chapter 10 part 2

table top steam sterilizers are?

compact steam sterilizer that has a chamber volume of no more than 2 cubic feet

table top sterilizers are not connected to a steam source they

generate their own steam from distilled water in a reservoir

common reason for table top sterilizers to have process failures

overloading

when loading table top sterilizers items should be

positioned to permit circulation of the steam, enough space between trays and packs approx. ¼ inch

table top sterilizers have four types of monitoring:

administrative, physical, chemical, biological

what is the biological spore used to monitor table top sterilizers?

geobacillus stearothermophilus

where is the cold point in a sterilizer?

normally in the center of the load towards the front of the chamber

qualification testing for table top sterilizers are done in

full loads

in most table top sterilizers drying is achieved by?

cracking the door approx. one-half inch

to reduce the potential for compressing contaminants into the packs personnel should don

sterile gloves over heat resistant gloves when transferring packs to the cool rack

as packages are removed from the sterilizer carts they should be expected for?

damage, package identification, visual change of external indicator, moisture

dry heat kills microorganisms by?

oxidation (decomposing the bacterial wall)

dry heat takes longer to kill and requires

much higher temperatures, longer exposure time

what is the gravity-type dry heat sterilizer

depends on gravity to lower the heat from top of sterilizer to the bottom

what is the convection type dry heat sterilizer

a fan that circulates the heat, providing for even heat inside the chamber

dry heat is less effective than

moist heat (steam) sterilization

what is the packaging choice for dry heat sterilization?

aluminum foil

what spore BI does dry heat use as biological monitoring?

bacillus atrophaeus

dry heat cycles should be biologically monitored with a BI at least

weekly

EO is the most stable

low temperature sterilant

EO is a gas at room temperature with a boiling point of

51.3F

two types of EO

undiluted 100% single dose cartridges, and mixtures

100% EO cartridges are

small and easy to use, cost effective, and operate under a vacuum

personnel should store 100% EO cartridges in

well ventilated area that has at least 10 air exchanges per hour

PPE for using EO

neoprene, butyl rubber, or nitrile rubber gloves and googles, or face shield

basic parameters of EO sterilization

gas concentration, exposure time, humidity, temperature

alkylation interferes with

the normal metabolism of microorganisms causing it to die ( the removal of hydrogen from the chemical structure if the microorganism)

for EO to penetrate cell walls microorganisms must be

hydrated

currently EO sterilizers with rigid chambers have

negative pressure throughout the cycle

at the beginning of the cycle, the EO sterilizer performs?

a chamber leak test

preparing items for EO sterilization packaging are maintained in a environment with

a relative humidity of 35% to 50%

other packaging that may be used for EO sterilization include

polypropylene wrappers, paper-plastic pouches, tyvek pouches

EO sterilizers should be loaded in a manner that allows

sterilant to easy circulate and reach all surfaces of the packages, facilitates humidification and aeration

personnel should use BIs containing

also Bacillus atrophaeus

EO placement of BI PCDs

in most cases in the center of the load

for the safety of patients all EO residuals must be

removed from sterilized items using a process called aeration

for EO aeration healthcare facilities must

use a single chamber process

aeration time is affected by?

heatth

the higher the temp, the ? the aeration time

shorter

typical minimum aeration times and temps for EO

122F for 12 hours or 140F for 8 hours

acute toxic effects of EO

irritation of the respiratory tract, eye irritation, headache, skin sensitization, vomiting, diarrhea, taste in mouth, drowsiness

chronic toxic effects of EO

respiratory tract irritation, secondary respiratory irritation, anemia, altered behavior, subacute polyneuropathy

byproducts of EO can also be formed during the sterilization process

ethylene glycol (antifreeze) when reacted with water

another byproduct of EO is

ethylene chlorohydrin (a colorless liquid with an ether-like odor that is very toxic by inhalation and skin absorption

EO mandatory PPE

impermeable aprons or full body coverings, EO resistant gloves, goggles or face shields

EO is regulated by?

OSHA, EPA, FDA

activities that are most likely to produce exposures to EO

unloading sterilizer, removing BI vials, changing EO cylinders, removing items from the sterilizer-aerator

under regulation EO monitoring results must be shared with each employee within

15 days of results

emergency plans for EO leaks and spills

must have a written plan, have visible and audible alarm to alert employees, procedures for evacuation

ventilation of EO is?

dedicated exhaust system, vented to the outside of building, the vent must not end within 25 feet of any building air intake source

low temperature gas plasma sterilization is?

a quick, low temp process that uses a combination of hydrogen peroxide vapor and gas plasma to effectively and safely sterilize packages devices

LTGP is used for many

multiple and single channel flexible endoscopes, rigid endoscopes, endoscopic instruments, cameras, stereotactic devices, fiber optic light cords

what is the Low temp gas plasma sterilizer called?

Sterrad

sterrad the cycle time is approximately

55 minutes

during the sterilization cycles, the sterrad sterilizer operates at what temp?

113 degrees F and does not exceed 131 degrees F

Sterrad (LTGP) sterilizer provides two cycles

standard and advance

what is the standard cycle for the sterrad (LTGP)?

processes general surgical instruments and devices, in 28 minutes

what is the advance cycle in the sterrad sterilizer (LTGP)

processes general surgical instruments and devices and a limit of 10 lumens per cycle, 38 mins

Sterrad 100NX provides four cycles

standard, flex, duo, and express

in the sterrad 100NX, in the standard cycle, how long is the cycle and what can be processed?

47 minutes and most instruments, rigid endoscopes

in the sterrad 100NX, how long is the flex cycle and what does it process?

42 minutes and flexible endoscopes

in the sterrad 100NX, how long is the DUO cycle, and what does it process?

60 minutes, longest cycle

In the sterrad 100nx how long is the Express cycle?

24 minutes and processes the da Vinci 3d endoscopes

what items should not be placed in any LTGP sterilizer?

Cellulose-based materials, count sheets, implants, liquids

what are the parameters for the LTGP sterilization ?

time, temperature, hydrogen peroxide gas plasma

how many ampules are in a hydrogen peroxide cassette

10 single ampules

the phases of the sterilization process for LTGP

vacuum, injection, diffusion, plasma, (repeat), Vent

LTGP vacuum phase

all air is removed from the chamber and the packages until the pressure is reduced to below atmospheric pressure

LTGP injection phase

correct pressure has been reached, a pre measured amount of 59% hydrogen peroxide is pumped from the cassette into the vaporizer bowl

LTGP diffusion phase

chamber returns to atmospheric pressure and hydrogen peroxide vapor is driven into small crevices and lumens of the devices in the chamber.

LTGP injection, diffusion, plasma

all three phases are repeated a second time

LTGP vent phase

at the end of the second sequence RF is turned off, air is vented into the chamber through HEPA filters, returning the chamber to atmospheric pressure

LTGP plasma phase

chamber pressure is reduced by vacuum, and RF energy is radiated within the chamber from the electrode screen, RF ionizes and the hydrogen peroxide, creating hydrogen peroxide gas plasma

what goes in to sterrad low temp gas plasma

tyvek (all plastic) pouches, rigid containers validated, polypropylene based wraps

LTGP when is the most effective sterilizer performance is achieved when

the load contains a mixture of metal and plastic items

tyvek pouches should be placed on

their edge

Low temp gas plasma CI color change that is red

unprocessed

low temp gas plasma CI color golden or lighter

after exposure to hydrogen peroxide

sterrad low temp CI indicator colors

red to yellow

when incubating LTGP BI what is the incubation temperature?

131 degrees to 140 degrees for at least 24 hours

sterrad velocity BIs offer

rapid read outs 15-30 minutes

low temperature hydrogen peroxide LTHP is a?

low temp sterilization process that uses vaporized hydrogen peroxide as the sterilant

what is LTHP intend use?

sterilizing heat or moisture sensitive devices

because of the byproducts of the hydrogen peroxide sterilant are oxygen and water vapor it does not

require additional aeration

what is a low temperature hydrogen peroxide sterilizer?

steris Vpro

Vpro sterilizers have 3 pre-programmed sterilization cycles

lumen, non lumen, flexible

LTHP parameters

time, temperature, and hydrogen peroxide concentration

in Vpro, as hydrogen peroxide diffuses and contacts surfaces, what process occurs?

an oxidative process that inactivates microorganisms

Vpro sterilization has three phases

conditioning phase, sterilization phase, aeration phase

low temp hydrogen peroxide CI indicator colors

magenta when unprocessed, orange/yellow when exposed to hydrogen peroxide

what is hydrogen peroxide ozone sterilization

a low temperature method that uses both vaporized hydrogen peroxide and a small amount of ozone in a multi phase process

what is ozone

a very reactive form of oxygen that is a bluish irritating gas of pungent odor

how large Is the hydrogen peroxide ozone sterilizer

4.4 cubic feet

what is the load capacity for hydrogen peroxide ozone chamber

up to 75 pounds

what is the cycle time for hydrogen peroxide ozone

approximately 46 to 50 minutes, same cycle for all loads

personnel can use hydrogen peroxide ozone to sterilize?

dedicated or mixed loads of general instruments, rigid and semi rigid endoscopes, flexible endoscopes

hydrogen peroxide ozone sterilization method only uses

electric power and oxygen, no need for drain or special ventilation

what devices are not compatible with hydrogen peroxide ozone?

implants, glass or plastic ampules containing liquid, devices made of rubber, textile fabrics

hydrogen peroxide ozone solution

125-280 solution

when preparing items for hydrogen peroxide ozone sterilization personnel should use:

wraps ouches made of nonwoven polyethylene with polyester, aluminum containers, metal and plastic trays