HSPA Decontamination and Cleaning Verification 2 — Questions and Answers
Question 1: What does a positive protein residual test indicate about a cleaned instrument?
- The instrument is sterile
- Organic soil remains and cleaning was inadequate (Correct answer)
- The sterilization cycle failed
- The instrument has been lubricated
Correct answer: Organic soil remains and cleaning was inadequate
A positive protein test detects residual organic contamination, indicating inadequate cleaning.
Protein residual tests use colorimetric reagents reacting with amino acids on instrument surfaces. Instruments failing must be recleaned and retested before sterilization.
Question 2: What is the purpose of ATP bioluminescence testing in decontamination?
- To measure sterilizer temperature
- To detect residual organic contamination by measuring ATP levels (Correct answer)
- To verify cleaning solution pH
- To test instrument sharpness
Correct answer: To detect residual organic contamination by measuring ATP levels
ATP testing detects adenosine triphosphate on surfaces, providing a rapid quantitative measure of cleaning effectiveness.
ATP bioluminescence uses luciferase enzyme to generate light in the presence of ATP. Results in Relative Light Units are available in seconds, making it a rapid objective cleaning verification method.
Question 3: How should visual inspection of cleaned instruments be performed?
- Under normal room lighting
- Using a magnifying glass or illuminated magnifier under adequate lighting (Correct answer)
- By feeling with gloved hands
- Visual inspection is unnecessary with automated washers
Correct answer: Using a magnifying glass or illuminated magnifier under adequate lighting
Inspection requires magnification and bright lighting to detect residual soil, damage, or corrosion.
Lighted magnification (minimum 3x) under bright focused lighting is used to examine all surfaces including box locks, serrations, and joints. Items failing inspection must be returned for recleaning.
Question 4: What is a Tosi test (Wash Check) used to verify?
- Sterilizer vacuum function
- Effectiveness of the washer-disinfector cleaning cycle (Correct answer)
- Biological indicator results
- Water quality in final rinse
Correct answer: Effectiveness of the washer-disinfector cleaning cycle
Tosi tests use standardized test soils run through the washer to verify cleaning effectiveness.
These standardized devices are coated with defined test soil and run through the wash cycle. Complete soil removal indicates effective cleaning. Tests should be run at least daily.
Question 5: Why is it important to test cleaning solution concentration during manual cleaning?
- To ensure the solution looks blue enough
- To verify detergent is at manufacturer-specified concentration for optimal cleaning (Correct answer)
- To check water temperature
- To determine disposal timing
Correct answer: To verify detergent is at manufacturer-specified concentration for optimal cleaning
Testing ensures the solution is mixed to the correct dilution ratio for optimal enzyme activity and cleaning.
Under-diluted solutions waste product and may damage instruments; over-diluted solutions have insufficient active ingredients. Chemical test strips or refractometers verify proper dilution.
Question 6: What action should be taken when a cleaning verification test fails?
- Continue processing and retest tomorrow
- Document failure, remove load for recleaning, investigate cause, and retest after corrective action (Correct answer)
- Discard all instruments
- Increase detergent concentration for next cycle
Correct answer: Document failure, remove load for recleaning, investigate cause, and retest after corrective action
A failure requires documentation, recleaning, root cause investigation, corrective action, and successful retesting.
Systematic response includes: document failure, quarantine and reclean affected items, investigate root causes, implement corrective action, verify with new test, and document all actions taken.
HSPA Decontamination and Cleaning Verification 2
What does a positive protein residual test indicate about a cleaned instrument?