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Sterile Processing CBSPD Test
Decontamination Area - Answer -Where soiled items are received and cleaned. *All levels for the same tray should be labeled w/a tag to identify the level number and set to which it belongs. Preparation and Packaging Area - Answer -where cleaned items are inspected, assembled, and packaged. Sterilization Area - Answer -where terminal sterilization is performed. Sterile Storage Area - Answer -where sterile items are stored until needed. Sterile Stores - Answer -where items for patient care from outside manufacturers are stored. Sometimes referred to as Medical Supply Distribution, Central Supply, or similar designation. Case Cart Area - Answer -where sterile supplies (trays and/or sterile items from outside manufacturers) are kept and picked for surgical cases. Dispatch - Answer -where sterile and clean items are dispensed. Loaner Area - Answer -for the receipt and return of instruments borrowed for specialty procedures. Patient Care Equipment Clean-Up Area - Answer -where patient care equipment is cleaned and disinfected. SPD Responsibilities - Answer -providing dependable, reliable services to enhance the quality of patient care. Instruments sets, patient care equipment, and other medical devices must be processed and distributed in an accurate and timely manner so that patient care is not adversely affected. Work Flow - Answer -how the work progresses through the department or processing area. *Dirty to Clean People Flow - Answer -how people move through the department or processing area. *Clean to Dirty
Traffic Control - Answer -controlling access to SPD Ethics - Answer -the discipline dealing with what is good and bad and with moral duty and obligation. Ethical Actions - Answer -actions that conform to accepted and professional standards of conduct. Morals - Answer -deal with or relate to principles of right and wrong behavior. Unethical Professional Conduct - Answer -failure to conform to moral standards or policies. Professional Ethics - Answer -principles of conduct governing an individual or group. American Medical Association (AMA) - Answer -the most important organization related to healthcare ethics. Regulation - Answer -a principle, rule, or law designed to control or govern behavior. Agencies that issue regulations - Answer -EPA, FDA, OSHA and State health departments Standard - Answer -an established norm determined by opinion, authority, research and/or theory. Recommended Practices - Answer -statements of sound principles of practice based on scientific data and opinions of experts. Agencies that set standards - Answer -AAMI, CDC Examples of recommended practices - Answer -documents developed by IAHCSMM, SGNA, AORN Environmental Protection Agency (EPA) - Answer -Registers and regulates environmental disinfectants, controls emissions into the air and water, regulates the manufacture and sale of EO gas Food and Drug Administration (FDA) - Answer -regulates all medical devices. MedWatch (recalls); approves reprocessing of single use devices; require IFU (instructions for use) Function of CS/SPD - Answer -receives, cleans, decontaminates, assembles, inspects, disinfects, sterilizes reusable medical and surgical devices
NFPA Red Diamond - Answer -flammability NFPA Yellow Diamond - Answer -instability NFPA White Diamond - Answer -special hazard information The Joint Commission (TJC) formally (Joint Commission on Accreditation of Healthcare Organizations (JCAHO)) - Answer -voluntary; establishes accrediting standards and conducts onsite inspections; annual competency testing Association for the Advancement of Medical Instrumentation (AAMI) - Answer - voluntary; sets standards for CS/SPD Association of peri-Operative Registered Nurses (AORN) - Answer -voluntary; develops nationally recognized standards, recommended practices and guidelines for peri- operative setting Association for Professionals in Infection Control (APIC) - Answer -voluntary; international organization dedicated to prvention and control of infections Society of Gastroenterology Nurses and Associates (SGNA) - Answer -voluntary; established standards for effective processing of flexible endoscopes Department Of Transportation (DOT) - Answer -enforces laws relating to transportation of medical wastes American National Standards Institute (ANSI) - Answer -voluntary; proposes standards to include enhancing the global competitiveness and quality of life World Health Order (WHO) - Answer -voluntary; furthers international cooperation in improving health conditions National Institute for Occupational Safety and Health (NIOSH) - Answer -division of CDC; oversees airborne control/respiration masks Fire Safety - Answer -ALL equipment (including personal) should be safety checked by Biomedical Engineering Dept. and approval label attached before use Class A Fire Extinguisher - Answer -ordinary combustibles Class B Fire Extinguisher - Answer -flammable and combustible liquids Class C Fire Extinguisher - Answer -electrical equipment Class D Fire Extinguisher - Answer -combustible metals
Class K Fire Extinguisher - Answer -oils/fats in cooking appliances R>A>C>E (fire safety) - Answer -Remove/Rescue; Alarm; Contain/Confine; Extinguish P>A>S>S (operation of fire extinguisher) - Answer -Pull the pin; Aim the nozzle; Squeeze the handle; Sweep the stream over base of fire Personal Protective Equipment (PPE) - Answer -MUST be worn to protect from blood and bodily fluid Sharps - Answer -instruments/devices with points/blades disposable sharps must be disposed in - Answer -rigid biohazard container warm up jackets - Answer -worn to prevent hair and bacterial shedding from bare arms Quality Assurance (QA) - Answer -collection of data and identification of issues Training - Answer -should be standardized TAH - Answer -Total Abdominal Hysterectomy THA - Answer -Total Hip Arthroplasty Lap Appy - Answer -Laparoscopic Appendectomy Lap Chole - Answer -Laparoscopic Cholecystectomy ORIF - Answer -Open Reduction Internal Fixation CABG - Answer -Coronary Artery Bypass Graft BKA - Answer -Below the Knee Amputation TSA - Answer -Total Shoulder Arthroplasty Anatomy - Answer -structure, form and organization of body parts superior - Answer -toward the head inferior - Answer -toward the feet distal - Answer -toward end of limb proximal - Answer -top of limb; opposite distal
hyoid bone - Answer -located in neck; supports tongue and swallowing; only bone NOT articulated w/another vertebral column - Answer -vertebrae separated by discs; lumbar, thoracic and cervical spine PLIF - Answer -Posterior Lumbar Interbody Fusion Thoracic cage - Answer -sternum and 12 pairs of ribs; protect organs of chest and upper abdomen Making an opening into thoracic cavity to give surgeons access to lung and heart - Answer -Thoracotomy Appendicular skeleton - Answer -Appendages Pectoral girdle - Answer -scapula and clavicle connect bones of arms and aids movemnet Upper limb bones - Answer -humerus, radius, ulna, carpals, metacarpals and phalanges Carpal Tunnel Repair - Answer -removing tissue displaced bone in wrist area to release pressure on median nerve Lower limb bones - Answer -femur, tibia, fibula, patella, tarsals humerus, radius, ulna - Answer -connect at elbow joint carpals, metacarpals, phalanges - Answer -form wrist and hand femur, tibia, fibula - Answer -connect at knee joint patella - Answer -knee bone tarsals - Answer -ankle; metatarsals and phalanges form ankle and foot Joints - Answer -junctions between bones; articulation total hip and knee sets; osteotomes; screw sets - Answer -instruments used for skeletal system skeletal muscle - Answer -responds to stimulation by contracting and relaxing; voluntary; striated; *attached to bone by a tendon smooth muscle - Answer -involuntary movement; slower to contract and relax; common throughout body systems (e.g. digestive tract)
Types of muscle tissue - Answer -Cardiac; Smooth; Skeletal cardiac muscle - Answer -makes up heart; contracts automatically; involuntary and rhythmical ACL - Answer -Anterior Cruciate Ligament a repair to the muscles and ligaments of the shoulder joint - Answer -Rotator Cuff Repair Integumentary system - Answer -skin, hair, glands and nails largest organ OF the body - Answer -skin epidermis; dermis; hypodermis - Answer -layers of integument epidermis - Answer -superficial protective layer dermis - Answer -deeper than epidermis; *contains nerves and blood supply hypodermis (subcutaneous) - Answer -deepest layer of skin circulatory system - Answer -pumps blood (tissue) throughout the entire body and removes waste products transportation, regulation, protection - Answer -3 main functions of the circulatory system heart - Answer -pumps more than 10 gallons of blood a minute through arteries and veins; has 4 chambers atria - Answer -upper chambers; receive blood back from veins ventricles - Answer -lower chambers; force blood out of heart into arteries separated by septum - Answer -right and left chambers separated by mitral (bicuspid) and tricuspid valves - Answer -atria and ventricles when veins vs. arteries are reversed in the concept of blood flow - Answer -pulmonary; bluish color of vein indicate blood needs oxygen sternal saws, open heart instruments, coronary dilators - Answer -instruments used for circulatory system
pancreas - Answer -secretes pancreatic juice for digestion; regulates blood sugar instruments used for digestive system - Answer -laparoscopes, sigmoidoscope, colonoscope, laparotomy set central nervous system - Answer -brain and spinal cord peripheral nervous system - Answer -nerves connecting brain and spinal cord to the other outside parts of the body somatic system - Answer -peripheral nerves communicate w/ skin and skeletal muscles autonomic system - Answer -nerves communicate w/visceral organs cover spinal cord - Answer -vertebrae covers brain - Answer -skull protect membrane between bones and soft tissue of central nervous system - Answer - meninges carry messages from brain to organs and muscles - Answer -motor nerves carry information to the brain - Answer -sensory nerve gather information - Answer -dendrites ONE of the largest organs in the body; controls all movement; monitors and maintains all body systems - Answer -brain cerebrum - Answer -*center of consciousness; largest part of brain cerebellum - Answer -maintains balance brain stem - Answer -essential functions controlled 3 parts of brain - Answer -cerebrum, cerebellum, brain stem spinal cord - Answer -conducts nerve impulses; center for spinal reflexes; provides two way communication between brain and body major divisions of nervous system - Answer -autonomic/involuntary nervous system; voluntary nervous system
nervous system composed of two major parts - Answer -central nervous system (brain an spinal cord); peripheral nervous system (nerves that connect brain and spinal cord to other parts of body) autonomic/involuntary nervous system - Answer -conducts impulses to smooth muscle, cardiac muscle and glands; controls heart rate and breathing voluntary nervous system - Answer -sensation; mental function; skeletal muscle contractions instruments used for the nervous system - Answer -craniotomy sets; cervical fusion discs; laminectomy sets craniotomy - Answer -making an opening into the skull to access the brain sensory organs - Answer -extensions of the nervous system that allow perception of environment sense of smell - Answer -olfactory septoplasty - Answer -straightening or removing cartilage and/or bone in the nose when the nasal septum is deformed, injured or fractured sense of taste - Answer -gustatory eyebrow, facial muscles, eyelids, eyelashes, conjunctiva and tear ducts - Answer - associated structures of eye eyeball - Answer -fibrous and vascular tunics, retina; sclera; cornea;iris; pupil; retina sense of sight - Answer -eyes refract and focus incoming light waves onto photoreceptors in back of eye organ of hearing - Answer -ear ear - Answer -plays role in equilibrium and balance; consist of the smallest bones of the body tympanoplasty - Answer -reconstructing the ear drum so sound waves can be sent to the middle and inner ear ear consist of - Answer -tympanic cavity and membrane; malleus, incus, and stapes; eustachian tube connects middle ear to throat; cochlea (organ of corti) myringotomy set(ear); cataract set(eye); corneal transplant set(eye) - Answer - instruments used for sensory organs
fallopian tubes - Answer -transports egg to uterus uterus - Answer -environment for implantation of egg and development of fetus mammary glands - Answer -produce milk for nourishment of child after birth BSO - Answer -Bilateral SalpingoOopherectomy Bilateral SalpingoOopherectomy - Answer -removing both fallopian tubes and ovaries instruments used for the reproductive system - Answer -laparotomy sets; vaginal delivery sets; vasectomy set microbiology - Answer -branch of biology; deals with microorganisms and their effects on other living organisms minute living things too small to be seen with the naked eye - Answer -microorganisms etiology - Answer -branch of science; studies the cause of and origins of disease/abnormal conditions state of being soiled or infected by contact with infectious organisms or other material - Answer -contamination infection - Answer -invasion of body tissue by microorganisms which multiply and produce a reaction host - Answer -animal, plant or human that supports the growth of microorganisms microbe - Answer -organisms of microscopic/submicroscopic size; generally include viruses, rickettsiae, bacteria, algae, yeasts and molds chain of infection - Answer -six steps; causative agent, reservoir of the agent, portal of exit, mode of transmission, portal of entry, susceptible host causative agent - Answer -the microorganism that causes an infectious disease reservoir of the agent - Answer -the place where an infectious agent (microorganism) can survive portal of exit - Answer -the path by which an infectious agent leaves the reservoir mode of transmission - Answer -the method of transfer of an infectious agent from the reservoir to a susceptible host
portal of entry - Answer -the path used by an infectious agent to enter a susceptible host susceptible host - Answer -a person or animal that lacks the ability to resist infection by infectious agent bacteria, viruses, fungi, protozoa and microscopic algae - Answer -microorganisms include some but not all _______________ are harmful to your body - Answer -microorganisms few microorganisms are__________ - Answer -pathogenic (disease producing) pathogenic - Answer -disease producing mesophiles - Answer -often pathogenic to humans because they grow best at body temperature; 68-113 degrees F psychrophiles - Answer -like cold temperature; 59-68 degrees F thermophiles - Answer -like warm temperature; 122-158 degrees F bacteria measured in - Answer -microns 1 micron= - Answer -1/25 thousandths of an inch gram stain; Ziehl-Neilson stain - Answer -helps identify different types of bacteria via color change gram negative stain - Answer -red/pink gram positive stain - Answer -purple/blue the functional center of a cell that governs activity and heredity - Answer -nucleus cocci - Answer -round/spherical shaped cocci bacillus - Answer -rod shaped bacilli sprilillum - Answer -spiral and corkscrew flagella - Answer -thread like tails; help bacteria move through liquids binary fission - Answer -bacterial reproductive process that takes place when a mother cell divides into two daughter cells requirements for bacteria to survive - Answer -warmth, food, and water
spirochetes - Answer -spiral-like shape; found in water, sewage, soil and decaying organic matter; reason water in SPS decontamination needs to be looked at being treated (filtered, softened, distilled, sterile, etc.) viruses - Answer -one of a group of minute infectious agents that grow ONLY in living tissues/cells; require living host to multiply; not composed of cells protozoa - Answer -single celled (animal-like) microorganisms fungi - Answer -plant-like; can cause serious illness/death in immunocrompromised people prions - Answer -virus-like; cause variety of neurodegenerative diseases of humans and animals; have affinity for eye, brain and spinal cord tissues; *VERY difficult to kill by usual sterilization methods (considering HCF's willingness to reprocess- extended exposure time in steam) TSE - Answer -Transmissible Spongiform Encephalopathies BSE - Answer -Bovine Spongiform Encephalopathy; mad cow disease Creutzfeldt-Jakob Disease (CJD) - Answer -caused by prions; not a virus major cause of healthcare acquired infections - Answer -staph aureus MRSA - Answer -usually transmitted by healthcare workers due to poor/infrequent handwashing, or w/ pateients who have been on antibiotic therapy for a long time; Methicillin Resistant Staph Aureus Salmonella, M.tuberculosis, E.coli, streptococcus - Answer -Multi-Drug Resistant Organisms BMT - Answer -Bilateral MyringoTomy VRE - Answer -Vancomycin Resistant Enterococcus Myringotomy - Answer -making incision into tympanic membrane (eardrum) to permit fluid to drain and placing small tubes in membrane to permit continuous drainage Cholecystectomy - Answer -removing of gallbladder Coronary Artery Bypass Graft - Answer -removing a vein from the lower limb to bypass a blocked coronary artery of the heart AAA - Answer -Abnormal Aortic Aneurysm
Ex Lap - Answer -Exploratory Laparotomy IM - Answer -Intra-Medullary (femur/humerus) Standard Precautions (FKA Universal Precautions) - Answer -OSHA; handling infectious material as if they were infectious impervious - Answer -waterproof/water resistant; ideal against chemicals and bloodborne pathogens in decon Everything entering Decon - Answer -must be cleaned before leaving asepsis - Answer -the absence of pathogenic microorganisms that cause disease responsible for 90,000 deaths per year in the US according to CDC - Answer - Healthcare Acquired Infections; HAIs Nosocomial Infection - Answer -HAI; disease caused in the course of being treated in a hospital principle route of nosocomial infection - Answer -direct contact sentinel event - Answer -unexpected occurrence involving death/serious physical or psychological injury within hospital Root Cause Analysis (RCA) - Answer -determines underlying cause of adverse events; used after incident to uncover primary cause Surgical Site Infections (SSI) - Answer -SPS must do their part in their duty to prevent HCF - Answer -HealthCare Facility HCF Environments - Answer -major source of a variety of pathogens Evironmental Controls - Answer -Temp, Humidity and Air exchange requirements Decontamination Temp Requirement - Answer -60-65 Degrees (F) Decontamination Humidity Requirement - Answer -30-60% Decontamination Air Exchange Requirement - Answer -10 per hour Prep Assembly and Packaging Temp Requirement - Answer -68-73 Degrees (F) Prep Assembly and Packaging Humidity Requirement - Answer -30-60% (same as decon)
more than 90% of C. Diff HAIs occur - Answer -during or after antimicrobial therapy most effective means of reducing spread of C.diff - Answer -combination of hand hygiene and contact isolation No EPA registered products are available for inactivating C.Diff spores BUT - Answer - Bleach (hydrochlorite solution) has been shown to decrease rates of C.Diff contamination on environmental surfaces Defense mechanisms - Answer -keep us healthy resistance barriers - Answer -UNBROKEN skin and mucous membranes Immunity - Answer -defensive response of the body to antigens; Acquired (active vs passive) Portals of Exit - Answer -sneezing, coughing (Respiratory); feces, saliva (GI tract); secretions from penis and vagina, urine (Genitourinary tract) Portals of Entry - Answer -Mucous membranes (respiratory, GI, Genitourinary, conjunctiva); Skin (broken, hair follicles, sweat glands); Parenteral Tissue (injections, bites, cuts and wounds) reservoirs of infection - Answer -source of disease causing organisms must be present human reservoirs - Answer -people harbor organism and transmit directly or indirectly water that has been contaminated by human feces and animals - Answer -most notably responsible for GI disease condensation - Answer -the process by which a gas or vapor changes to liquid; leads to microbe build up, which leads to patient infection autoclave loads require - Answer -sufficient dry time and proper loading prior to set's steps of storage/distribution Modes of Disease Transmission - Answer -Contact; direct(physical contact), indirect(inanimate objects(fomites) and ventilation), droplets(respiratory secretions), airborne; Vehicles (air, food, water) corrugated cardboard boxes - Answer -ideal for logistically transporting medical supplies/equipment; Bugs love to hide/live on areas in between vectors - Answer -living things responsible for causing disease (insects/rodents)
fomite - Answer -inanimate (non living) object involved with the spread of an infection Hand washing - Answer -single most effective way to prevent infection; 15 second minimum unless sink turns off automatically after hand washing - Answer -water should be turned on via disposable towel and turned off using a different disposable towel always wash hands (when?) - Answer -before and after going on duty, before and after meals, after using bathroom, after sneezing/coughing into hands, after handling soiled items(garbage), before and after gloving, etc alcohol based hand antiseptics - Answer -60-95% concentration, only recommended if hands are not visibly soiled nails must be - Answer -1/4" or shorter; avoid artificial nails bloodborne pathogens - Answer -microorganisms that can be present in human blood and body fluids; are capable of producing disease in humans Under OSHA, a hospital's exposure control plan is designed to help protect employees against exposure to these - Answer -bloodborne pathogens OSHA Standard 29 CFR 1910.1030 - Answer -regarding bloodborne pathogens N95 mask - Answer -respirator filtering mask with thicker design to protect above average surgical mask; must fit-test (HCF respiratory therapy dept); may help protect against H1N1, SARS, tuberculosis and ebola; Not recommended for children or people with facial hair surgical N-95 mask - Answer -FDA- cleared as surgical mask, NIOSH certified as respirator; have all the qualities of N-95 along with evaluation for fluid resistance, flammability and biocompatibility all healthcare professionals must be properly trained in the handling of - Answer - medical waste due to incineration - Answer -no paper in biohazard containers, unless saturated (soaked/dripping) with blood; same for gloves, booties and other PPE prior to disposal in rigid sharps container - Answer -spores deemed not to be used may be recommended to be 'killed" via it's processing method (sharps container because containerized with glass inside plastic) HCF medical waste - Answer -microbiology lab waste, pathology and anatomy waste, blood/body fluid specimens, blood products and sharp items
