SPD Infection Control 2 — Questions and Answers
Question 1: What is the Spaulding Classification system used for in sterile processing?
- Categorizing sterilization methods by temperature
- Classifying medical devices based on infection risk to determine reprocessing level (Correct answer)
- Rating the effectiveness of disinfectants
- Organizing instruments by surgical specialty
Correct answer: Classifying medical devices based on infection risk to determine reprocessing level
The Spaulding Classification categorizes devices as critical, semi-critical, or non-critical based on their contact with the body and associated infection risk.
Developed by Earle Spaulding in 1968, this classification system divides medical devices into three categories: Critical items (contact sterile tissue/blood — require sterilization), Semi-critical items (contact mucous membranes/non-intact skin — require high-level disinfection minimum), and Non-critical items (contact intact skin — require low-level disinfection). This framework remains the foundation for all reprocessing decisions in healthcare and is referenced in CDC, AAMI, and FDA guidelines.
Question 2: Which type of personal protective equipment (PPE) is required in the decontamination area?
- Gloves only
- Gloves and gown
- Fluid-resistant gown, gloves, face mask, and eye protection (Correct answer)
- Surgical scrubs and a hair cover
Correct answer: Fluid-resistant gown, gloves, face mask, and eye protection
Full PPE including fluid-resistant gown, heavy-duty gloves, face mask, and eye protection is required due to exposure to bloodborne pathogens and chemical splashes.
OSHA Bloodborne Pathogens Standard and AAMI ST79 require comprehensive PPE in the decontamination area: fluid-resistant or impervious gown, heavy-duty utility gloves (not exam gloves), face mask or respirator, protective eyewear or face shield, and fluid-resistant shoe covers. This level of protection guards against exposure to bloodborne pathogens, aerosolized contaminants, and chemical cleaning agents. PPE must be donned before entering and properly doffed when leaving the decontamination area to prevent cross-contamination.
Question 3: What is a healthcare-associated infection (HAI)?
- An infection present at the time of hospital admission
- An infection acquired during the course of receiving healthcare treatment (Correct answer)
- A community-acquired infection treated in a hospital
- An infection caused by antibiotic resistance
Correct answer: An infection acquired during the course of receiving healthcare treatment
HAIs are infections patients acquire while receiving treatment for other conditions, making sterile processing's role in preventing them critically important.
Healthcare-associated infections (HAIs) are infections that patients develop during or as a result of receiving healthcare treatment and were not present or incubating at the time of admission. The CDC estimates that approximately 1 in 31 hospitalized patients has at least one HAI. Improperly reprocessed instruments are a recognized source of HAIs, which is why sterile processing departments play a critical role in infection prevention. Common HAIs include surgical site infections, catheter-associated urinary tract infections, and central line-associated bloodstream infections.
Question 4: What is the purpose of an exposure control plan in the SPD?
- To schedule instrument sterilization
- To outline procedures for preventing and managing occupational exposure to bloodborne pathogens (Correct answer)
- To track chemical inventory levels
- To document sterilizer maintenance schedules
Correct answer: To outline procedures for preventing and managing occupational exposure to bloodborne pathogens
The exposure control plan is an OSHA-mandated document that details how the facility prevents, evaluates, and follows up on occupational bloodborne pathogen exposures.
OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) requires every facility to maintain a written Exposure Control Plan. For SPD, this includes identification of at-risk tasks, engineering controls (sharps containers, safety devices), work practice controls (hand hygiene, PPE protocols), hepatitis B vaccination program, post-exposure evaluation procedures, and annual plan review. The plan must be accessible to all employees and updated annually to reflect new technology and procedures that reduce exposure risk.
Question 5: Which organism is commonly used as a reference for testing the effectiveness of sterilization against prions?
- Staphylococcus aureus
- Geobacillus stearothermophilus
- There is no standard biological indicator for prions (Correct answer)
- Mycobacterium tuberculosis
Correct answer: There is no standard biological indicator for prions
Prions are uniquely resistant to standard sterilization methods and there is no biological indicator that can verify prion inactivation through routine testing.
Prions (the infectious agents causing Creutzfeldt-Jakob disease and related conditions) are misfolded proteins that are extraordinarily resistant to conventional sterilization. Unlike bacteria, viruses, or fungi, prions cannot be cultured and no biological indicator exists to verify their inactivation. WHO and CDC recommend special reprocessing protocols for instruments suspected of prion contamination, including extended soak in sodium hydroxide (1N NaOH) or sodium hypochlorite (20,000 ppm), followed by gravity-displacement autoclaving at 134°C for 18 minutes. Some facilities opt to discard instruments used on confirmed prion cases.
Question 6: What is the primary reason for performing hand hygiene before putting on gloves in the SPD?
- To protect the gloves from degradation
- To reduce microbial contamination that could transfer through glove defects (Correct answer)
- To improve grip when handling instruments
- To comply with dress code requirements
Correct answer: To reduce microbial contamination that could transfer through glove defects
Gloves can have microscopic perforations, and hand hygiene before gloving reduces the risk of transferring microorganisms through these defects.
Hand hygiene before donning gloves is essential because studies show that up to 30% of gloves have microscopic perforations that are undetectable by the wearer. These defects can allow microorganisms from the hands to transfer to items being handled. In the SPD context, this means potentially introducing contamination to instruments during assembly and packaging. The CDC and WHO both recommend hand hygiene before gloving as part of standard precautions. Additionally, hands become contaminated during glove removal, making hand hygiene after doffing equally important.
SPD Infection Control 2
What is the Spaulding Classification system used for in sterile processing?