CER Endoscope Sterilization Methods 4 — Questions and Answers
Question 1: A technician finds that the chemical indicator inside a STERRAD sterilization pouch did not change color after the cycle. The BEST immediate action is:
- Release the load and document the color change
- Quarantine the load and investigate the cycle parameters before releasing items (Correct answer)
- Re-run the biological indicator and wait for results before deciding
- Assume the indicator was defective and release the load
Correct answer: Quarantine the load and investigate the cycle parameters before releasing items
A failed chemical indicator is a process failure signal; the load must be quarantined and the cycle investigated before any items are released for patient use.
Question 2: Which statement about sterilization vs. high-level disinfection (HLD) for flexible GI endoscopes is TRUE according to current US guidelines?
- Sterilization is always required for GI endoscopes
- HLD is the minimum standard for semi-critical flexible GI endoscopes when sterilization is not feasible (Correct answer)
- HLD and sterilization are equally acceptable for all endoscope types
- Sterilization is required only for endoscopes used in immunocompromised patients
Correct answer: HLD is the minimum standard for semi-critical flexible GI endoscopes when sterilization is not feasible
Current guidelines classify GI endoscopes as semi-critical devices for which HLD is the minimum acceptable standard, though sterilization is preferred when achievable.
Question 3: The STERRAD NX sterilization system uses which active sterilant?
- Peracetic acid
- Ethylene oxide
- Hydrogen peroxide vapor (Correct answer)
- Ozone
Correct answer: Hydrogen peroxide vapor
The STERRAD NX uses hydrogen peroxide vapor combined with a plasma phase to achieve sterilization at low temperatures.
Question 4: Which condition MOST compromises the efficacy of chemical sterilization?
- Using distilled water for rinsing before sterilization
- Residual organic soil or biofilm on the endoscope surfaces (Correct answer)
- Storing the sterilant at room temperature
- Exceeding the recommended sterilant contact time
Correct answer: Residual organic soil or biofilm on the endoscope surfaces
Organic soil and biofilm protect microorganisms by acting as a physical barrier that prevents sterilant penetration, making thorough pre-cleaning essential.
Question 5: What does the term 'Sterility Assurance Level (SAL)' of 10⁻⁶ mean?
- There is a 1 in 100 chance of a viable organism surviving
- There is a 1 in 1,000,000 probability of a single viable organism surviving on a sterilized item (Correct answer)
- The sterilant kills 10⁶ organisms per minute
- Six logs of microbial reduction have been achieved
Correct answer: There is a 1 in 1,000,000 probability of a single viable organism surviving on a sterilized item
SAL 10⁻⁶ means there is no more than a one-in-one-million probability that a single viable microorganism remains on a processed item.
Question 6: Which endoscope type is most likely to require sterilization rather than high-level disinfection?
- Standard gastroscope used for upper GI endoscopy
- Arthroscope entering a sterile body cavity (Correct answer)
- Bronchoscope used for airway examination
- Colonoscope used for colorectal screening
Correct answer: Arthroscope entering a sterile body cavity
Arthroscopes enter sterile body cavities (joints) and are classified as critical devices requiring sterilization under the Spaulding classification.
Question 7: In EO sterilization, which factor does NOT directly affect sterilization efficacy?
- EO gas concentration
- Relative humidity during the cycle
- Temperature of the sterilization chamber
- Color of the packaging material (Correct answer)
Correct answer: Color of the packaging material
The color of packaging material has no bearing on sterilization efficacy; the critical parameters are EO concentration, humidity, temperature, and exposure time.
CER Endoscope Sterilization Methods 4
A technician finds that the chemical indicator inside a STERRAD sterilization pouch did not change color after the cycle.
The BEST immediate action is: