CNOR 2024 (2) Zander
Where does a biological go in the sterilizer? ANS: On the bottom rack, centered and toward the front of
the door (coolest spot).
What is the process of preparing the sterilizers for the day? ANS: 1st run of the day: Warm up run with
empty sterilizer
2nd run of the day: Bowie Dick
3rd run of the day: instruments load.
Necessary steps for autoclaves: ANS: -Run a daily biological (Gravity & PreVac)
-Run a daily Bowie Dick (shows vacuum cycle worked)
- After repair (change/moving), do 3 BDs in a row
-Biological with EVERY implant
Bio how often with EO? ANS: Each load (loads take too long to aerate)
Packaging weight limit: ANS: 25 lbs --> BUT MFR INSTRUCTIONS ALWAYS WIN!
Packaging basics: ANS: -Approved for use in specific sterilizer
-No textiles
-No sealed peel pouches inside trays
-No rubber mats unless comes like that from manufacturer
-Integrator in corner and top level
-Indicator on inside and outside (Class 1)
-Count sheets on outside or sealed envelope inside (scrub cant touch
,How to store packages
Temp
Humidity ANS: Temp: 78 degrees
Humidity: 60%
- 8-10 inches from floor, 18" from ceiling, bottom of shelf must be solid
Peel Pouch basics ANS: -Don't stack them, lay on their sides.
-Only write/label the plastic side. Sterilizing goes through paper side.
-No heavy items
-Double pouch: Can't fold inner pouch, must fit sealed inside 2nd pouch. Follow manufacturers
instructions only.
Where does endoscope cleaning begin?
What if there's a delay? ANS: -Begins with manual cleaning at the field.
- clear the lumen with water
- wipe the exterior
-If Delay: Keep endoscope damp/wet but NOT submerged (incase of leaks or spills). DO NOT allow to
dry.
- Cover with damp sterile towel, and suction water into channels
What circumstances require extra cleaning of endoscopes? ANS: -Additional cleaning needs to be done
if ___ is used:
-Simethicone. (Gooey. Add low concentration to working channel NOT the water bottle)
,-Radiographic medium
-Lube
-Tissue adhesives (Benzoin)
-Poop (poor preps or if was done emergently)
What's the endoscope Handover Process? ANS: A scrub must tell the scope tech a report of
- what was done
- if it is extra dirty/requires additional cleaning
- when the procedure was finished
How soon after using must endoscopes be cleaned?
What is the decontamination process? ANS: Must be cleaned within 1 HOUR of use
-If there's a delay, must follow delayed processing instructions ACCORDING TO MANUFACTURER.
Decontamination:
- Leak test dirty scope (in case of holes)
- Visually inspect after manual cleaning
- Use 10x magnification
- Use Boroscope to look inside
What kind of testing is to be done on endoscopes to verify sterilization? ANS: ATP testing (swab for
protein, hgb)
- ATP testing should be done daily on rigid scopes.
- ATP testing MUST be done EVERY USE on FLEX SCOPES
(duodenoscope, US endoscopes, bronchoscopes, ureteroscopes, cystoscopes)
, How are endoscopes dried? ANS: *Actively dried after processing with
- Counter Top Dryer HOOKED UP or
- Drying Cabinet HOOKED UP
*Minimum 10 Minutes or until no visible moisture.
*Boroscope inspection or moisture detect test
What cycle doesn't count as a dry cycle for endoscopes UNLESS an extended time feature is used? ANS:
Automated air purge cycle in the AER (Automated Endoscope Reprocessor)
How must endoscopes be stored (2 options)? ANS: - Dry Cabinet
- +Positive Pressure Cabinet with HEPA Filter
(in a clean work room separate from dirty area, or area NOT in procedure room)
Risk assessment determines storage times based on risks at the facility, and culture results. Then write
policy.
Maintain endoscope processing records for length of time by hospital policy.
Nail rules:
How long?
Scrub rules:
Circ rules: ANS: Long: 2 mm
Scrubs: NO art nails/extenders, NO polish, NO jewelry hands/wrists .
Circs: Polish must be intact. No rings.
Where does a biological go in the sterilizer? ANS: On the bottom rack, centered and toward the front of
the door (coolest spot).
What is the process of preparing the sterilizers for the day? ANS: 1st run of the day: Warm up run with
empty sterilizer
2nd run of the day: Bowie Dick
3rd run of the day: instruments load.
Necessary steps for autoclaves: ANS: -Run a daily biological (Gravity & PreVac)
-Run a daily Bowie Dick (shows vacuum cycle worked)
- After repair (change/moving), do 3 BDs in a row
-Biological with EVERY implant
Bio how often with EO? ANS: Each load (loads take too long to aerate)
Packaging weight limit: ANS: 25 lbs --> BUT MFR INSTRUCTIONS ALWAYS WIN!
Packaging basics: ANS: -Approved for use in specific sterilizer
-No textiles
-No sealed peel pouches inside trays
-No rubber mats unless comes like that from manufacturer
-Integrator in corner and top level
-Indicator on inside and outside (Class 1)
-Count sheets on outside or sealed envelope inside (scrub cant touch
,How to store packages
Temp
Humidity ANS: Temp: 78 degrees
Humidity: 60%
- 8-10 inches from floor, 18" from ceiling, bottom of shelf must be solid
Peel Pouch basics ANS: -Don't stack them, lay on their sides.
-Only write/label the plastic side. Sterilizing goes through paper side.
-No heavy items
-Double pouch: Can't fold inner pouch, must fit sealed inside 2nd pouch. Follow manufacturers
instructions only.
Where does endoscope cleaning begin?
What if there's a delay? ANS: -Begins with manual cleaning at the field.
- clear the lumen with water
- wipe the exterior
-If Delay: Keep endoscope damp/wet but NOT submerged (incase of leaks or spills). DO NOT allow to
dry.
- Cover with damp sterile towel, and suction water into channels
What circumstances require extra cleaning of endoscopes? ANS: -Additional cleaning needs to be done
if ___ is used:
-Simethicone. (Gooey. Add low concentration to working channel NOT the water bottle)
,-Radiographic medium
-Lube
-Tissue adhesives (Benzoin)
-Poop (poor preps or if was done emergently)
What's the endoscope Handover Process? ANS: A scrub must tell the scope tech a report of
- what was done
- if it is extra dirty/requires additional cleaning
- when the procedure was finished
How soon after using must endoscopes be cleaned?
What is the decontamination process? ANS: Must be cleaned within 1 HOUR of use
-If there's a delay, must follow delayed processing instructions ACCORDING TO MANUFACTURER.
Decontamination:
- Leak test dirty scope (in case of holes)
- Visually inspect after manual cleaning
- Use 10x magnification
- Use Boroscope to look inside
What kind of testing is to be done on endoscopes to verify sterilization? ANS: ATP testing (swab for
protein, hgb)
- ATP testing should be done daily on rigid scopes.
- ATP testing MUST be done EVERY USE on FLEX SCOPES
(duodenoscope, US endoscopes, bronchoscopes, ureteroscopes, cystoscopes)
, How are endoscopes dried? ANS: *Actively dried after processing with
- Counter Top Dryer HOOKED UP or
- Drying Cabinet HOOKED UP
*Minimum 10 Minutes or until no visible moisture.
*Boroscope inspection or moisture detect test
What cycle doesn't count as a dry cycle for endoscopes UNLESS an extended time feature is used? ANS:
Automated air purge cycle in the AER (Automated Endoscope Reprocessor)
How must endoscopes be stored (2 options)? ANS: - Dry Cabinet
- +Positive Pressure Cabinet with HEPA Filter
(in a clean work room separate from dirty area, or area NOT in procedure room)
Risk assessment determines storage times based on risks at the facility, and culture results. Then write
policy.
Maintain endoscope processing records for length of time by hospital policy.
Nail rules:
How long?
Scrub rules:
Circ rules: ANS: Long: 2 mm
Scrubs: NO art nails/extenders, NO polish, NO jewelry hands/wrists .
Circs: Polish must be intact. No rings.
