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CBSPD EXAM COMPREHENSIVE
REVIEW 2024
Functions of SPD Our functions are Decontamination, Assembly/Prep & Pack, Sterilization & Storage. Placement of Instrumentation on Sterilizer rack Top shelf Peel packs tilted on edge/side Placement of Instrumentation on Sterilizer rack Middle shelf Textile, Basins, Non-Perforated trays - tilted on edge/side Where should Textiles etc. be placed on Sterilizer rack Textiles ect. should always be placed on the rack above the metal containers. Placement of Instrumentation on Sterilizer rack Bottom shelf Rigid container, perforated basket trays- placed flat LTGP back bottom shelf on top of tray/pack ( Geobacillus Sterarothermophilus) Incubated @ 131-140 deg. BI placement for Steam over the drain ( Geobacillus Sterarothermophilus) Incubated @ 131-140 deg. BI placement for ETO center of load (Geobacillus Sterarothermophilus ) Incubated @ 99 degrees BI placement for LTHP center top shelf (Geobacillus Sterarothermophilus ) Incubated @ 131-140 deg. BI placement for Ozone
upper shelf (Geobacillus Sterarothermophilus ) Incubated @ 131-140 deg. BI placement for Dry Heat fullest densest load (Bacillus Atrophaeus) Incubated @ 96-120 deg. Cleaning is the removal of contamination from an item to the extent necessary for further processing or for the intend use. AAMI (Association for the Advancement of Medical Instrumentation) Issues standards which is an established norm based on theory,opinion, authority, & research AAMI is not law but recognized as best practices. AAMI makes recommendations for sterilization based on opinion, research, authority, and /or theory. 2 types of contact transmission direct and indirect via a reservoir. Which is either by human, animal or nonliving means as soil or water. direct contact person to person or physical contact between the source to the person by animals which is considered a vector that causes Lymes disease via ticks/lice which is a spriochete that is spiral shaped also causes syphilis, Influenza via birds & Rabies via rats,bats, skunks, foxes, dogs,cats. Indirect contact via objects/fomites inanimate objects. Instrument Usage : Hemostats Hemostats are used to clamp arteries to stop the flow of blood. Instrument Usage : Scissors
Must be displayed in facilities where a hazardous substance is stored, manufactured, or used per OSHA. metal brushes metal brushes are used on Tungsten Carbide ( gold handled) for cleaning when needed. Nylon & plastic brushes are used for cleaning all other instrumentation when needed. Quality assurance is the collection of data & identification of issues that can be identified by anyone and is continuous quality improvement. one of the way to find issues is by random audits. Ethics what is good, bad, and moral and doing the right thing. work ethics understanding cultural differences is a trait of good work ethics. Morals principles of right & worng Agencies that are mandatory OSHA,FDA,DOH, & EPA we must do what they say compliance is not an option. Regulation a rule that must be followed it is not optional it is issued by regulatory agencies only. Recommendation are issued by AAMI, AORN, & CDC and are considered best practices. Quats are low-level disinfectants effective against gram-positive bacteria are bactericidal and used on inanimate objects
like bed, tables, walls, & floors. Not effective against lipid- based viruses. Used in dietary & nursery departments & must remain wet for the required time to be effective. Halogens are oxidizing agents that can remove oxygen from living things & cause death. Bleach (hypochlorite) Is commonly used low to medium level disinfectant in the Halogens. It can destroy Hep Virus & HIV Iodine is another used as skin antiseptic to reduce microorganisms and prep skin for surgery. Phenolics are carbolic-acid effective against vegetative bacteria, fungi, some mycobacteria, but not against bacterial spores & some viruses. They are bcteriostatic and leave residue. not in dietary, baby equipment, mattresses & surgical instruments. but can be used on TB contaminated fomites. Alcohol are antiseptics/sanitizers that can kill mycobcteria, & fungi. They are Bacterricidal and flammable. Hydrogen Peroxide A general environmental cleaner-disinfectant For a disinfectant to perform correctly disinfectant must remain wet for the stated time to perform correctly. Low-level disinfectants can destroy Hep B Virus (HBV) Sterile supplies can be stored on
Class B extinguisher Gasoline, oil, paint flammable liquids Class C extinguisher electrical equipment Class D extinguisher Metals & metal alloys Class K extinguisher cooking oils striations voluntary movement are not a characteristics of smooth muscle. first step in processing a flexible endoscope Leak test Factors required for life water, food, oxygen, & pressure Portals of Exit: Respiratory tract by sneezing/Cough for TB, Whooping Cough, Pneumonia, Measles, Mumps Smallpox and is the most common via droplets. Portals of Exit: GI Tract by Feces/Saliva for Salmonella, Cholera, Shingles, Typhoid Fever, Polio mostly found in contaminated water and soil. Portals of Exit: Genitourinary tract By the Penis/ Vagina secretions also in Urine. All loads with implants must have a BI HAIs (Hospital Acquired Infections) 90,000 deaths a year are related to HAI's or nosocomial infections by direct contact. Bowie Dick Test pack
A chemical monitor that test the air removal, presence of non-condensable gasses & air leaks of Pre-Vac dynamic air removal sterilizers. Bowie Dick Test is ran at 3-3 1/2 min. @270F daynamic-Air-Removal Decontamination is the use of physical/chemical means reducing the number of microorganisms from objects where they are not able to pass infectious particles. When marking instruments only use Marking tape, chemical etching, color bonding Prep & pack parameters: Temp 68-73 deg. Humidity 30-60% Ideal 50% Pressure- Positive Air exchange 10 instrument colors: Blue Titanium instruments instrument colors:Black/ebonized Laser surgery instruments instrument colors:Gold handled Tungsten Carbide instrument colors:Black handled Super sharps scissors pH scale 1-14 above 7 is Alkaline below 7 is acidic 5=Acidic 7=Neutral 9=Alkaline Decontamination Area parameters
Not recommended for food areas, nursery's or porous materials, surgical instruments & rinsed off when used on hard surfaces with alcohol. Sterile Storage Parameters Temp:68 - Humidity= 35 - Air exchanges = minimum 4- pressure= positive dust covers should be used for Trays that are not used often that face storage challenges. Dust covers should also be used if stacking cannot be avoided due to space restrictions. before dust cover can be placed items must be completely cooled before the dust cover can be placed minimum of 30-120 minutes. JC / JCAHO Joint Commission requires annual competency testing for all employees. hygrometer measures humidity making sure that the humidity is at the proper levels helps prevent the growth of microoganisms. Black dots in a fiberoptic light cable Indicate that there is damage to the glass rods. Sterilizer Anatomy Drain line of the most important parts to check, is the coldest part of the sterilizer because this is where the air & steam exit. Where the thermometer is located and where the PCD/Bowie dick test pack is placed for testing because it is the location of greatest challenge in the steam sterilizer. door gasket the second most important to check Sterilizer jacket is where steam is kept warm and
surrounds the internal chamber. Internal chamber where the steam purged into the chamber should be 97-100% dry saturated steam w/3% entrained water. simultaneous wrapping Use of two thicknesses of a wrapping material at the same time. Sequential wrapping wrapping one wrap after another. Rigid Scopes Arthroscope, Hysteroscope, Resectoscope, Laparoscope, Cystoscope, Nephroscope, Otoscope Soft cloth and detergent Should be used to clean fiberoptic light cables Woven Textiles Wrap is made of 100% cotton, reusable, & have 30- day expiration date. they are also not a good barrier. woven textiles can be used in Steam, EO/ ETO Packing Materials: Non Woven wraps is made of cellulose fibers-plastic polymers-paper pulp, are single use and provide an excellent barrier. Non-woven can be used in Steam, EO/ETO, Low Temperature Gas Plasma Packing Materials: Tyvek pouches are made of all plastic and should never be put in trays. Tyvek can be used in EO/ETO, Low Temperature Gas Plasma,Ozone Tyvek can not be used in Steam
All loads back to the last negative BI should be recalled if you have a positive BI. Because a positive BI means the sterilization cycle did not kill spores. The color of the BI would be yellow/fluorescent if it is positive. the BI should remain purple if it is negative. Chemical Indicator Class: Autoclave tape Chemical Indicator Class: 2 Bowie Dick Chemical Indicator Class: Glass Ampule, monitors only one parameter Chemical Indicator Class: 4 Multi-Variable Indicator, monitors 2 or more parameters Chemical Indicator Class: Integrating Indicator monitors all critical parameters; Can perform in parallel with a BI Chemical Indicator Class: Emulating Indicators monitor cycle verification When discarding Glutaraldehyde Use running water when discarding Glutaraldehyde down the drain unless your state DOH states different. A Biological has 1 Million spores and less than one spore should be viable from 1,000,000 after the sterilization cycle. Aeration removal of ETO Aeration times 8 hr. @ 140* 10 hr. @ 130* 12 hr. @ 122* Drying time in a steam sterilizer is affected by
weight of sets, load configuration, type of package, steam quality, & metal mas among other factors. Par-level replenishment ( Fixed Inventory Level) A predetemined inventory for each supply. Supplies are centralized & standardized. Using department not responsible for inventory control. Uses a barcode scanner. Computerized Lock Supply System is part of a par-level system that is called vending machine/ATMs. principles of cleaning: 1 Solution must contact all surfaces principles of cleaning: Action to enhance cleaning principles of cleaning: Scrubbing, spraying, cavitation principles of cleaning: All hinges completely open principles of cleaning: Multipart instruments disassembled principles of cleaning: Separate multi-level trays principles of cleaning: prevent damage to instruments-heavy on bottom light on top principles of cleaning: Avoid mixing dissimilar metals-causes electrolysis principles of cleaning: Always clean containers before re-sterilization or use If an item dropped and has a dustcover
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