Assembly and Instrument classification

What is the main purpose of the assembly area in MDRD

The purpose of the assembly area is to prepare items for sterilization.

The assembly area prepares instruments for sterilization by

5 steps

Sorting

Inspecting

Assembling

Packaging for sterilization

Labeling

The most common instrument lubricant is a thin white liquid called instrument milk. what are 5 benefits of using it

It is designed to protect and lubricate instruments

It contains an antimicrobial ingredient to prevent growth of pathogens, as solution sitting at room temperature for extended periods can be a growth medium for microorganisms

Instrument milk solution is water soluble to allow for steam penetration during sterilization

It is a thin consistency to easily penetrate difficult to reach and tight fitting surfaces of instruments to support easy movement of parts

It has a rust inhibitor

What is oil used for?

Oil is used to lubricate power equipment and instruments. It is water soluble to allow steam penetration for sterilization.

Items received from the decontamination area are first sorted into one of two groups for delivery to the appropriate assembly location and consists of ___ and ____/____ grade

Surgical grade and floor/ward grade

Examples of like-groups include

Towel clips, scissors, clamps, needle holders, forceps, handles and suction tips

List the four difficult to clean areas of instruments

Teeth and jaws

Box locks

Ratchets

Lumens

What are the 12 considerations for handling of instruments

Handle instruments with care

Do not bounce of throw them into processing baskets or into the sink

Handle instruments individually or in small lots to prevent them from becoming tangled

Do not overload baskets

Place heavy instruments in the bottom of the basket

Instruments with concave (curved) surfaces should be placed upside down so they can drain

Open hinged instruments or place them on special racks that keep the jaws apart.

Avoid layering instruments as this may conceal surfaces from being exposed to the washing and rinsing process

Taking apart instruments consisting of two or more parts may not be interchangeable so they must be kept together

Disposable blades and needles are discarded at point of use, and should not be returned to the MDRD

Careful inspection and handling of instruments is necessary to prevent personal sharps-related injuries

All sharps incidents must be reported

Sharps include cutting instruments such as 1-3

Scissors

Curettes

Chisels

How can rongeurs be tested for sharpness?

Using a piece of cardboard (the thickness of a business card). The instrument should bite cleanly through the card

How can osteotomes and chisels be tested for sharpness?

Using a piece of paper, should cut through cleanly

What are the four ways to ensure lumens are cleaned?

Check both ends for cleanliness

Pipe cleaners or suction stylets can be used to remove debris from suction tips or initial lumen cleaning

Appropriate sized brushes should be used for secondary leaning or cleaning instruments with long lumens

Lumens must be flushed with water until water runs clean, then dried with forced air

You should assemble instruments sets accurately according to the

Department instructions

Guidelines for set assembly identify that the MDRD technician should process with:

a. Heaviest items wrapped separately

b. Lightest items mixed with heaviest items to prevent damage

c. Heaviest items placed on top of tray

d. Heaviest items placed on bottom of tray

Heaviest items placed on the bottom of tray

Passivation is a process that ____ manufacturing _____ and applies an ________ coating to ______ the instrument through repeated ___ and ____

Passivation is a process that removes manufacturing impurities and applies an anticorrosion coating to protect the instrument through repeated use and reprocessing

The cause of instrument pitting is the ___ to ____ solutions, _____

The cause of instrument pitting is exposure to saline solutions blood, potassium, chloride and the number of other compounds

Ward grade instruments consist of a ____ finish

shiny

Surgical grade instruments consist of a __ ___ ____ finish

Tungsten carbide matte finish

300 grade steel is called ___ type

Austenitic

400 grade steel is called ____ type

Martensitic

The basic classification of surgical instruments are grouped into the following five categories:

Sharps

Clamps

Grasping instruments

Retractors

Miscellaneous instruments

What are clamps used for ?

Clamps forceps are generally used to stop bleeding and designed to tightly compress bleeding vessels. Clamps can also be used for grasping and holding muscle facia.

What are tissue forceps used for?

Tissue forceps: are used for grasping or holding tissue during surgery

What are towel clamps used for?

Towel clamps or clips: Are used to hold cords, tubing, sterile towels and drapes on the patient.

What are retractors used for?

Retractors: are used to hold back tissue, organs, or would edges in order to obtain proper exposure of the operative site

What does IMS stand for?

Instrument Management System

What are the two parts that an IMS consists of?

The hardware consists of a network of computers, a central server, workstations that include scanners, and printers

The software consists of the system program and the proprietary instrument management program

Define a linear barcode

An optional machine-readable representation of data relating to the object which it is attached

List the 12 benefits of an IMS system

Track costs

Support quality assurance initiatives

Items can be directly traced to patients

Locate missing instruments/sets

Immediate changes to set lists, and MIFU

Images of set lists, and set case carts

Track the frequency of flashed items

Reduce instrument inventory, standardize sets, and prioritize purchases

Reduce errors

Immediate recall identification and location of items for retrieval

Prioritize or fast track items

Education and orientation training