HSPA Processing of Patient Care Equipment 2 — Questions and Answers
Question 1: How should a blood pressure cuff be reprocessed per Spaulding classification?
- Sterilization
- High-level disinfection
- Low-level disinfection as a non-critical item (Correct answer)
- No reprocessing needed
Correct answer: Low-level disinfection as a non-critical item
Blood pressure cuffs contact only intact skin, classifying them as non-critical items requiring low-level disinfection.
Non-critical items can be cleaned with EPA-registered hospital disinfectants. Though infection risk is low, consistent disinfection prevents transmission of MRSA, VRE, and C. difficile.
Question 2: What reprocessing level is required for flexible GI endoscopes?
- Low-level disinfection
- Intermediate-level disinfection
- High-level disinfection minimum, sterilization preferred (Correct answer)
- Sterilization always required
Correct answer: High-level disinfection minimum, sterilization preferred
Endoscopes contacting mucous membranes are semi-critical, requiring HLD minimum with sterilization preferred.
HLD is typically achieved with AERs using glutaraldehyde, OPA, or peracetic acid. Multiple outbreaks have been linked to inadequately reprocessed endoscopes.
Question 3: How should reusable laryngoscope blades be reprocessed?
- Wiping with alcohol pad
- Low-level disinfection
- High-level disinfection or sterilization (Correct answer)
- No reprocessing needed
Correct answer: High-level disinfection or sterilization
Laryngoscope blades contact oropharyngeal mucous membranes, making them semi-critical devices.
Sterilization is strongly preferred because the procedure often involves blood contact. Many facilities have transitioned to single-use disposable blades.
Question 4: What special considerations apply to robotic surgical instrument reprocessing?
- Processed same as standard instruments
- Complex design requires specific manufacturer IFU, specialized cleaning tools, and careful reassembly with function testing (Correct answer)
- Only external wiping needed
- Always single-use
Correct answer: Complex design requires specific manufacturer IFU, specialized cleaning tools, and careful reassembly with function testing
Robotic instruments have complex multi-component designs requiring manufacturer-specific reprocessing.
Challenges include: limited use-life tracking, articulating joints with internal channels, specialized cleaning adapters, electrosurgical insulation inspection, and proprietary sterilization parameters.
Question 5: What is the correct procedure for C. difficile contaminated instruments?
- Standard cleaning and disinfection
- Discard instruments
- Standard cleaning followed by sterilization, as C. diff spores resist most disinfectants (Correct answer)
- Only UV light treatment
Correct answer: Standard cleaning followed by sterilization, as C. diff spores resist most disinfectants
C. difficile spores resist most disinfectants but are killed by sterilization.
Standard sterilization is effective when preceded by proper cleaning. For environmental surfaces, sporicidal agents (sodium hypochlorite 5,000 ppm) are needed.
Question 6: How should single-use disposable devices be managed?
- Can be reprocessed once
- Reprocess only if undamaged
- Never reprocessed in-house; dispose after one use per FDA regulations unless using FDA-registered third-party reprocessor (Correct answer)
- Labeling is just a suggestion
Correct answer: Never reprocessed in-house; dispose after one use per FDA regulations unless using FDA-registered third-party reprocessor
FDA prohibits in-house SUD reprocessing. Only FDA-registered third-party reprocessors may do so.
Third-party reprocessors must register as manufacturers, validate methods, submit 510(k) clearance, and accept manufacturer-level liability.
HSPA Processing of Patient Care Equipment 2
How should a blood pressure cuff be reprocessed per Spaulding classification?