mycobacteria. However, they are not effective against bacterial spores and some viruses. Phenolics are bacteriostatic, meaning they inhibit the growth of bacteria, and they leave a residual film. Due to the residual film, they are not recommended for use in food preparation areas, nurseries, nursery equipment, or on porous materials such as mattresses. Therefore, phenolics are the correct answer in this scenario.

Fume controls, such as local exhaust hoods, are recommended for the use of Glutaraldehyde as a high-level disinfectant. This is because Glutaraldehyde can release vapors during processing, which can be harmful if inhaled. Using local exhaust hoods helps to capture and remove these vapors, ensuring a safer working environment.

Halogens are a type of environmental disinfectant that have the ability to remove oxygen from molecules, do not leave a toxic residue, are generally not affected by hard water, are inexpensive, and are fast-acting.

The given answer is correct because all of the mentioned substances, glutaraldehyde, OPA (Ortho-phthaldehyde), and hydrogen peroxide, are types of high-level disinfectants. These substances are commonly used in healthcare settings to kill or inactivate a wide range of microorganisms, including bacteria, viruses, and fungi. They are effective in disinfecting medical instruments and surfaces that may come into contact with patients, helping to prevent the spread of infections.

AERs (Automated Endoscope Reprocessors) offer several advantages over manual processing. They automate and standardize several important reprocessing steps, reducing the likelihood that an essential reprocessing step will be skipped. Additionally, AERs reduce personnel exposure to high-level disinfection (HLD) chemicals and overall reprocessing time by eliminating unnecessary steps.

The appropriate PPE that should be worn when working with disinfectants includes a face shield to protect the face from splashes or sprays, a mouth mask to prevent inhalation of any airborne particles, gloves that are impervious to the chemicals being used to protect the hands, a gown or apron that is impervious to the chemicals being used to protect the body, and shoe coverings to prevent contamination of footwear. Additionally, respiratory protection is necessary to protect against both airborne exposure to bacteria and vapors that are generated by the disinfectants being used. However, a full-body haz-mat suit is not necessary in this case.

High-level disinfectants are not recommended for use on items that come into contact with patient tissue because they tend to leave residuals behind that can potentially cause tissue damage. This statement is true. High-level disinfectants are strong and effective in killing microorganisms, but they can also be corrosive and toxic. When used on items that come into contact with patient tissue, such as medical instruments, the residuals left behind can cause irritation, allergic reactions, or even tissue damage. Therefore, it is important to use appropriate disinfectants that are safe for patient tissue.

MEC tests are used to test the concentration levels of microbial colonization. This means that MEC tests are specifically designed to measure the effectiveness of a sterilant or disinfectant in inhibiting or eliminating microbial growth. By conducting MEC tests, one can determine the minimum concentration of a chemical or agent required to prevent microbial colonization. This information is crucial in ensuring the efficacy of sterilization and disinfection processes in various settings, such as healthcare facilities, laboratories, and food processing industries.