Surgical Asepsis and Sterility: Best Practices and Techniques

Flashcards covering key vocabulary and concepts from Chapter 7 on Surgical Asepsis and Sterility.

Asepsis

The practice of preventing contamination by microorganisms.

Surgical Conscience

An ethical responsibility to maintain sterile technique and quality patient care.

Disinfection

Process that destroys most, but not all, microorganisms on inanimate surfaces.

Sterilization

Complete destruction of all microorganisms, including spores, on inanimate surfaces.

Decontamination

Removal or destruction of contaminants by physical or chemical means.

Critical Items

Items that must be sterile because they enter the bloodstream or body cavity.

Semi-Critical Items

Items that come into contact with mucous membranes or non-intact skin.

Non-Critical Items

Items that only contact intact skin and do not require sterilization.

High-level Disinfection

A disinfection process that eliminates all microorganisms except large numbers of bacterial spores.

Steam Sterilization

The process of destroying all microorganisms using saturated steam under pressure, requiring specific cycle times, temperatures, and pressures for efficacy.

Ethylene Oxide (ETO) Sterilization

Low temperature gas sterilization for heat-sensitive materials, involving a specific cycle time for exposure followed by aeration.

Event-related sterility

The sterility of an item is determined by how it is handled rather than by a time-based expiration.

Mechanical Monitoring

Using tools to monitor the effectiveness of sterilization processes.

Chemical Sterility Indicators

Indicators used to show that sterilization conditions have been met.

Administrative Controls of Sterilization

Documentation and maintenance measures to ensure effective sterilization.

Medical Asepsis

Practices that reduce the number and transfer of pathogens (e.g., handwashing, cleaning).

Surgical Asepsis

Practices that render and maintain objects and areas free from microorganisms; also known as sterile technique.

Biological Indicators

Devices containing bacterial spores used to monitor the effectiveness of sterilization processes by confirming microbial death.

Cleaning

The physical removal of all visible soil and organic material from an object or surface; it is the first step in decontamination.

Sterile Field

An area maintained free of all microorganisms to protect the integrity of a sterile item, patient, or area.

Preventing Environmental Cross-contamination

Measures taken to prevent the spread of microorganisms from environmental surfaces to patients, staff, or sterile items.

Classification of Patient Care Items

Categorizing medical devices based on the risk of infection they pose, determining the level of reprocessing required (e.g., Critical, Semi-critical, Non-critical).

Levels of Disinfection

The categorization of disinfection processes based on their efficacy against different types of microorganisms: High-level, Intermediate-level, and Low-level.

High-level Disinfectant Compounds

Chemical agents capable of destroying all microorganisms except large numbers of bacterial spores (e.g., glutaraldehyde, hydrogen peroxide, peracetic acid).

Intermediate-level Disinfectant Compounds

Chemical agents capable of destroying vegetative bacteria, mycobacteria, most viruses, and most fungi, but not bacterial spores (e.g., alcohol, iodine, phenolics, chlorine compounds).

Important Part of Maintaining Asepsis

Vigilance and strict adherence to established protocols, including proper hand hygiene, sterile technique, and environmental controls.

Instrument Decontamination and Preparation for Sterilization

The initial process of cleaning, inspecting, and preparing instruments—often involving manual cleaning, enzymatic soaks, and sometimes ultrasonic cleaning—before terminal sterilization.

CST Care of Instruments Before Transport

At the point of use, the Certified Surgical Technologist (CST) removes gross soil, disassembles multi-part instruments, and places them in appropriate containers with enzymatic foams or solutions to prevent drying of bioburden.

Care of Instruments in CSPD Decontamination

In the Central Sterile Processing Department (CSPD) decontamination area, instruments undergo thorough manual cleaning, ultrasonic cleaning, and rinsing to remove all organic and inorganic materials before inspection and sterilization.

Three-Sink Method for Decontamination

A systematic method for manual decontamination in CSPD: 1) wash with detergent, 2) rinse with tap water, and 3) rinse with distilled or deionized water.

Final Preparation for Sterilization

The meticulous steps following decontamination and cleaning, which include inspection for damage, assembly of instrument sets, proper packaging, and labeling of items for the chosen sterilization method.

Steam Sterilization Principles and Factors

The process of destroying all microorganisms using saturated steam under pressure, with critical factors including time, temperature, and steam penetration to ensure efficacy.

Gravity Displacement Sterilizers

A type of steam sterilizer where air is displaced by incoming steam that enters at the top of the chamber and forces cooler, denser air out through a drain at the bottom.

Steam Sterilization Monitoring and Considerations

Includes validating load configuration, proper packaging, and using physical (gauges), chemical (indicators), and biological (spore tests) monitoring methods to ensure effective sterilization.

Ethylene Oxide (ETO) Cycle Time and Aeration

ETO sterilization involves a lengthy exposure cycle (e.g., 2-15 hours) at low temperatures, followed by a crucial aeration phase (e.g., 8-12 hours) to remove toxic residual ETO gas from items.

Hydrogen Peroxide Gas Plasma Sterilization

A low-temperature sterilization method using hydrogen peroxide vapor that is converted into plasma through radiofrequency or microwave energy, effectively killing microorganisms on heat and moisture-sensitive items, with cycle times typically ranging from 28-38 minutes.

Alternative Low-Temperature Sterilization Methods

Sterilization technologies for heat and moisture-sensitive items, besides ETO, such as hydrogen peroxide gas plasma, peracetic acid systems, and ozone sterilization.

Sterile Supply Maintenance and Storage

The practices involved in handling, storing, and rotating sterile items in designated, clean, and dry environments to maintain their sterility until the point of use.

Medical Asepsis

Practices that reduce the number and transfer of pathogens (e.g., handwashing, cleaning).

Surgical Asepsis

Practices that render and maintain objects and areas free from microorganisms; also known as sterile technique.

Biological Indicators

Devices containing bacterial spores used to monitor the effectiveness of sterilization processes by confirming microbial death.

Cleaning

The physical removal of all visible soil and organic material from an object or surface; it is the first step in decontamination.

Sterile Field

An area maintained free of all microorganisms to protect the integrity of a sterile item, patient, or area.

Preventing Environmental Cross-contamination

Measures taken to prevent the spread of microorganisms from environmental surfaces to patients, staff, or sterile items.

Classification of Patient Care Items

Categorizing medical devices based on the risk of infection they pose, determining the level of reprocessing required (e.g., Critical, Semi-critical, Non-critical).

Levels of Disinfection

The categorization of disinfection processes based on their efficacy against different types of microorganisms: High-level, Intermediate-level, and Low-level.

High-level Disinfectant Compounds

Chemical agents capable of destroying all microorganisms except large numbers of bacterial spores (e.g., glutaraldehyde, hydrogen peroxide, peracetic acid).

Intermediate-level Disinfectant Compounds

Chemical agents capable of destroying vegetative bacteria, mycobacteria, most viruses, and most fungi, but not bacterial spores (e.g., alcohol, iodine, phenolics, chlorine compounds).

Important Part of Maintaining Asepsis

Vigilance and strict adherence to established protocols, including proper hand hygiene, sterile technique, and environmental controls.

Instrument Decontamination and Preparation for Sterilization

The initial process of cleaning, inspecting, and preparing instruments—often involving manual cleaning, enzymatic soaks, and sometimes ultrasonic cleaning—before terminal sterilization.

CST Care of Instruments Before Transport

At the point of use, the Certified Surgical Technologist (CST) removes gross soil, disassembles multi-part instruments, and places them in appropriate containers with enzymatic foams or solutions to prevent drying of bioburden.

Care of Instruments in CSPD Decontamination

In the Central Sterile Processing Department (CSPD) decontamination area, instruments undergo thorough manual cleaning, ultrasonic cleaning, and rinsing to remove all organic and inorganic materials before inspection and sterilization.

Three-Sink Method for Decontamination

A systematic method for manual decontamination in CSPD: 1) wash with detergent, 2) rinse with tap water, and 3) rinse with distilled or deionized water.

Final Preparation for Sterilization

The meticulous steps following decontamination and cleaning, which include inspection for damage, assembly of instrument sets, proper packaging, and labeling of items for the chosen sterilization method.

Steam Sterilization Principles and Factors

The process of destroying all microorganisms using saturated steam under pressure, with critical factors including time, temperature, and steam penetration to ensure efficacy.

Gravity Displacement Sterilizers

A type of steam sterilizer where air is displaced by incoming steam that enters at the top of the chamber and forces cooler, denser air out through a drain at the bottom.

Steam Sterilization Monitoring and Considerations

Includes validating load configuration, proper packaging, and using physical (gauges), chemical (indicators), and biological (spore tests) monitoring methods to ensure effective sterilization.

Ethylene Oxide (ETO) Cycle Time and Aeration

ETO sterilization involves a lengthy exposure cycle (e.g., 2-15 hours) at low temperatures, followed by a crucial aeration phase (e.g., 8-12 hours) to remove toxic residual ETO gas from items.

Hydrogen Peroxide Gas Plasma Sterilization

A low-temperature sterilization method using hydrogen peroxide vapor that is converted into plasma through radiofrequency or microwave energy, effectively killing microorganisms on heat and moisture-sensitive items, with cycle times typically ranging from 28-38 minutes.

Alternative Low-Temperature Sterilization Methods

Sterilization technologies for heat and moisture-sensitive items, besides ETO, such as hydrogen peroxide gas plasma, peracetic acid systems, and ozone sterilization.

Sterile Supply Maintenance and Storage

The practices involved in handling, storing, and rotating sterile items in designated, clean, and dry environments to maintain their sterility until the point of use.

Low-level Disinfection

A disinfection process that kills some viruses and bacteria, but not mycobacteria or spores, typically used for non-critical items or environmental surfaces.

Peracetic Acid Sterilization

A liquid chemical sterilization method that rapidly sterilizes heat-sensitive instruments by oxidizing microbial cellular components, known for its short cycle times.

Ozone Sterilization

A low-temperature sterilization method that uses ozone gas to destroy microorganisms through oxidation, suitable for moisture and heat-sensitive medical devices, with varying cycle times depending on the load and system.