HSPA Chapters 9 & 10 Reading Guide

Disinfection

Process destroying most microorganisms but not reliably destroying bacterial spores.

Low-Level Disinfection (LLD)

Process destroying vegetative bacteria, some fungi, and viruses, but not spores.

Intermediate-Level Disinfection (ILD)

Process destroying vegetative bacteria, mycobacteria, most viruses, and fungi, but not spores.

High-Level Disinfection (HLD)

Process destroying all microorganisms except large numbers of bacterial spores.

Spaulding Classification

System classifying medical devices based on infection risk: critical, semicritical, noncritical.

Contact Time

The length of time a disinfectant must remain wet on a surface.

Disinfectant

A chemical agent used on inanimate objects to destroy microorganisms.

Disinfection limitation

It is used to eliminate many microorganisms, but does not reliably destroy bacterial spores.

Factors in disinfection effectiveness

Proper cleaning, correct concentration, and contact time.

Disinfection selection basis

It is selected based on the Spaulding classification of the device.

Why clean before disinfection?

Soil shields microorganisms from the disinfectant and can deactivate the chemical.

Low-level disinfection use

Commonly used for noncritical patient-care items.

High-level disinfection target

Destroys all microorganisms except large numbers of bacterial spores.

ILD vs. HLD difference

HLD kills all vegetative microorganisms and mycobacteria; ILD does not reliably kill mycobacteria.

Disinfectant instructions

Manufacturer's instructions must be followed to ensure they are used safely and effectively.

PPE in disinfection

Required to protect workers from chemical exposure.

Why is contact time critical?

Insufficient contact time prevents the chemical from killing the targeted microorganisms.

Improper disinfection risk

Can increase the risk of healthcare-associated infections (HAIs).

Stainless Steel

An alloy of iron, chromium, and other elements highly resistant to corrosion.

Martensitic Stainless Steel

Hardened, magnetic stainless steel used for sharp cutting instruments.

Ringed Instrument

An instrument with finger rings for gripping and manipulating, like scissors.

Box Lock

The hinge point or joint where two halves of a surgical instrument meet.

Ratchet

The locking mechanism on ringed instruments that holds them closed.

Passivation

Chemical process applying a protective chromium oxide layer to prevent corrosion.

Surgical instrument classification

Commonly classified based on their design or function.

Major instrument categories

Cutting, clamping, retracting, and grasping/holding instruments.

Why identify instruments correctly?

Ensures correct assembly, proper function, and prevents delays during surgery.

Instrument locking mechanism

The ratchet allows a ringed instrument to lock into place.

Instrument joint area

The box lock is the joint area where two halves meet.

Instrument inspection areas

Instrument jaws, tips, and blades must be inspected for damage and cleanliness.

Effect of damaged instruments

Can cause tissue trauma, procedural delays, or fail to function properly.

Surgical instrument handling

Should be handled carefully to prevent damage and misalignment.

Box lock processing position

Instruments with box locks should be processed in the open position.

Purpose of testing instruments

To ensure they function properly and are safe for surgical use.

Central Service role in safety

Ensures clean, sterile, and fully functional instruments reach the patient.

Microorganism

A microscopic organism, such as a bacterium, virus, or fungus.

Spore

A highly resistant, dormant structure formed by some bacteria to survive harsh conditions.

Binary fission

The primary method of asexual reproduction in bacteria.

Biofilm

A colony of microorganisms protected by an extracellular matrix that resists cleaning.

Decontamination area

The physical area where contaminated items are received, sorted, and cleaned.

Cavitation

The process in ultrasonic cleaners where low-pressure bubbles implode to dislodge soil.

Impingement

The physical force of spraying water to mechanically knock soil off instruments.

Protease enzyme

An enzymatic cleaner specifically effective against protein-based soils like blood.

Lipase enzyme

An enzymatic cleaner specifically effective against fat-based soils.

Toxic Anterior Segment Syndrome (TASS)

Acute eye inflammation caused by chemical or detergent residues on ophthalmic instruments.

Central Service (CS) / Sterile Processing Department (SPD)

The department that receives, decontaminates, packages, sterilizes, and distributes medical devices.

PPE

Personal Protective Equipment; specialized clothing or equipment worn to protect against hazards.

IFU

Instructions for Use; manufacturer's mandatory guidelines for processing medical devices.

Standard Precautions

Infection prevention practices treating all human blood and bodily fluids as infectious.

Healthcare-Associated Infection (HAI)

An infection acquired by a patient during the course of receiving healthcare.

Sterile Processing Workflow

A strict one-way flow moving from decontamination to preparation, sterilization, and storage.

Decontamination vs. cleaning

Cleaning is physical soil removal; decontamination makes an item safe to handle without PPE.

Gross soil

Visible tissue, blood, bone, or other body fluids left on surgical instruments.

Sharps

Devices or objects with corners, edges, or projections capable of cutting or piercing.

Turnover

The cycle time between the completion of one procedure and preparation for the next.

Goals of point-of-use treatment

To prevent soil drying, prolong instrument life, reduce biofilm, and protect transport technicians.

Surgical Site Infection (SSI)

An infection that occurs after surgery in the part of the body where the surgery took place.

Chain of Infection

A series of six linked steps required for an infection to develop and spread.

Asepsis

The absence of microorganisms that cause disease.

Biocidal

An activity or chemical agent that is capable of killing living organisms, especially microorganisms.

Fomite

An inanimate object that can harbor and transmit infectious agents.

Pathogen

A microorganism capable of causing disease.

Six elements of the chain of infection

Causative agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

Three primary routes of transmission

Contact, droplet, and airborne.

Medical vs. Surgical Asepsis

Medical asepsis (clean technique) limits pathogens; surgical asepsis (sterile technique) completely eliminates all microorganisms.

Standard

A recommended guideline or benchmark established by consensus or professional organizations.

Best Practice

A method or technique consistently shown to produce superior results compared to other means.

HIPAA

Health Insurance Portability and Accountability Act; federal law protecting the privacy of patient health information.

Three categories of FDA recall

Class I (high risk of death/injury), Class II (temporary/reversible risk), Class III (low risk).

Bowie-Dick Test

A test used to detect air leaks and inadequate air removal in dynamic-air-removal steam sterilizers.

Biological Indicator (BI)

A sterilization monitoring device containing viable spores used to demonstrate that sterilization conditions were met.

Chemical Indicator (CI)

A device used to monitor one or more sterilization parameters through a physical or chemical change.

Geobacillus stearothermophilus

The spore-forming microorganism used to biologically monitor steam and hydrogen peroxide gas plasma sterilizers.

Ethylene Oxide (EtO) target spore

Bacillus atrophaeus is the spore used to biologically monitor EtO sterilization.

Three parameters of steam sterilization

Saturated steam, temperature, and exposure time.

Superheated steam

Dry steam that has been heated to a temperature higher than its boiling point.

Wet pack cause

Inadequate drying time, incorrect loading, or poor steam quality.

Sterile storage temperature

Should be maintained between 68°F and 75°F.

Sterile storage humidity

Should not exceed 70% relative humidity.

Sterile storage air exchanges

A minimum of 4 air exchanges per hour under positive pressure.

Event-related sterility

Concept that sterile packages remain sterile until an event causes them to become contaminated.

Water quality in CS

Essential to prevent instrument staining, corrosion, scaling, and pyrogen reactions.

Deionised water

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

Reverse Osmosis (RO)

A water purification process using a semipermeable membrane to remove impurities.