Wrapping
Name the two types of folds for wrapped instruments and describe the orientation of the wrapper.
-Square fold oriented "squarely" in front of the user
-Envelope fold oriented with a corner pointing toward the user in a diamond shape
What types material are peel packs made of?
A combination of paper and plastic or a combination of tyvek and plastic
Name some of the aspects that should be checked before packaging an instrument for sterilization.
Inspect of cleanliness, make sure they are function properly (jaws line up, rathchets work, handles aren't too stiff), cutting edges are sharp, no chipping or breaks, no pins or screws are loose.
Where should nonporous items be placed on the rack if it is a combined load?
On the lowest shelf
What types of things are cleaned using level 3 disinfectants?
Floors, walls, furniture, and general equipment.
Name two types of materials used for wrapping and a few differences for each.
Woven textiles- re-usable, laundered, chemically treated to make them water resistant, single-ply (must use two), made of cotton or polyester.
Nonwoven textiles- single-use, disposable, usually come two-ply
Name the ways peel-packed items can be sterilized.
Ethylene Oxide or EtO, steam, or sterrad
How should instrument trays be assembled?
Inner tray is perforated to all flow if sterilant, towels in the bottom if the tray to absorb moisture, instruments placed on stringer to maintain open position, heavy items placed on bottom of the tray with lighter items on top.
Name some important aspects of loading the sterilizer.
Orient rigid containers so they lie flat (do not stack)
Arrange jars, tubes, and canisters on their sides with the covers off to provide escape of air and free flow of steam
Arrange everything loosely and avoid contact with other instrument packs or trays
What types of items are cleaned when using a level 1 disinfectant?
Endoscopes, biopsy forceps, cytology brushes, etc.
What can be placed on the outside of a wrapped tray to pro-long shelf-life?
A thick plastic wrap or dust cover
True or false: A peel-packed instrument should never be placed inside of a second peel-pack or "double peel packed".
False: it is perfectly acceptable to put a smaller peel packed instrument inside of a larger peel pack. In fact it often adds extra durability against tears or punctures.
Name some important inspection points when manually cleaning instruments.
Box locks, jaws, teeth, ratchets.
What should be the weight limit on instrument sets and why?
Instrument sets should not exceed 25 pounds because they are unsafe for personnel to lift and are more difficult to dry after sterilization.
What level of disinfectant is gluteraldehyde when used at an exposure time of 20 minutes?
Level 1
Name some of the recommended characteristics for packaging materials.
-Non-toxic
-low-lint
-flexible, durable, memory free
-remains free of holes, punctures or wear after going into the sterilizer
Describe the orientation of an instrument in a peel pack.
Tips facing away from the "opening end", make sure box locked instruments are open (may be placed in a paper card), make sure all sharp tips are protected or double peel packed, make sure sharp tips face the plastic side, make sure the appropriate size peel pack is used so that the whole instrument is visible.
Name at least 4 of the 7 aspects that should be labeled on an instrument being sterilized.
Package contents, shelf-life (if applicable), date of sterilization, cycle number, initials of employee, department in which it is to be sent (if applicable)
What color do indicators change when exposed to
Sterrad?
Steam?
Why?
Sterrad- red to yellow or dark to light
Because the hydrogen peroxide has a bleaching affect on the indicator.
Steam- tan to brown or light to dark
Because the heat from the steam.
What level of disinfectant is sodium hypochlorite (bleach) when used at an exposure time on only 10 minutes?
Level 2
What are size and weight requirements for wrapped instruments?
-No larger than 12x12x20
-No heavier than 12 pounds
How are peel packs sealed before sterilization and how should they be placed in the sterilizer?
Sealed using either the sticky tab on the peel pack or sealed using heat. They should be spaced out when placed in the sterilizer and should never be placed underneath a heavier item.
What specifics are involved in the handling of a scope or objects with a lumen?
If being gas sterilized leave a residual amount of water inside to ensure no air is trapped.
For gas sterilization, towel dry.
Instrument containers that hold medical devices during sterilization and also protect devices from contamination during storage and transport.
Rigid Container System
Name 4 chemicals used for disinfection.
Gluteraldehyde, hydrogen peroxide, paracetic acid, ethyl or isopropyl alcohol, carbolic acid, iodophor solution, sodium hypochlorite (bleach).