Transcript Chapter (Domain) 6: Cleaning, Disinfecting, Packaging, Sterilizing

Domain 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transportation,
and Storing Instruments and Supplies(12%-22 Questions)
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Objectives
• Identify the topics in Domain 6 and their
corresponding elements.
• Apply elements and topics to the chapters
and module in the study guide.
• Identify additional resources available.
• Assess your current knowledge.
• Develop a study plan.
• Identify your assignments.
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Chapter (Domain) 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transporting, and Storing
Instruments and Supplies
Module 1: Microbiological Considerations Related to
Infection Control Principles
Topics:
• Handling and disposition of biohazardous materials
• Microbiology
• Standard and transmission-based precautions
Elements (your nursing interventions)
• Use appropriate Personal Protective Equipment (PPE)
• Describe appropriate handling and disposition of
hazardous materials (blood, infectious pathogens such
as Creutzfeldt-Jakob Disease [CJD])
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PPE
• The Centers for Disease Control and
Prevention (CDC) has created a PowerPoint®
presentation on the use, application, donning,
and discarding of proper PPE materials.
• Play CDC slide show now
PowerPoint is a registered trademark of Microsoft Corp, Redmond, WA.
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Additional Resources
• CDC - Creutzfeldt-Jakob Disease, Classic (CJD)
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Use Appropriate PPE
Eyewash stations must be available for
exposure to any hazardous material. The
station must be located within _________ from
the location of possible exposure.
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 30 seconds
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Answer
B. 10 seconds
SRP (2014), Safe Environment of Care: IX.i.3. (p. 244).
The eyewash station must be located within 10 seconds
from areas where exposure may occur and immediately
available if the exposure is related to a caustic or strong
acidic chemical.
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Chapter (Domain) 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transporting, and Storing
Instruments and Supplies
Module 2: Cleaning and Disinfecting Instruments and
Supplies
Topics:
• Regulatory requirements for tracking of materials and
instruments brought in from outside the facility.
• Principles of cleaning and disinfection.
• Professional (AORN Perioperative Standards and
Recommended Practices, Association for
Advancement of Medical Instrumentation [AAMI]) and
regulatory standards (Occupational Safety and Health
Administration [OSHA], Centers for Disease Control
[CDC])
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Chapter (Domain) 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transporting, and Storing
Instruments and Supplies
Elements (your nursing interventions):
• Choose the appropriate method for cleaning and
disinfection of contaminated equipment and
instruments.
• Manage materials and instruments brought in from
outside the facility.
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Additional Resources
• Association for the Advancement of Medical
Instrumentation (AAMI)
• Summit Report: Priority Issues From the AAMI/FDA
Medical Device Reprocessing Summit.
• http://www.aami.org/htsi/reprocessing/pdfs/2011_Rep
rocessing_Summit_publication.pdf
• 40 page report of summit findings
• Video from NBC
• Dirty Instruments Hurt Patients
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Choose appropriate method for cleaning and
disinfection of contaminated equipment and
instruments
_______ on the table during a surgical
procedure require decontamination before
processing to the required level of safety for
patient use.
A. All instruments used on the patient
B. All instruments
C. All visibly soiled instruments
D. Only instruments contaminated
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Answer
B. All instruments
B&K. (2013). Chapter 17: Decontamination and
disinfection: Instrument cleaning and disinfection. (p.
287).
“All instruments on the table during a surgical procedure
require decontamination before processing to the
required level of safety for patient use.”
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Chapter (Domain) 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transporting, and Storing
Instruments and Supplies
Module 3: Packaging and Sterilization of
Instruments and Supplies
Topics:
• Principles of packaging and sterilization.
Elements (your nursing interventions):
• Select appropriate packaging.
• Determine appropriate sterilization method.
• Select appropriate method(s) for
biological/chemical monitoring.
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Determine appropriate
sterilization method
In using a dynamic air removal (pre-vac)
sterilizer to sterilize a set of wrapped
instruments, which of the following indicates the
proper cycle:
A. 3 minutes at 121.1 °C (250 degrees F).
B. 4 minutes at 132.2 °C (270 degrees F).
C. 10 minutes at 121.1 °C (250 degrees F).
D. 10 minutes at 132.2 °C (270 degrees F).
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Answer
B. 4 minutes at 132.2°C (270 degrees F).
SRP. (2014). Sterilization: Table 4. (p. 581).
The AAMI recommendation for dynamic air removal
steam sterilization for wrapped instruments is 4 minutes
at 270 degrees F.
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Chapter (Domain) 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transporting, and Storing
Instruments and Supplies
Module 4: Principles of Transporting and Storing Sterile
Supplies
Topics:
• Environmental conditions of sterilization and storage
areas.
• Principles of transporting and storage.
Elements (your nursing interventions):
• Select appropriate methods for transporting and
storage of processed supplies and instruments.
• Monitor environmental conditions (humidity and
temperature) of sterilization and storage areas.
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Select appropriate methods for transporting and
storage of processed supplies and instruments
Warm or hot items should not be unloaded from
a sterilizer onto a cool surface because it could
cause:
A. contamination by dust collection.
B. mixing of sterile and non-sterile items.
C. the potential for steam condensation.
D. accidental damaging of delicate instruments.
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Answer
C. the potential for steam condensation.
SRP. (2014). Sterilization and Disinfection: VI.d.1., p.
581.
The combination of temperatures may lead to
condensation and moisture within the sterile packages
or containers. Any time a sterile item has moisture
within or on it, the item must be considered unsterile.
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Chapter (Domain) 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transporting, and Storing
Instruments and Supplies
Module 5: Principles of Biological and
Chemical Monitoring
Topics:
• Documentation requirements for sterilization,
biological, and chemical monitoring.
Elements (your nursing interventions):
• Document actions related to cleaning, disinfecting,
packaging, sterilizing, transporting, and storing
instruments and supplies.
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Document actions related to cleaning,
disinfecting, packaging, sterilizing, transporting,
and storing instruments and supplies
Class 5 chemical integrating indicators should
be used to monitor sterilizers used for IUSS.
How often should these Class 5 devices be
used?
A. Every load.
B. Monthly.
C. Weekly.
D. Daily.
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Answer
A. Every load.
SRP. (2014). Sterilization, VII.c.3., p. 582.
Biological indicators and chemical indicators should be
used to monitor sterilizer efficacy and assess
compliance with established monitoring standards.
Class 5 chemical integrating indicators should be used
within each sterilizer container or tray.
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Chapter (Domain) 6: Cleaning, Disinfecting,
Packaging, Sterilizing, Transporting, and Storing
Instruments and Supplies
Module 6: Safe Handling Practices for
Hazardous and Biohazardous Materials
Topics:
• Handling and disposition of hazardous materials.
Elements (your nursing interventions):
• Describe appropriate handling and disposition of
hazardous materials (chemotherapy medications
and radioactive materials).
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Describe appropriate handling and
disposition of hazardous materials
Formaldehyde may be used in a gaseous or
liquid form. The vapors are toxic to the:
A. skin.
B. gastrointestinal tract.
C. eyes.
D. respiratory tract.
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Answer
D. respiratory tract.
B&K (2013), Chapter 13: Potential source of injury to
the caregiver and patient, p. 228.
“Formaldehyde may be used in a gaseous or liquid
form. The vapors are toxic to the respiratory tract.”
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Study Plan
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Review your facilities policies related to Domain 6.
How often do you use IUSS?
Locate the temperature and humidity monitors?
Spend a day observing in CSP.
Locate outdates on suture and miscellaneous items.
Check package integrity in instrument store room.
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Assignments
Study guide.
• Read Chapter 6
• Complete reading assignments
• Complete activities
Next presentation
• Case study applying domain 6
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