CER High-Level Disinfection Processes 3 — Questions and Answers
Question 1: Ortho-phthalaldehyde (OPA) has what primary advantage over glutaraldehyde for high-level disinfection?
- Lower cost per gallon
- Faster acting at room temperature with less irritation (Correct answer)
- Broader spectrum of kill including prions
- Does not require MRC testing
Correct answer: Faster acting at room temperature with less irritation
OPA works faster than glutaraldehyde (12 minutes vs. 20 minutes) and produces fewer fumes, reducing occupational health concerns.
Question 2: When performing high-level disinfection in an automated endoscope reprocessor (AER), which step must be verified manually before loading the scope?
- That the HLD cycle temperature is set correctly
- That thorough manual cleaning and leak testing have been completed (Correct answer)
- That the AER drain cycle has finished
- That the scope serial number matches the AER log
Correct answer: That thorough manual cleaning and leak testing have been completed
Manual cleaning and leak testing must be completed before placing the scope in an AER, as the AER does not compensate for inadequate pre-cleaning.
Question 3: A flexible endoscope fails a leak test. What should be done before proceeding with HLD?
- Proceed with HLD and inform biomedical engineering afterward
- Perform HLD with the cap removed to allow fluid drainage
- Remove the scope from service and send it for repair (Correct answer)
- Re-test the scope in clean water to confirm the leak
Correct answer: Remove the scope from service and send it for repair
A scope that fails leak testing must be taken out of service and sent for repair to prevent internal damage from HLD chemicals and cross-contamination.
Question 4: Which personal protective equipment (PPE) is required when handling glutaraldehyde HLD solutions?
- Gloves only
- Gloves and face shield only
- Gloves, gown, and eye/face protection at minimum (Correct answer)
- No PPE required if the basin is covered
Correct answer: Gloves, gown, and eye/face protection at minimum
At minimum, gloves, a fluid-resistant gown, and eye/face protection are required when handling glutaraldehyde due to its toxic and sensitizing properties.
Question 5: What is the purpose of rinsing an endoscope thoroughly with sterile or filtered water after HLD?
- To rehydrate the scope's internal channels
- To remove residual disinfectant that could harm patients (Correct answer)
- To lower the surface temperature before storage
- To activate antimicrobial properties of the scope materials
Correct answer: To remove residual disinfectant that could harm patients
Residual HLD chemicals can cause mucosal injury in patients, so thorough rinsing with sterile or filtered water after HLD is essential.
Question 6: Which statement about peracetic acid (PAA) used in AERs is correct?
- PAA must be stored refrigerated between uses
- PAA is typically single-use and disposed of after each cycle (Correct answer)
- PAA can be reused for up to 14 days like glutaraldehyde
- PAA requires neutralization before drain disposal
Correct answer: PAA is typically single-use and disposed of after each cycle
Peracetic acid used in most AER systems is formulated as a single-use product and discarded after each cycle, unlike reusable HLD solutions.
Question 7: At what point should a logbook entry for HLD processing be completed?
- At the end of each shift as a batch record
- Immediately after each scope is processed (Correct answer)
- Only when the HLD solution is changed
- When the scope is returned to the storage cabinet
Correct answer: Immediately after each scope is processed
Documentation must be completed immediately after each scope is processed to ensure accurate traceability and compliance with infection control standards.
CER High-Level Disinfection Processes 3
Ortho-phthalaldehyde (OPA) has what primary advantage over glutaraldehyde for high-level disinfection?