Chapter 8- Cleaning

Cleaning

Deionized (DI) water

Water that has had all ions removed through an ion exchange process.

Distilled water

Water that is heated to steam, then allowed to cool and condense.

Cavitation

The process used by an ultrasonic cleaner in which low-pressure bubbles collapse (implode) and dislodge soil from instruments.

Electroplating

A process that uses electrical current in a solution to produce a metallic coating

Impingement

The spray-force action of pressurized water against instruments being processed to physically remove bioburden

Thermal Disinfection

Use of heat to reduce the amount of microorganisms (excluding spores) on a medical device

Emulsifier

Any ingredient used to bind together substances that typically do not combine such as oil and water

Surfactant

A substance that lowers the surface tension of the water and increases the solubility of organic compounds

Chelating agents

Chemicals that hold hard water minerals in solution and prevent soap or detergent from reacting with the minerals

Toxic anterior segment syndrome (TASS)

Acute postoperative infammatory reaction in which a noninfectious substance enters the anterior segment of the eye and induces toxic damage to the intraocular tissues.

Decontamination area

The location within a healthcare facility designated for the collection, retention and cleaning of soiled and contaminated items.

Humidity

Amount of water vapor in the atmosphere; expressed as a percentage of the total amount of vapor the atmosphere could hold without condensation

Negative Pressure

Air pressure inside the room that is lower than the air pressure outside the room, causing the air to flow into the room with the lower (negative) air pressure.

Biohazardous waste

Waste containing infectious agents that present a risk or potential risk to human health

Utility Water

Water as it comes from the tap that may need further treatment to achieve the required specifications. This water is mainly used for flushing washing and rinsing.

Critical Water

Water that is extensively treated to ensure that microorganisms, organic, and inorganic materials are removed

Biocide

A substance of microorganism that kills or controls the growth of living organisms

Reverse Osmosis (RO)

A water purification process by which impurities are removed from water using a semipermeable membrane.

[workbook] What is the preferred pH for detergents used for most cleaning process?

Neutral pH

[workbook] Which of the following statements about the use of washer-disinfectors is not true?

All items should be washed on the same cycle.

[workbook] Water must be degassed each time an ultrasonic cleaner’s tank is changed because excess bubbles:

reduce the energy of the cavitation process

[workbook] Written cleaning instructions for surgical instruments should be provided by the:

Device manufacturer

[workbook] Floors and walls in the decontamination area should be:

Constructed to tolerate cleaning chemicals

[workbook] Untreated water

increases the likelihood of mineral scale deposits

[workbook] These are used to breakdown fatty deposits on instruments

Lipase enzymes

[workbook] Instrument lubrication is performed

after cleaning

[workbook] To prevent coagulation of proteins, instruments should be pre-rinsed using:

Cool water

[workbook] Detergents used in mechanical cleaners should be:

Low foaming

[workbook] During manual cleaning, instruments should be brushed using a

To-and-fro motion

[workbook] Powered surgical instruments:

cannot be immersed

[workbook] The decontamination area should have

negative airflow in relation to the other areas of the department

[workbook] Ultrasonic irrigators are used to

clean devices with lumens

[workbook] Rigid container filter retention plates should be

removed from the container and lid and cleaned separately

Automatic washers clean using a spray-force action called

impingement

The mechanical process by which an ultrasonic cleaner work is called

cavitation

To prevent aerosolization, items should be brushed

below the surface of the water.

[workbook] Cleaning brushes with (blank) bristles are usually used in the decontamination process

nylon

[workbook] How often should an ultrasonic cleaner be degassed?

Every time the water is changed

[workbook] How often should eyewash/shower stations be activated to verify they are performing to standards?

Weekly

[workbook] The best way to clean a suction lumen is:

Using a correctly sized brush

Where is the decon area most likely to be located at?

Near the operating room (OR) because most soiled instruments are generated there.

Borescopes should be…

used to view the internal surfaces of lumens

Lighting is…

Essential to a safe work environment and is a key element in the cleaning process. Instrument cleaning requires attention to detail, and lighting must be adequate for technicians to perform inspections associated with the cleaning process.

When should horizontal surfaces be cleaned?

At the beginning or end of each shift and as needed

When should spills be cleaned?

immediately

Can cleaning equipment that been used in decon, be used in other areas of the department?

No

Where should you don and doff ppe?

outside the decon work area, adjacent to the decontamination room.

What can poor water quality do?

Impact the performance of chemicals used for cleaning and disinfection and leave deposits on the items that have been cleaned.

If reusable brushes are used, they should be (blank) per the IFU to ensure they are not a source of contamination

Decontaminated

Should disposable brushes be used? True or false?

True

non-linting cloth is recommended because it reduces the risk of lint fibers being left on the instruments. True or false?

True

When should cloths be changed?

Regularly or when visibly soiled.

When should sponges be replaced?

After each use

What is instrument air?

Instrument air is compressed air that has had dust, dirt and other pollutants removed. Instrument air is used to power some medical devices such as pneumatic drills and saws. It is also used to dry medical devices after cleaning and decontamination.