MDRAO Infection Prevention and Control 3

Question 1

What is the difference between cleaning, disinfection, and sterilization in the hierarchy of reprocessing?

Accepted Answer

Cleaning removes soil and reduces bioburden; disinfection kills most pathogens but not all spores; sterilization eliminates all viable microorganisms including spores

Answer

They are interchangeable terms for the same process of making instruments safe to use

Answer

Disinfection is more effective than sterilization for heat-sensitive devices

Answer

Cleaning achieves sterility; disinfection adds a chemical barrier; sterilization is for cosmetic finish

Question 2

What is biofilm and why is it a significant concern in medical device reprocessing?

Accepted Answer

Biofilm is a structured community of microorganisms encased in a self-produced extracellular matrix that strongly adheres to surfaces and is highly resistant to cleaning, disinfection, and sterilization

Answer

Biofilm is a chemical film left by industrial lubricants that must be removed before sterilization

Answer

Biofilm forms only on external surfaces and is easily removed by standard washing

Answer

Biofilm is a protective coating applied to instruments during manufacture to prevent corrosion

Question 3

How does methicillin-resistant Staphylococcus aureus (MRSA) influence reprocessing procedures in the CSSD?

Accepted Answer

MRSA has no special reprocessing implications — standard decontamination and sterilization effectively eliminate MRSA

Answer

MRSA requires instruments to be sterilized using only EO gas, not steam

Answer

Instruments from MRSA patients must be single-use only and discarded after one use

Answer

MRSA instruments require double the standard sterilization cycle time

Question 4

What is the significance of the term 'window of soilability' in medical device reprocessing?

Accepted Answer

The period after use during which instruments are relatively easy to clean before organic soil dries, hardens, and potentially forms biofilm on instrument surfaces

Answer

The time window after sterilization during which an instrument can be used before it becomes contaminated by environmental exposure

Answer

The specific room in the CSSD designated for receiving soiled instruments

Answer

The acceptable time limit between an instrument's manufacture date and first use

Question 5

Which organization in Ontario provides the primary infection prevention and control guidance for healthcare facility reprocessing practices?

Accepted Answer

Ontario Public Health — through the Provincial Infectious Diseases Advisory Committee (PIDAC)

Answer

Health Canada — through the Food and Drug Act provisions

Answer

The Ontario Hospital Association (OHA) — through voluntary hospital guidelines

Answer

The College of Nurses of Ontario (CNO) — through nursing practice standards

Question 6

What is the correct action when instruments from a patient suspected of having variant Creutzfeldt-Jakob disease (vCJD) are identified in the decontamination area?

Accepted Answer

Immediately quarantine the instruments, notify the infection control practitioner, and follow the facility's prion risk management protocol

Answer

Process the instruments through the standard steam sterilization cycle and release for use

Answer

Disinfect the instruments with 70% isopropyl alcohol for 30 minutes and then sterilize

Answer

Increase the steam sterilization temperature to 140°C for additional safety margin