CER Endoscope Sterilization Methods 5 — Questions and Answers
Question 1: A flexible endoscope labeled 'NOT compatible with EO sterilization' by its manufacturer should be processed using:
- Any alternative low-temperature sterilization method the facility prefers
- Only the methods specifically validated and approved by the endoscope manufacturer (Correct answer)
- Steam sterilization at reduced temperature
- The most readily available reprocessing method
Correct answer: Only the methods specifically validated and approved by the endoscope manufacturer
Reprocessors must follow the endoscope manufacturer's validated and approved reprocessing methods to ensure safety, efficacy, and device integrity.
Question 2: Which statement about ozone sterilization is accurate?
- It is the most widely used low-temperature sterilization method in the US
- Ozone is generated on-site from oxygen and water, eliminating the need for chemical storage (Correct answer)
- It is effective against all microorganisms including prions
- Ozone sterilization requires long aeration times similar to EO
Correct answer: Ozone is generated on-site from oxygen and water, eliminating the need for chemical storage
Ozone sterilization systems generate ozone on-site from oxygen, eliminating the need to store hazardous chemicals, and it breaks down to oxygen and water after the cycle.
Question 3: Before loading an endoscope into an automated endoscope reprocessor (AER) set to run a sterilization cycle, the technician MUST:
- Perform pre-cleaning, leak testing, and manual cleaning per IFU (Correct answer)
- Only perform a leak test to detect channel damage
- Confirm the patient's infection status and adjust the cycle accordingly
- Remove all detachable parts and sterilize them separately in the autoclave
Correct answer: Perform pre-cleaning, leak testing, and manual cleaning per IFU
Pre-cleaning, leak testing, and manual cleaning must always precede any automated reprocessing cycle to remove gross soil and verify device integrity.
Question 4: The purpose of a 'parametric release' in sterilization is to:
- Release items based solely on biological indicator results
- Release a sterilized load based on verified physical and chemical process parameters without waiting for BI incubation (Correct answer)
- Allow immediate use of a sterilized endoscope before monitoring results
- Test each item individually for sterility before release
Correct answer: Release a sterilized load based on verified physical and chemical process parameters without waiting for BI incubation
Parametric release relies on verified sterilization process parameters (time, temperature, pressure, concentration) as evidence of sterility rather than awaiting BI culture results.
Question 5: Which of the following correctly describes the mechanism of action of hydrogen peroxide plasma sterilization?
- H₂O₂ vapor alone denatures proteins at high temperatures
- Hydrogen peroxide vapor is energized into plasma, generating free radicals that destroy microbial cell walls and DNA (Correct answer)
- Plasma ionizes water molecules that subsequently destroy microorganisms
- UV light activates H₂O₂ to produce a sterilizing ozone layer
Correct answer: Hydrogen peroxide vapor is energized into plasma, generating free radicals that destroy microbial cell walls and DNA
In plasma sterilization, hydrogen peroxide vapor is exposed to radiofrequency energy, creating plasma that releases free radicals (OH• and HO₂•) with potent antimicrobial activity.
Question 6: A sterilization cycle fails its chemical indicator but passes its biological indicator. The correct interpretation is:
- The load is sterile because the biological indicator is the gold standard
- Both indicators must be evaluated together; a failed CI warrants investigation even with a passing BI (Correct answer)
- The chemical indicator was defective and can be ignored
- The load should be released after a repeat BI test passes
Correct answer: Both indicators must be evaluated together; a failed CI warrants investigation even with a passing BI
Both chemical and biological indicators provide complementary information; a failed chemical indicator signals a potential process deviation that must be investigated regardless of BI results.
Question 7: Under OSHA regulations, healthcare workers routinely using EO sterilization must be protected by which measure?
- Annual skin allergy testing
- Engineering controls, PPE, and exposure monitoring with permissible exposure limits enforced (Correct answer)
- Mandatory vaccination against EO-related illness
- Wearing standard surgical masks during all EO sterilization tasks
Correct answer: Engineering controls, PPE, and exposure monitoring with permissible exposure limits enforced
OSHA's EO standard (29 CFR 1910.1047) requires engineering controls, administrative controls, PPE, and air monitoring to protect workers from EO exposure within permissible limits.
CER Endoscope Sterilization Methods 5
A flexible endoscope labeled 'NOT compatible with EO sterilization' by its manufacturer should be processed using: