RTH 110

Question Answer
Briefly explain the methods used for testing for contamination Swab surface- send for C & S;
Broths- pour into equipmen, recapture, send for culture; Spore capsules negative growth
Auto Claving Steam and pressure achieves denaturation an coagulation
What are 3 elements for infection to spread? 1. Source of infecting organism 2. Susceptible host and 3. mode/route of infection transmission
What are potential sources of infection within the hospital? People and contaminated objects
Spore A small usually single-cell reproductive body that is resistant to adverse environmental conditions.
Interfere with metabolism The cell cannot use or produce energy so it either dies or cannot multiply
Acetic Acid Found in white vinegar, kills most vegetative bacteria
Bacteria Unicellular microorganisms that lack organelles
Where is acetic acid most used? Patient at home care for their equipment: nebulizers, cpap machines
Low level disinfectant
1 part vinegar 3 parts water
Cycle strips Just show object has been through cycle
Which common pieces of respiratory equipment are common sources of bacteria Bronchoscopes
Examples of high level disinfectants Glutaraldehyde and Sodium hypochlorite (bleach)
Glutaraldehyde in general kills what? Vegetative bacteria, fungi and viruses and common spores
What are the benefits of bleach? Fast acting, inexpensive, broad spectrum disinfectant
Examples of intermediate level disinfectants Alcohols (70% ethyl 90% isopropyl)
What is the difference between low, intermediate and high level disinfectants. Low kilss most bacteria, some viruses and fungi. Intermediate will kill vegatative bacteria and fungi, variable effect against spore and certain viruses. and High destroys all microorganisms easily except bacterial spores
Autoclaving Steam and pressure achieve denaturation and coagulation. Equipment is pre-cleaned and packaged in penetrable packaging.Inexpensive, relatively fast. Items suitable for use up to one year after processing
What are the 4 methods of sterilization? 1. Incineration. 2. Autoclaving 3. Gas sterilization (ETO) and 4. Ionizing Radiation
What are the processing indicators? Capsules or strips placed in whit equipment during sterilization process. Color changes when process has been completed.
What is the appropriate concentration of ethyl or isopropyl alcohol when used for surface disinfecting? 70% Ethyl
90% isopropyl
Why are spores special? Most difficult to kill. Good indicators of sterilization process
Duration of contents of liquid gas equation Gas remaining (l) / flow (l/min)
Is it possible to eliminate all pathogens? It is immpossible to eliminate all pathogens. Infection control procedures are designed to remove pathogens either by general sanitation (keeping the environment clean) or by using specialized processing techniques to decontaminate equipment
Processing indicators (cycle) can only prove the item has been processed
Decreased Surface tension Surface of the pathogen becomes porous to fluids which enter the cell and cause rupture
Processing by risk How an item is to be used determines the cleaning level needed
Pasteurization Destroys pathogens through moist heat below the boiling point of water to kill vegetative organisms. 63-70 * C for 30 minutes
What are the three steps used to prepare equipment for sterilization? 1. Wash and rinse or surface disinfect. 2. Dry completely 3. Reassemble or package for further processing
What is a possible toxic byproduct of ethylene oxide sterilization Ethylene glycol (antifreeze)
Coagulation Reduce cell protein to a gelatinous mass
Denaturation Chemical alteration of the cell protein
Viruses A pathogen that is able to multiply only within the living cells of a host
What are the major considerations when using disposable equipment Cost, Quality and unable to reuse
Fungi any group of unicellular, multicellular or spore producing organisms that feed off organic matter
Sterilization The removal of all microorganism and other pathogens from and object or surface
Spores a primitive usually unicellular often environmentally resistant, dormant or reproductive body
After pasteurization, what do you do to the items? Items must be completely dried, then assembled and packaged
Examples of low level disenfectants Acetic Acid and Quartenary ammonium compounds
Acetic Acid Found in white vinegar, kills most vegetative bacteria
Quartenary ammonium compounds Kill fungi, bacteria, most viruses

Not sporacidal or tuberculocidal

Ionizing Radiation Using gamma rays
Primarily industrial use
Autoclaving Advantages Efficient, quick, cheap, clean and reliable
Gas sterilization (ETO) Colorless toxic gas that is a potent sterilizing agent. Requires special gas permeable packging. Needs biological indicator for sterilization monitoring (Attest). Requires proper aeration. Items are suitable for use up to one year after processing
ETO safety ETO causes nausea, disorientation, sore throat, eye and nose irritation.
Needs generous aeration time post cycle.
Disadvantages of ETO Long aeration time- up to 7 days
PVC and rubber may absorb gas and will need extra aeration time
Slow turn around time, therefore need more stock.
Advantages of ETO Excellent sterilizing properties
Possible to use on items which cannot be exposed to steam or be immersed like electrical equipment or heat sensitive material.
Good spore killer.
Ionizing radiation: using gamma rays Primarily industrial use- large walk in rooms. Not a factor in hospital: slow (2-3) days. Very expensive and massive shielding of room neccessary
Why use disposable equipment? cheap, Reliable, Can be thrown away after use.
Ethylene Glycol ETO combined with water droplets; antifreeze
ETO Gas sterilization. Ethylene Oxide. Colorless, toxic gas. Need biological indicators for sterilization.
Describe the chain of events used to minimize the spread of infection Decrease host susceptability (employee immunization);
Eliminate the source (general sanitation, equipment processing); Interrupt the transmission route (Equipment handling procedures, barrier precautions and single patient equipment)
What quality control methods are used to ensure proper equipment processing need confirmation by both cycle strips (gas or steam) and biological indicators for proper processing
What three elements must be present for infection to spread? Source, route and host
What is acetic acid? Found in white vinegar, kills most vegetative bacteria
Steps of basic equipment processing 1. Wash and rinse or surface disinfect 2. Dry completely 3. Reassemble or package for further processing (any contaminated equipment from isolation area should be double bagged and labeled)
What are the four ways pathogens can be affected to achieve sterilization? 1. Denaturation 2. Coagulation 3. Decreased surface tension 4. Interfere with metabolism
pH range of Cidex 7.5-8.5
How long once opened will cidex still fully be potent 14 days
What is the most common solution for surface disinfection? Alcohol 70% ethyl 90% isopropyl
Sterile fluids Resealable and disposed of in 24 hours.
Used for suctioning, refilling humidifiers and rinsing equipment
Ethynol 70% ethyl 90% isopropyl
How do you properly dispose of single patient use equipment? should be thrown away inside the patient's room
Sodium hypochlorite Fast acting, inexpensive, broad spectrum disinfectant
Bleach
High level disinfectant
The best use of alcohol Good for disinfecting small surfaces such as stethoscopes, ventilators
Incineration If object is too contaminated to clean or disposable. Must use a high temperature and complete. Has limited use
Detergent washing Soap usually in form of powder or liquid for cleaning
Temperature for pasterurization 63-70 C for 30 minutes
Testing for contamination 1. Swab surfaces- send for C & S
2. Broths
3. Spore capsules negative growth
Equipment processing 1. all equipment should be adequately cleaned by removing organic soil and disassembled
2. Any contaminated equipment from isolation areas double bagged and labled before take for processing
3. Gloves must be worn
Pathogens Disease causing microorganisms
Usage of alkaline glutaraldehyde (Cidex) Used for disinfection and or sterilization. Bactericidal in 10 minutes, tuberculocidal in 10 minutes, sporacidal in 10 hours. Good for reusable plastics and bronchoscopes
Sonacide Acid Gluteraldehyde. Used for disinfection. Bacterialcidal in 10 minutes, Tuberculocidal in 20 minutes, Sporacidal in 1 hour
pH of sonacide 2.5- 3.5
How long does Sonacide remain fully potent 28 days
What is disinfection? Destroys vegetative forms of pathogens but not spores
High level disifection Destroys all microorganisms easily except bacterial spores
What indicators do we depend on to guarantee sterilization? biological indicators. Attest: confirm sterility has been achieved