SPD - Sterile Processing Department Technician High-Level Disinfection Questions and Answers 1 — Questions and Answers
Question 1: An SPD technician is reprocessing a flexible gastroscope. After thorough manual cleaning, what is the next critical step BEFORE immersing the scope in the high-level disinfectant solution?
- Dry the channels with compressed air.
- Immerse the scope in a saline solution.
- Perform a leak test. (Correct answer)
- Attach the scope to the automated reprocessor.
Correct answer: Perform a leak test.
Leak testing must be performed after manual cleaning but before immersion in a high-level disinfectant. This step is crucial to verify that the internal and external sheaths of the endoscope are intact. A leak could allow fluid to enter internal components, causing significant damage and preventing effective disinfection.
Question 2: What is the primary purpose of performing a Minimum Effective Concentration (MEC) test on a reusable high-level disinfectant solution?
- To confirm the disinfectant is still potent enough to kill microorganisms. (Correct answer)
- To measure the pH level of the solution.
- To verify the solution's temperature is correct for use.
- To document the lot number of the chemical test strip.
Correct answer: To confirm the disinfectant is still potent enough to kill microorganisms.
The Minimum Effective Concentration (MEC) test is a quality control measure to ensure that the active ingredient in a reusable high-level disinfectant has not been diluted below the manufacturer-specified level required for effective disinfection. With repeated use, the solution can become diluted and less potent.
Question 3: According to the Spaulding Classification system, high-level disinfection is the required processing method for which category of medical devices?
- Critical items that enter sterile tissue.
- Non-critical items that only touch intact skin.
- Semi-critical items that contact mucous membranes or non-intact skin. (Correct answer)
- Environmental surfaces in the operating room.
Correct answer: Semi-critical items that contact mucous membranes or non-intact skin.
The Spaulding Classification categorizes devices based on infection risk. Semi-critical items, such as endoscopes and respiratory therapy equipment, contact mucous membranes or non-intact skin and require, at a minimum, high-level disinfection to eliminate all vegetative microorganisms, mycobacteria, and viruses.
Question 4: A technician is manually disinfecting an instrument using a glutaraldehyde solution. Which of the following safety precautions is MOST critical?
- Wearing standard latex surgical gloves.
- Using the chemical in a well-ventilated area or under a local exhaust hood. (Correct answer)
- Ensuring the room has standard positive-pressure air circulation.
- Storing the chemical in an open basin for easy access.
Correct answer: Using the chemical in a well-ventilated area or under a local exhaust hood.
Glutaraldehyde releases vapors that are irritating to the respiratory system, eyes, and skin. OSHA has established recommended exposure limits for this chemical. To protect employees, it is critical to use glutaraldehyde in a well-ventilated area, preferably with a dedicated local exhaust ventilation system, to minimize inhalation of fumes.
Question 5: Which of the following is a mandatory final step for a flexible endoscope after it has undergone high-level disinfection and thorough rinsing, but before it is stored?
- Wiping the exterior with a saline-soaked cloth.
- Wrapping the endoscope in a peel pouch for sterilization.
- Coiling the endoscope tightly to fit in a small container.
- Flushing all channels with 70% isopropyl alcohol followed by forced, filtered air. (Correct answer)
Correct answer: Flushing all channels with 70% isopropyl alcohol followed by forced, filtered air.
Proper drying is essential to prevent the growth of waterborne microorganisms during storage. Flushing the channels with 70% isopropyl alcohol aids in displacing water and facilitates rapid evaporation. Following this with forced, filtered air ensures all moisture is removed from the internal channels before the scope is hung for storage.
Question 6: After an instrument undergoes high-level disinfection, it must be thoroughly rinsed. According to AAMI standards, what is the recommended quality for this final rinse water?
- Standard hot tap water.
- A sterile saline solution.
- Utility water that has been allowed to sit for one hour.
- Critical water (e.g., sterile, distilled, deionized, or reverse osmosis water). (Correct answer)
Correct answer: Critical water (e.g., sterile, distilled, deionized, or reverse osmosis water).
AAMI ST108 specifies that the final rinse water for items that have been high-level disinfected should be "Critical Water." This is water that has been extensively treated to remove microorganisms and other contaminants, such as through reverse osmosis, distillation, or deionization. Using lower quality water, like tap water, could re-contaminate the device.
An SPD technician is reprocessing a flexible gastroscope.
After thorough manual cleaning, what is the next critical step BEFORE immersing the scope in the high-level disinfectant solution?