Infection Prevention and Control Flashcards

A Medical Device Reprocessing Technician (MDRT) is preparing to manually clean a surgical instrument contaminated with blood and tissue. According to Routine Practices (Standard Precautions), what is the minimum Personal Protective Equipment (PPE) the technician must wear?

Answer: A fluid-resistant gown, eye protection, a surgical mask, and utility gloves.

Routine Practices require the use of appropriate PPE to protect against splashes and aerosol generation, which are significant risks during manual cleaning. This includes a fluid-resistant gown to protect clothing and skin, eye protection (goggles or face shield) to protect mucous membranes of the eyes, a mask to protect the nose and mouth, and heavy-duty utility gloves to prevent sharps injuries and exposure to contaminated fluids.

Which of the following is the most critical first step in the decontamination process for reusable medical devices?

Answer: Thorough manual or mechanical cleaning.

Cleaning is the essential first step in reprocessing. It removes organic soil, such as blood and tissue, which can shield microorganisms from disinfection or sterilization processes. If an instrument is not properly cleaned, subsequent disinfection or sterilization steps may be ineffective.

A flexible endoscope, which is used to visualize the gastrointestinal tract, comes into contact with mucous membranes. According to the Spaulding Classification system, how should this device be categorized and reprocessed?

Answer: Semi-critical; requires, at a minimum, high-level disinfection.

The Spaulding Classification system categorizes medical devices based on the risk of infection involved with their use. Devices that contact mucous membranes or non-intact skin, like flexible endoscopes, are considered semi-critical. The minimum required reprocessing for semi-critical devices is high-level disinfection (HLD), although sterilization is preferred when possible.

In the chain of infection, what role does a contaminated surgical instrument play?

Answer: Mode of transmission.

The chain of infection consists of six links. A contaminated instrument serves as a vehicle, or fomite, that transfers the infectious agent from the reservoir to the susceptible host. This makes it the 'mode of transmission'. The infectious agent is the pathogen itself, not the object carrying it.

An MDRT is working in the decontamination area and their gloved hand is accidentally punctured by a sharp instrument. What is the most appropriate immediate action to take?

Answer: Immediately remove the gloves, wash the area with soap and water, and report the injury.

In case of a sharps injury, the immediate priority is to decontaminate the wound by washing it thoroughly with soap and water. The incident must then be reported immediately to a supervisor according to the facility's occupational health and safety policy for post-exposure follow-up. Continuing to work or simply covering the wound is unsafe.

According to Canadian Standards Association (CSA) Z314-18, the physical layout of a Medical Device Reprocessing Department (MDRD) is designed to facilitate one-way workflow. What is the primary infection prevention purpose of this design?

Answer: To prevent cross-contamination between soiled and clean/sterile items.

A one-way workflow from the decontamination (soiled) area to the preparation/packaging (clean) area and then to the sterilization/storage (sterile) area is a fundamental principle of MDRD design. This directional flow is crucial to prevent clean and sterile items from coming into contact with or being contaminated by soiled items, thus breaking the chain of infection.