CRCST % with correct answers

CRCST % Low temp sterilization requirements - correct answer -Efficacy: has capability of providing minimum required sterility assurance level (SAL) -Safety: no toxic residuals remaining after cycle completion -Exposure monitoring: ability to monitor sterilization process to ensure concentrations of sterilants in the work area remain within any required exposure limits -Sterilization performance monitoring: monitored using physical, chemical, and biological indicators -Penetration: must be able to penetrate through packaging material -Material compatibility: no changes in device functionality after cycle -Adaptability: compatible with or easily modified to meet existing health care practices -Approval: cleared by appropriate regulatory agency Toxicity Standards for Low Temp sterilizers - correct answer Ethylene Oxide -OSHA PEL: 1.0 ppm -NIOSH IDLH Limit: 800 ppm Hydrogen Peroxide -OSHA PEL: 1.0 ppm -NIOSH IDLH Limit: 75 ppm Ozone -OSHA PEL: .1 ppm NIOSH IDLH Limit: 5 ppm Low temp sterilizer process used - correct answer EtO: inactivates microbes by a process called alkylation Hydrogen Peroxide & Ozone: destroy microbes through oxidation -> chemicals that are gases at room temp are more effective penetrants b/c they will not cause condensation Oxidation - correct answer hydrogen peroxide gas plasma, vaporized hydrogen peroxide, and ozone use this. addition of oxygen to a compound with a loss of electrons. Ethylene oxide (EtO) Efficacy and Penetration - correct answer Efficacy: Alkylation process destroys cells ability to metabolize or reproduce Penetration: its a small molecule that vaporizes easily penetrate through material (plastic included) -High vapor pressure -Low boiling point EtO Cycle and Process - correct answer Preconditioning & Humidification Gas introduction Exposure Evacuation Air washes -must go through aeration cycle to remove residual EtO EtO Parameters and Safety - correct answer Gas concentration: 450-1200 mg/L Temp: 98-145 degrees Relative Humidity: 40-80% Exposure time: 1-6 Hours Aeration time: 8-12 hours at 122-140 degrees must be in room with air exchange 10 per hour, neg pressure room. EtO should not be used to sterilize... - correct answer -liquids: will combine with liquids and could produce harmful byproducts -devices with energy source: could spark in chamber -leather EtO Packaging and Performance measures - correct answer packaging: do not use aluminum foil, nylon films, polyester, pas films, and styrofoam performance measure: Physical Chem indicators Biological indicators- bacillus atrophaeus spores Hydrogen Peroxide Gas Plasma - correct answer -safer than EtO -faster turnaround time -byproducts from cycle non toxic H2O2 Gas Plasma efficacy and penetration - correct answer Efficacy: -use hydrogen peroxide solution ranging from 59-95% -destroys gram negative and gram positive vegetive bacteria Penetration -uses deep vacuums, multiple pulse additions of sterilant and increased concentration Phases of H2O2 gas plasma - correct answer Vacuum: load heats while vacuum system removes remaining water. Air is removed from chamber until pressure is reduced to below atmospheric pressure Injection: remeasured amount of concentration of hydrogen peroxide is pumped into vaporizer bowl Diffusion: drives H2O2 into small areas and lumens of device, chamber returns to atmospheric pressure to accomplish Plasma: vacuum decreases pressure, radio freq energy is radiated. RF energy ionizes H2O2 creating gas plasma Vent: air vented into chamber through bacterial high-efficiency particulate air filters process byproducts: oxygen and water H2O2 Gas plasma parameters and performance monitors - correct answer Time: 24-75 min Cycle temp: less than 131 degrees H2O2 concentration: 59-95% Performance monitors -physical: parameters are printed and recorded -Chemical: internal/external -Biological: geobacillus Stearothermophilus H2O2 Gas plasma not compatible with... - correct answer liquids and powders any materials that absorb liquid Items that contain cellulose Vaporized Hydrogen Peroxide (VHP) Efficacy and Penetration - correct answer Efficacy: uses 59% H2O2 solution Penetration: vaporized H2O2 injected 4 times, upon 4th load aerated VHP is exhausted from chamber through a catalytic converter that converts it into water and oxygen VHP cycle - correct answer Conditioning: remove air and moisture. chamber is evacuated then recharged with dry sterile air Leak test: Vacuum is held to ensure leak tight chamber Sterilization: enhance penetration by injecting H2O2 vapor into chamber 4 times Aeration: chamber exhausted through catalytic converter turning it into water and oxygen VHP Parameters and Packaging - correct answer cycle temp: less than 122 degrees H2O2 concentration: 59% Time: 28-55 min Packaging: polywrap, made 100% from polypropylene VHP Performance monitors - correct answer Physical: operate on fixed auto cycles controlled by microprocessor Chem: CI Biological: Geobazillus Stearothermophillus Ozone Sterilization (O3) Efficacy - correct answer Generate sterilants using medical grade oxygen and water O3 sterilizes by oxidizing proteins and enzymes causing death the organisms O3 Cycle - correct answer 4 1/2 Hour cycle 2 identical half cycles vacuum is dean followed by humidification phase, O3 is then injected into chamber. -O3 converted to oxygen at end Ozone Parameters - correct answer Cycle temp: 87.4 - 97 Degrees F O3 concentration: 59% Relative humidity: 85-100% Time: 4 1/2 hours Ozone Safety and packaging - correct answer Safety: bluish color, pungent odor - toxic gas odor threshold: .003-.01 ppm Packaging: woven fabric and metal foils are a NO GO Manual Disinfection Documentation - correct answer Date Test strip results expiration date items disinfected if scope name of tech who cleared it name of patient What can cause Chemical indicators to fail - correct answer utility or sterilizer malfunction bad loading techniques wrong cycle incorrect CI monitor poor storage of CIs Positive BI reasons - correct answer wrong BI or PCD Incorrect placement not following IFU Incorrect strange of BI incorrect cycle not loading cart to allow for airflow Validation - correct answer done by device manufacturer to obtain, record and interpret test results required to establish a process consistently producing sterile products -microbiological placed in hardest spots to reach with BI or Liquid suspension -subjected to 3 cycles at 1/2 exposures Verification - correct answer procedures ran by health care facility to confirm that the validation undertaken by manufacturer is applicable to specific setting Bowie-Dick Test - correct answer class II CI placed over chamber drain complete uniform color change = neg blotchy color change = positive