CIS Decontamination Questions and Answers 2 — Questions and Answers
Question 1: What is the difference between cleaning, disinfection, and sterilization?
- All the same process
- Cleaning removes soil, disinfection kills most pathogens, sterilization destroys all microbial life including spores (Correct answer)
- Sterilization is less effective than disinfection
- Cleaning is the final step
Correct answer: Cleaning removes soil, disinfection kills most pathogens, sterilization destroys all microbial life including spores
These represent escalating levels of microbial reduction: cleaning removes soil, disinfection kills vegetative pathogens, and sterilization destroys all life forms including spores.
Cleaning is the essential prerequisite that physically removes soil and reduces bioburden. Disinfection kills most pathogenic organisms but not necessarily spores. Sterilization achieves SAL 10^-6 killing all life forms. Cleaning must always precede both.
Question 2: What is the significance of bioburden in the decontamination process?
- Not a relevant concept
- Higher bioburden increases the challenge to the sterilization process (Correct answer)
- Only refers to visible contamination
- Measured after sterilization
Correct answer: Higher bioburden increases the challenge to the sterilization process
Bioburden is the population of microorganisms before sterilization. Higher levels present a greater challenge and increase sterilization failure risk if cleaning is inadequate.
Sterilization is logarithmic — each time interval kills a fixed percentage. Higher starting bioburden requires more time to achieve SAL 10^-6. Organic matter can also shield microorganisms from sterilant contact. Inadequate cleaning is the most common cause of sterilization failure.
Question 3: What precautions must be taken when transporting contaminated instruments?
- No special precautions
- Closed, puncture-resistant, leak-proof containers via designated routes separate from clean traffic (Correct answer)
- Simply place on a cart
- Wrap in surgical drapes
Correct answer: Closed, puncture-resistant, leak-proof containers via designated routes separate from clean traffic
Instruments must be in enclosed, puncture-resistant, leak-proof containers with biohazard labels, transported via designated soiled corridors.
Containment prevents sharps injuries and fluid leakage. Biohazard labeling is required. Designated routes prevent cross-contamination. Instruments should be treated with enzymatic foam to prevent bioburden drying during transport.
Question 4: What is the purpose of negative air pressure in the decontamination area?
- To keep the room cooler
- To prevent aerosolized contaminants from flowing into cleaner adjacent spaces (Correct answer)
- To improve ultrasonic cleaner efficiency
- To reduce equipment noise
Correct answer: To prevent aerosolized contaminants from flowing into cleaner adjacent spaces
Negative pressure ensures air flows into the decontamination area from cleaner spaces, preventing contaminated aerosols from migrating to clean areas.
Cleaning processes generate aerosols containing microorganisms. Negative pressure (minimum -0.01 inches water gauge) ensures air flows inward. Air is exhausted to the outside, not recirculated. Minimum 6 air changes per hour. The assembly area should have positive pressure.
Question 5: Why must instrument box locks be kept open during cleaning?
- To make instruments easier to identify
- To allow cleaning solution to reach inner joint surfaces where bioburden accumulates (Correct answer)
- To prevent instruments from falling
- Box locks should remain closed
Correct answer: To allow cleaning solution to reach inner joint surfaces where bioburden accumulates
Opening box locks exposes inner joint surfaces where blood and tissue accumulate. Closed locks trap contamination that cleaning cannot reach.
During surgery, blood and tissue are forced into box lock joints by clamping action. Cleaning solutions and ultrasonic cavitation cannot reach the inner surfaces of a closed lock. Residual contamination can dry and carbonize during sterilization, creating a permanent reservoir.
Question 6: What is the role of mechanical action in decontamination?
- Not important with strong chemicals
- Physically dislodges and removes bioburden, working synergistically with chemical detergents (Correct answer)
- Replaces need for chemical agents
- Only automated action is acceptable
Correct answer: Physically dislodges and removes bioburden, working synergistically with chemical detergents
Mechanical action (friction, water jets, ultrasonic cavitation) is essential because chemicals alone cannot remove adherent soil from surfaces.
Mechanical action is one of Sinner's four cleaning elements (time, temperature, chemical, mechanical). Detergents emulsify soil while mechanical action breaks surface attachment and carries debris away. Neither alone is as effective as the combination.
CIS Decontamination Questions and Answers 2
What is the difference between cleaning, disinfection, and sterilization?