HSPA Workflow and Quality Assurance 2 — Questions and Answers
Question 1: What is the correct workflow sequence in a sterile processing department?
- Storage, Decontamination, Assembly, Sterilization
- Decontamination, Assembly/Inspection, Sterilization, Sterile Storage, Distribution (Correct answer)
- Sterilization, Decontamination, Storage, Distribution
- Assembly, Sterilization, Decontamination, Distribution
Correct answer: Decontamination, Assembly/Inspection, Sterilization, Sterile Storage, Distribution
SPD workflow follows unidirectional flow from soiled to clean through five stages.
Physical barriers and differential air pressure separate areas. Decontamination has negative pressure; assembly and sterile areas have positive pressure to prevent cross-contamination.
Question 2: Why is positive air pressure maintained in sterile storage relative to corridors?
- To keep the room warm
- To prevent unfiltered air from entering when doors open (Correct answer)
- To dry packages faster
- To reduce humidity for comfort
Correct answer: To prevent unfiltered air from entering when doors open
Positive pressure causes air to flow outward when doors open, preventing corridor contamination.
The sterile storage area requires positive pressure, temperature at or below 75°F, humidity at or below 70%, minimum 10 air exchanges per hour, and restricted access.
Question 3: What is a count sheet or pick list used for?
- Counting employees on shift
- Documenting exact instruments and quantities for each tray set (Correct answer)
- Tracking sterilization cycles per day
- Recording patient names
Correct answer: Documenting exact instruments and quantities for each tray set
Count sheets list every instrument and quantity for each tray, guiding assembly and verification.
Count sheets should include instrument images, descriptions, special instructions, required indicators, and notes. They prevent incomplete trays from reaching the OR.
Question 4: What is event-related sterility maintenance?
- Items expire after a fixed number of days
- Sterility is maintained until an event compromises packaging integrity (Correct answer)
- Events trigger automatic re-sterilization
- Only sealed containers use this approach
Correct answer: Sterility is maintained until an event compromises packaging integrity
Properly packaged items remain sterile until an event compromises the barrier.
Time alone does not cause sterility loss. Only physical breach of packaging allows contamination. This is the current standard recommended by AAMI, CDC, and Joint Commission.
Question 5: What key metrics should an SPD quality program track?
- Only instruments processed per day
- Sterilization failure rates, cleaning verification, defect rates, tray errors, IUSS usage, and turnaround times (Correct answer)
- Only patient infection rates
- Only employee attendance
Correct answer: Sterilization failure rates, cleaning verification, defect rates, tray errors, IUSS usage, and turnaround times
Comprehensive QA tracks metrics across all process areas including sterilization, cleaning, assembly, and IUSS.
Metrics should be reviewed monthly with trend analysis. Additional tracking includes equipment downtime, safety incidents, and documentation completeness.
Question 6: What does 'sterile to sterile, unsterile to unsterile' mean in distribution?
- Store sterile items together
- Sterile items must only contact sterile items/surfaces; unsterile items kept separate (Correct answer)
- Organize shelves by category
- Distribute sterile items first
Correct answer: Sterile items must only contact sterile items/surfaces; unsterile items kept separate
This principle ensures sterile items contact only sterile surfaces and remain separated from non-sterile items.
During distribution: separate transport carts, no contact with non-sterile surfaces, clean carts before loading. In storage: items above floor level, away from walls and ceilings.
HSPA Workflow and Quality Assurance 2
What is the correct workflow sequence in a sterile processing department?