Quiz 6: Environmental cleaning, waste management and decontamination of medical devices

Please choose the one, most correct answer to each question or statement.

1. Infection can be easily transmitted from:
   • Inadequately cleaned healthcare environments
   • Properly sterilized medical instruments
   • Clean and dry surfaces
   • Single-use medical devices.
2. Environmental surfaces in healthcare facilities should be:
   • Carpeted to reduce the noise levels.
   • Non-compatible with hospital detergents and disinfectants
   • Rough and porous
   • Easy to clean.
3. Domestic or cleaning staff:
   • Require appropriate personal protective equipment (PPE) suitable for their work
   • Require immunisation against meningitis
   • Do not need to undergo IPC training
   • Are not at risk of acquiring infections from patients.
4. Regarding frequently touched areas:
   • Micro-organisms are easily transferred from people’s hands to surfaces
   • The closer the surface to the patient, the lower the chance of pathogen transfer to the patient
   • No special attention should be paid when cleaning these areas
   • Surfaces get wiped clean by those that touch them.
5. Terminal room cleaning is required for patients with:
   • A community-acquired pneumonia
   • Pulmonary mycobacterium tuberculosis (PTB)
   • A myocardial infarction
   • A fungal toe-nail infection.
6. The terminal cleaning process requires:
   • Routine cleaning of the room
   • Re-carpeting or re-tiling of the room
   • Repainting of the room
   • Removal of all linen, consumables and PPE plus cleaning, wiping down with disinfectant.
7. Accidents and blood spills should be handled as follows:
   • A written procedure should be available for management of accidents and spills
   • Personal protective equipment is not needed when cleaning spills
   • Blood spills should be wiped over with chlorine at concentration 100 parts per million
   • Chlorine should be applied directly to the spill so as to avoid touching the surface.
8. Training in healthcare waste management should be provided to:
   • Cleaners/domestic staff
   • Radiographers
   • Pharmacists
   • All healthcare facility staff.
9. Effective management of clinical waste involves:
   • Source segregation of waste into robust, colour-coded plastic bags
   • A waste storage area that is accessible to all staff and visitors
   • Incineration of all types of waste
   • Highly mechanised systems of moving clinical waste from point of generation to disposal.
10. There is a high risk of sharps or needlestick injury to staff when:
    • Sharps containers are mounted on the wall
    • Puncture-proof containers are used
    • Sharps containers are filled higher than indicated two-thirds full mark
    • Sharps containers are located within easy reach of the clinician.
11. The cleaning process for reprocessing used medical devices:
    • Physically removes soil and organic matter, with bacteria and viruses
    • Kills and destroys almost all pathogens
    • Is capable of killing spores
    • Is capable of killing prions.
12. According to the Spaulding classification:
    • Endoscopes are critical devices
    • Surgical instruments are critical devices
    • Blood pressure cuffs and stethoscopes are semi-critical devices
    • The operating theatre floor is seen as semi-critical.
13. When processing medical devices:
    • The device can be reliably disinfected without needing prior cleaning
    • Devices should be soaked to allow the disinfectant to penetrate organic matter
    • Soaking gives a sense of security that the item is safe to re-use
    • Cleaning must precede any other step of reprocessing.
14. Cleaning of medical devices:
    • Does not require wearing of any personal protective equipment (PPE)
    • Can be effective without the need to disassemble equipment
    • Should be done with a soft nylon brush to scrub the device below the water level
    • Involves leaving the cleaned device soaking in water until needed for use on a patient.
15. Disinfection of medical devices:
    • Destroys all micro-organisms
    • Is best achieved using chemical disinfectants
    • Eliminates the need for prior cleaning of devices
    • Reduces pathogens to levels not harmful to health.
16. Disinfectants:
    • Both alcohol and chlorine disinfectants are effective at killing Clostridium difficile
    • Are used for killing pathogens on live tissue
    • Act rapidly to kill pathogens
    • Have no known side-effects.
17. The ideal disinfectant should:
    • Leave a visible mark to show it has worked
    • Have a rapid onset of action
    • Be safe for use on live tissue
    • Be corrosive to surfaces.
18. The sterile services department (SSD) should:
    • Process all critical and semi-critical items in a hospital
    • Have a single large room where ‘clean’ and ‘dirty’ instruments are processed
    • Be operated by cleaners in the wash room
    • Routinely allow operating theatre staff to process instruments in the surgical area.
19. An advantage of autoclave sterilizers is:
    • They do not require trained staff to operate
    • They can be used for all medical devices
    • They are cheaper to purchase than disinfectants
    • They have a rapid process leaving no toxic residue.
20. Validation of autoclave sterilizers uses:
    • The Bart Dickson test
    • Swabbing the instruments for bacterial contamination
    • Visual inspection for cleanliness of the instruments
    • Physical, biological and chemical indicators.