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HSPA Sterile Processing (CRCST) Exam Cheat Sheet (2026)
A free, printable HSPA Sterile Processing (CRCST) exam cheat sheet: the 186 highest-yield points to know, grouped into 7 sections that follow the exam's content areas, each section with its published weight.
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- 186 of the 186 points carry a citation to the rule they come from.
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- 400 free HSPA Sterile Processing (CRCST) practice questions on the same material, every one explained.
- Last updated: August 2026.
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In the Sterile Processing Technician (CRCST) guide: A memorise-cold numbers box, a named-traps list and a worked scenario closing every one of the seven chapters. Practice here stays free.
Departmental Considerations
15% of the exam- Pressure relationships are the values that never change
- Decontamination is negative. The clean workroom and sterile storage are positive. The sterilizer equipment room is negative and exhausted outdoors.· AAMI ST79
- ASHRAE 170 sets the HVAC values; ST79 tells you which edition applies
- ST79 deleted its own HVAC numbers in 2017 and defers to the edition of ANSI/ASHRAE/ASHE 170 in force when the system was installed or last upgraded.· AAMI ST79
- 10 air changes per hour is legacy for decontamination and current for the sterilizer equipment room
- The pre-2017 AAMI figure of 10 is still repeated everywhere. Recent ASHRAE 170 editions put decontamination at a minimum of 6 and the sterilizer equipment room at 10.· ANSI/ASHRAE/ASHE 170
- Monitor and record temperature, humidity, and pressure at least daily
- Records must be retrievable. A blank log is itself a finding, because it leaves the department unable to bound an excursion it later has to assess.· HSPA
- An out-of-range reading triggers document, notify, risk assessment
- Document the reading, notify the supervisor and facilities, then run a multidisciplinary risk assessment with infection prevention on the affected items. Never prop a door open to fix a temperature problem; that destroys the pressure relationship.· AAMI ST79
- Cleaning tools are dedicated per zone
- Mops, buckets, and cloths used in decontamination never cross into the clean workroom or sterile storage. Every zone's schedule and completion are documented.· AAMI ST79
- A Safety Data Sheet is required for every hazardous chemical, accessible every shift
- Standardized 16-section format. Containers are labeled with the product identifier and hazard information, and chemicals are never decanted into unlabeled containers.· OSHA 29 CFR 1910.1200
- Eyewash within 10 seconds of travel, capable of 15 minutes of flushing
- Unobstructed access, both eyes simultaneously, hands-free, tepid water. Drench hoses and squeeze bottles are supplements, not primary eyewash units.· ANSI/ISEA Z358.1
- Eyewash units are activated and documented weekly
- The weekly flush clears stagnant water from the line and proves the valve still operates. The check is recorded.· ANSI/ISEA Z358.1
- OSHA states no eyewash numbers of its own
- OSHA requires suitable facilities for quick drenching or flushing; the 10-second and 15-minute figures come from the consensus standard and from ST79, which OSHA references as guidance.· OSHA 29 CFR 1910.151
- Scrubs are laundered by a health-care-accredited laundry, not at home
- Facility-provided attire, laundered after each daily use, and changed immediately when wet, soiled, or contaminated.· AAMI ST79
- All head and facial hair is covered except eyebrows and eyelashes
- Complete coverage, every time, in every restricted area of the department.· AAMI ST79
- No artificial nails, extenders, or polish; nails short and clean
- Natural nails do not extend beyond the fingertip. No jewelry on the hands or wrists.· AAMI ST79
- Shoe covers are protective equipment, not routine attire
- They are worn when gross contamination can reasonably be anticipated, then removed with hand hygiene. Everyday shoes are clean, closed-toe, and non-skid.· OSHA 29 CFR 1910.1030
- Change out of surgical attire before leaving the facility
- Whether cover apparel is required inside the building is facility policy; leaving the building in departmental attire is not.· AAMI ST79
- Workflow moves in one direction only, dirty to clean
- Physical barriers separate soiled from clean. Remove all protective attire and perform hand hygiene before entering the clean workroom.· AAMI ST79
- ST79 designates two areas: unrestricted and restricted
- Decontamination and prep and packaging are both restricted. Semi-restricted is a surgical suite term, not a sterile processing zone.· AAMI ST79
- A traffic-control policy must name who enforces it
- It also limits access, sets entry and attire criteria, and extends the dress code to visitors and vendors.· AAMI ST79
- Set the working level at or slightly below elbow height
- Combine with anti-fatigue mats, adjustable surfaces, carts instead of carrying, and lifting close to the body with the legs.· OSHA
- FDA, CMS, and OSHA carry the force of law
- FDA clears devices and their reprocessing instructions, CMS sets Conditions of Participation, OSHA regulates worker safety.· FDA
- ANSI/AAMI and AORN documents are voluntary consensus standards
- They are written in should, not shall, and are nonetheless the recognized standard of care, cited by surveyors and in litigation.· AAMI ST79
- The Joint Commission is an accreditor, not a regulator
- Its leverage comes from CMS deeming authority. Losing accreditation costs a facility its deemed status for Medicare and Medicaid payment.· CMS
- Device manufacturer instructions for use govern reprocessing
- They are device specific and FDA reviewed. Facility policy may be more conservative but may never fall below the validated requirement.· FDA
- There is no national record retention period
- ST79 says requirements vary; the facility sets policy from state, local, federal, and accreditor requirements plus the statute of limitations. Any universal number of years is a wrong answer.· AAMI ST79
- Records exist for recall, compliance, and legal defense
- Load records, monitoring results, disinfection logs, maintenance records, incident reports, and employee training and competency files.· AAMI ST79
- A rising IUSS rate is an inventory and scheduling signal
- It points to insufficient instrument sets, scheduling pressure, or late loaners, not to failing sterilizers.· AAMI ST79
- Six Sigma reduces variation and defects; LEAN removes waste
- The two are frequently combined. Quality assurance itself is continuous, running competency verification, documentation review, cleaning verification, environmental monitoring, and preventive maintenance year round.· AAMI ST79
Cleaning, Decontamination and Disinfection
21% of the exam- Resistance hierarchy: prions, spores, mycobacteria, nonenveloped viruses, fungi, vegetative bacteria, enveloped viruses
- Prions and spores are hardest to kill; enveloped viruses such as HIV and hepatitis B are easiest. Any option calling HIV hard to kill is wrong.· CDC
- Biofilm requires mechanical action, not just chemistry
- It forms on soiled wet surfaces and inside lumens and shields organisms from detergents and sterilants. Brushing and flushing disrupt it; soaking does not.· AAMI ST79
- Suspected CJD is escalated, never processed routinely
- Prions resist conventional sterilization. The facility's infection prevention department defines an extended protocol from current CDC and WHO guidance.· CDC
- Break any one link and the infection is prevented
- Agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Reprocessing attacks the reservoir and transmission links most directly.· CDC
- Hand hygiene is the single most effective infection prevention measure
- Performed after glove removal, after leaving decontamination, before eating, and between tasks. Gloves never replace hand hygiene.· CDC
- Treat all blood and body fluids as infectious, always
- Standard precautions do not depend on a known diagnosis, on isolation status, or on whether the item looks soiled.· CDC
- Hepatitis B vaccine offered free within 10 working days of assignment
- Employers also supply protective equipment, annual training, and a written exposure control plan reviewed at least annually, all at no cost to the employee.· OSHA 29 CFR 1910.1030
- Doff gloves, gown, eye protection, mask — hand hygiene between and after
- Don clean to dirty with gloves over the gown cuffs. Remove all attire inside decontamination before leaving the area.· OSHA 29 CFR 1910.1030
- Personal eyeglasses are not eye protection
- They lack side and splash shielding. Use goggles with a mask or a full face shield wherever splashing is anticipated.· OSHA 29 CFR 1910.1030
- Sharps are never handled directly
- Move them with forceps into a puncture-resistant labeled container, never recap or hand-pass, and report the loose sharp back to the procedural area.· OSHA 29 CFR 1910.1030
- No food, drink, cosmetics, or contact lens handling in decontamination
- This includes a lidded beverage on a shelf. Aerosols settle on the outside of the container.· OSHA 29 CFR 1910.1030
- Keep instruments moist from the moment the case ends
- Remove gross soil at the point of use and apply a moisture-retention product or damp towel. Never let soil dry on the device.· AAMI ST79
- Never use saline on instruments
- Chloride attacks the passive layer of stainless steel and causes pitting and corrosion. Warm saline is worse still, because heat coagulates protein onto the instrument.· AAMI ST79
- Transport soiled items in closed, leak-proof, labeled containers
- Containers or carts must prevent leakage and carry a biohazard label or color coding. A sheet over an open cart does not satisfy the requirement.· OSHA 29 CFR 1910.1030
- Document and report inadequate point-of-use cleaning
- Reporting the pattern is part of the receiving technician's job. Educating the procedural area is the only durable fix for baked-on soil.· AAMI ST79
- Decontamination is under negative pressure
- Air flows into the room and is exhausted out, never toward the clean workroom or sterile storage, which are positive. Pressure direction is the value that does not change between standard editions.· AAMI ST79
- Leak test a flexible endoscope before immersion
- A breached sheath lets fluid into the scope's interior. A scope that fails the test goes to repair without being immersed.· AAMI ST91
- Prepare chemicals exactly per the label
- Correct product, labeled dilution, labeled water, within the expiration date. More detergent is not a stronger process.· AAMI ST79
- Inspect and maintain cleaning tools and equipment daily
- Discard splayed brushes, clean strainers and drains, confirm spray arms rotate freely and jets are clear, and take a malfunctioning unit out of service rather than working around it.· AAMI ST79
- Brush under the water surface, never above it
- Submerged brushing prevents contaminated aerosols that expose the worker and the room air. The same logic applies to water guns.· AAMI ST79
- Keep wash water below about 140 degrees F (60 degrees C)
- Heat coagulates protein soil onto the instrument and destroys enzymatic activity. Hotter is not better for cleaning.· AAMI ST79
- Ultrasonic cleaning works by cavitation and must be degassed
- Run fresh solution to drive out dissolved gas, keep the lid closed, never mix dissimilar metals, and change the solution at least daily.· AAMI ST79
- Thermal disinfection is not sterilization
- The hot washer-disinfector rinse reduces bioburden so items can be handled safely; critical devices still require terminal sterilization.· AAMI ST79
- An automated endoscope reprocessor never replaces manual cleaning
- Leak test, then manually clean and brush every channel, then load with all channels correctly connected.· AAMI ST91
- Toxic Anterior Segment Syndrome is caused by residues, not organisms
- Rinse ophthalmic instruments completely with the specified water quality, flush cannulas immediately, and dedicate cleaning supplies to them.· AAMI ST79
- Use critical water for the final rinse
- Treated water free of minerals, ions, and endotoxins prevents residue deposition. Utility water is acceptable for washing and initial rinsing.· AAMI ST79
- Neutral pH, about 6 to 8, is the default for instrument detergents
- Alkaline products damage aluminum and certain coatings; acidic products are reserved for descaling. The device instructions for use always govern.· AAMI ST79
- Enzymatic cleaners clean but do not disinfect
- Protease, lipase, and amylase break down protein, fat, and starch. They reduce soil so sterilization can work; they kill nothing.· AAMI ST79
- Verify washer cleaning efficacy at least weekly, preferably daily
- Soil test devices detect spray-arm blockages, pump failures, and chemical delivery problems. A failure takes the machine out of service and reopens everything it processed since the last pass.· AAMI ST79
- Critical sterilize, semicritical high-level disinfect, noncritical low-level disinfect
- Sterile tissue or vascular system, mucous membranes or nonintact skin, intact skin. Cleaning comes first at every level, and Spaulding sets a minimum, not a maximum.· CDC
- Test reusable high-level disinfectant with the product's own strip
- Per the label, typically before each use or at least daily, and document the result. A solution that fails is discarded immediately.· CDC
- Discard at the end of reuse life or on a failed concentration test, whichever comes first
- Days remaining in the reuse period never override a failed test strip.· CDC
- Full contact time at the labeled temperature, fully immersed
- All channels filled, no air pockets. On a surface, the equivalent is staying visibly wet for the whole labeled time — a wipe that dries early cleaned but did not disinfect.· CDC
- A failed disinfection quality test means the devices were not disinfected
- Quarantine and reprocess them, document and report the failure, and investigate the cause, exactly as for a failed sterilization load.· AAMI ST91
Preparation and Packaging
21% of the exam- Verify heat sealer settings and inspect every seal
- Temperature and pressure are checked per the manufacturer's schedule. A seal must be continuous and uniform across its full validated width; a pouch with a channel or a weak spot is remade, never taped.· AAMI ST79
- Insulation damage is found with a tester, not by eye
- AORN's guidance is to test electrosurgical and laparoscopic insulation before each use. A detected break takes the instrument out of service; tape is never a repair.· AORN
- Inspect under task lighting plus lighted magnification
- Ordinary overhead light hides fine cracks, residual soil, and worn tips. Borescopes extend the same inspection inside lumens and scope channels.· AAMI ST79
- Stage supplies before assembly, and inspect the supplies themselves
- Crushed or damp wrap, expired indicators, and aged self-seal adhesive are defects that disappear from view the moment the package is closed.· AAMI ST79
- Inspect every instrument individually under lighted magnification
- Fine cracks, residual soil, adhesive, cement, staining, and worn tips are invisible to the unaided eye. Selective inspection based on complaints is not acceptable.· AAMI ST79
- An item that is not clean goes back to decontamination
- It is never wiped at the assembly bench. A wipe does not reach what the washer missed, and the soil is evidence the cleaning process needs attention.· AAMI ST79
- Test scissors with the distal third of the blades
- Cut the manufacturer-specified test material. Never test a cutting edge with a finger or fingernail. Ratchets are closed to the first tooth and tapped.· AAMI ST79
- Use only water-soluble, steam-penetrable instrument lubricant
- Petroleum oils and industrial sprays block sterilant contact and can leave toxic residue. Lubricate after cleaning, before packaging, only where the instructions call for it.· AAMI ST79
- Remove failed instruments from service and document them
- Tag it, send it for repair, and annotate the count sheet so the operating room learns about the gap before the case. The repair log is what turns single failures into a visible pattern.· AAMI ST79
- Assemble to the count sheet and document every exception
- Verify by name, size, and quantity. Record missing items and document substitutions; never substitute silently or assemble by the tray's general appearance.· AAMI ST79
- Identify instruments by number, etching, or measurement, not by shape
- Two instruments can differ only in length, jaw curvature, or serration pattern. A ruler and a catalog belong on the assembly bench.· AAMI ST79
- Hinged instruments are assembled open on a stringer
- A closed ratchet shields the metal-to-metal contact surface from steam and is a common cause of sterilization failure in individual instruments.· AAMI ST79
- Heavy low, delicate on top, concave items on edge
- Tip guards must be sterilant permeable; liners and mats must be approved for sterilization and must not block perforations. Basins and cups drain rather than pool.· AAMI ST79
- Keep total set weight to about 25 pounds, evenly distributed
- Including the tray and containment device. Heavier sets retain condensate, dry poorly, produce wet packs, and cause musculoskeletal injuries.· AAMI ST79
- Class 1 shows exposure only
- Autoclave tape and pouch markings distinguish processed from unprocessed packages. They say nothing about cycle adequacy or sterility.· AAMI ST79
- Class 5 integrating indicators respond to all critical variables
- Their performance is correlated to a reference biological indicator, which is why they appear in process challenge devices and in implant loads.· AAMI ST79
- Class 6 emulating indicators are cycle specific
- They are labeled for a single set of stated values and are invalid in any other cycle. A steam indicator is equally meaningless in a hydrogen peroxide chamber.· AAMI ST79
- The internal indicator goes in the hardest-to-reach spot inside the package
- Center of a wrapped set, deepest corner of a container. An external indicator goes on every package unless an internal one is visible through the packaging.· AAMI ST79
- An unchanged internal indicator means the package is not used
- Return the tray for full reprocessing and review the load records and remaining packages. No chemical indicator of any class proves sterility.· AAMI ST79
- Match the packaging system to the sterilization method first
- Cellulose wraps, paper pouches, muslin, and cotton absorb hydrogen peroxide and abort a gas plasma cycle. Every packaging system must be validated for the cycle it will see.· AAMI ST79
- Secure wrap with sterilization indicator tape only
- Never staples, pins, paper clips, rubber bands, or ordinary tape. Inspect the wrap against the light for holes and thin spots, and apply it snugly but without tension.· AAMI ST79
- Never fold, cut, tape, or resize a peel pouch
- Folding blocks sterilant, stresses the seal, and voids the manufacturer's validation. Use a correctly sized pouch or a different packaging system.· AAMI ST79
- Inspect container filters, gaskets, valves, and latches before every use
- Single-use filters are replaced each cycle and seated under their retention plate. A tamper-evident lock is applied after assembly and checked at the point of use.· AAMI ST79
- A rigid container is not airtight
- Sterilant must be able to enter and air must be able to leave. Any answer that describes sealing a container completely is wrong.· AAMI ST79
- Loaner sets are packaged from the vendor's written instructions
- Verify every item against the vendor list, follow that set's own instructions for packaging and cycle, and raise discrepancies before the set is packaged.· AAMI ST79
- Every package label carries a lot control number
- Sterilizer identification, cycle or load number, and date, plus contents, technician, destination, and any missing items. This is the foundation of recall capability.· AAMI ST79
- Write on the plastic side of a pouch and on the tape of a wrapped pack
- Never on the paper side of a pouch, never across a seal, and never directly on the wrapper. Ink wicks through porous barriers.· AAMI ST79
- Use an approved non-bleeding marker, never a ballpoint or pencil
- A hard point scores and can perforate packaging material. Printed and electronic labels are equally acceptable.· AAMI ST79
- Flag implants, loaner sets, and the required cycle on the label
- Each of those changes how the package is handled downstream, and the label is the only thing the next person sees.· AAMI ST79
- Label before sterilization, not after
- Writing on a processed package means handling and pressing on a sterile barrier with a pen.· AAMI ST79
Sterilization Process
21% of the exam- Four parameters must all be met: time, temperature, moisture, and direct contact
- Any one of the four failing means the load is not sterile, regardless of the other three. Residual soil, a closed box lock, or trapped air all defeat the contact requirement.· AAMI ST79
- Pressure is not a sterilization parameter
- It exists only to raise water's boiling point so steam can reach 250 or 270 degrees F. An option listing pressure as a critical parameter is wrong.· AAMI ST79
- Steam must be saturated, approximately 97 percent dry
- Excess moisture produces wet packs and poor penetration; superheat destroys the condensation mechanism that does the killing.· AAMI ST79
- Sterility assurance level is 10 to the minus 6
- No more than a one-in-one-million probability that a single processed item remains nonsterile. It is a probability, not a body count.· AAMI ST79
- The drain is the coldest point in the chamber
- Air is heavier than steam and settles at the front bottom drain, which is why the temperature sensor and the process challenge device belong there. Clean the drain screen daily.· AAMI ST79
- Every cycle runs conditioning, exposure, and exhaust with drying
- Air removal problems are conditioning failures, temperature shortfalls are exposure failures, and wet packs are usually exhaust-and-dry failures.· AAMI ST79
- The jacket manages heat; it is not part of the sterilizing space
- It keeps chamber walls hot to limit condensation and aid drying. A worn or dirty door gasket is a leading cause of leaks and aborted cycles.· AAMI ST79
- Look up an error code, do not clear and rerun it
- Respond as the manual directs, take the unit out of service if the process is in doubt, and document and report the fault.· AAMI ST79
- Gravity wrapped set: about 30 minutes at 250 degrees F, or about 15 minutes at 270 degrees F
- Passive air removal takes longer. Drying time is added on top of exposure and is commonly 30 minutes or more for wrapped goods.· AAMI ST79
- Dynamic-air-removal wrapped set: about 4 minutes at 270 degrees F, or about 3 minutes at 275 degrees F
- Active air evacuation lets steam reach surfaces immediately, which is why exposure is so much shorter than gravity at the same temperature.· AAMI ST79
- The device instructions for use set the required minimum parameters
- Parameters are never shortened below the validated minimum for turnaround. Conflicts between the device and the available sterilizer are resolved before the device goes into service.· AAMI ST79
- An aborted cycle means the whole load is unsterile
- If the sterilizer cancels, alarms on an air leak, or misses a parameter on the printout, the load is quarantined and reprocessed no matter what the indicators show.· AAMI ST79
- IUSS never shortens cleaning
- Full decontamination comes first. IUSS shortens only packaging, drying, and storage.· AAMI ST79
- IUSS items are used immediately and never stored
- The item is transported directly to the point of use in a validated containment device. There is no shelf life and no sterile storage for an IUSS item.· AAMI ST79
- Common IUSS gravity parameters: 270 degrees F for 3 minutes, metal only
- Porous, cannulated, and lumened items typically need a longer exposure such as 10 minutes in a gravity cycle, always per the device instructions.· AAMI ST79
- Avoid IUSS for implants
- If a documented emergency makes it unavoidable, use a process challenge device with a rapid-readout biological indicator and a Class 5 integrating indicator, notify the surgeon, and document the early release.· AAMI ST79
- Ethylene oxide requires mandatory aeration after every load
- Residual EO absorbed into polymers is toxic and must be driven off, commonly 8 to 12 hours or longer at elevated temperature per the sterilizer and device instructions.· OSHA 29 CFR 1910.1047
- No cellulose in hydrogen peroxide sterilizers
- Paper, linen, cotton, and cellulose-based wraps absorb hydrogen peroxide and cause cycle cancellation. Use only compatible polypropylene wrap, pouches, and containers.· AAMI ST58
- Hydrogen peroxide byproducts are water and oxygen
- There is no toxic residual, so loads are used immediately with no aeration — the method's main operational advantage over ethylene oxide.· AAMI ST58
- Dry heat is for anhydrous materials
- Oils, ointments, and powders that steam cannot penetrate, at roughly 320 degrees F for 2 hours or 340 degrees F for 1 hour.· AAMI ST79
- Liquid chemical sterilization produces no shelf life
- The device comes out wet and unpackaged, so it is transferred aseptically and used at once. It can never be stored for a later case.· AAMI ST58
- Choose steam whenever the device tolerates heat and moisture
- Every low-temperature method carries cost, cycle time, material restriction, or worker safety burdens, so they are reserved for devices steam would destroy.· AAMI ST79
- Metal below, textiles above, chamber loaded loosely
- Condensate drips downward, so absorbent textile packs beneath metal trays reliably produce soaked wrappers. Nothing touches the chamber walls.· AAMI ST79
- Peel pouches go on edge, paper to plastic
- Stacking pouches flat or overlapping them traps air and moisture between layers and blocks steam from reaching the porous side.· AAMI ST79
- Verify that every package in the load is validated for this cycle
- A cellulose-wrapped tray in a peroxide chamber aborts the cycle; a low-temperature-only device in a steam chamber is destroyed.· AAMI ST79
- A wet pack is a contaminated pack
- Moisture wicks microorganisms from the outside of the package to the contents. Reprocess from the beginning; never air dry, wipe, or re-run only the drying phase.· AAMI ST79
- Do not touch or move a load until it has cooled
- Handling hot, damp packages drives contamination through the packaging. Cool on the cart, away from vents and traffic, for 30 minutes or longer.· AAMI ST79
- Review and initial the physical record for every cycle before releasing the load
- Time, temperature, and pressure are verified against the cycle specification. A shortfall quarantines the load and triggers evaluation of the sterilizer, not a rerun.· AAMI ST79
- Physical, chemical, and biological monitors are used together, never interchangeably
- Each answers a different question, and no single monitor of any type establishes sterility on its own.· AAMI ST79
- Match the spore to the method
- Geobacillus stearothermophilus for steam, hydrogen peroxide, and ozone; Bacillus atrophaeus for ethylene oxide and dry heat.· AAMI ST79
- Steam biological indicator at least daily, every load preferred, every implant load required
- Implant loads use a process challenge device with a biological indicator and are quarantined until the result is negative, except in a documented emergency.· AAMI ST79
- The unprocessed control must grow
- Same lot, never sterilized, incubated alongside the test indicator. No growth in the control invalidates the test. Incubator temperature is verified and documented.· AAMI ST79
- Place the process challenge device in the coldest, most challenging location
- In a steam sterilizer, generally the bottom shelf near the front over the drain, where residual air settles. Follow the sterilizer manufacturer instructions.· AAMI ST79
- Bowie-Dick daily, empty chamber, first cycle after warm-up
- It tests air removal and steam penetration, not lethality, at 270 to 275 degrees F for the time the test manufacturer specifies, usually no more than about 4 minutes because overexposure can mask a failure.· AAMI ST79
- Run the vacuum leak test on the sterilizer's schedule, commonly weekly, and after repairs
- A leaking dynamic-air-removal chamber pulls room air back in during conditioning and defeats air removal entirely.· AAMI ST79
- Every package carries a lot control number
- Sterilizer identification, cycle number, and date, so any package traces back to its load record and any load traces forward to its packages.· AAMI ST79
- A positive biological indicator triggers immediate recall back to the last negative
- Take the sterilizer out of service, retrieve and quarantine every affected load, and never keep processing while waiting for a retest.· AAMI ST79
- Requalification is three consecutive empty-chamber cycles with negative biological indicators
- Dynamic-air-removal sterilizers add three passing Bowie-Dick tests. Required after a failure and also after installation, relocation, or major repair.· AAMI ST79
- Escalate when affected items reached patients
- Notify risk management and infection prevention, and document the investigation and corrective action in the quality record.· AAMI ST79
- Load documentation exists for recall, traceability, and legal defense
- Sterilizer, cycle number, date and time, contents, parameters achieved, operator, and all monitoring results, kept manually or in a tracking system.· AAMI ST79
Sterile Storage, Transport and Inventory Management
9% of the exam- Sterile storage: positive pressure, not above about 75 degrees F, humidity not above 60 percent
- Pressure direction is the fixed value; the numeric air-change and temperature requirements come from the applicable edition of ANSI/ASHRAE/ASHE 170, monitored and documented daily.· AAMI ST79
- Shelf clearances: 8 to 10 inches from the floor, 18 inches below the ceiling or the sprinkler heads, about 2 inches from outside walls
- These protect against floor contamination during wet cleaning, preserve fire-suppression coverage, and keep condensation on exterior walls away from packages.· AAMI ST79
- The 18-inch clearance is in ST79 §11.1.1, and originates in the fire code
- NFPA 13 protects the sprinkler spray pattern for the whole room. Aisles and exits stay clear and electrical panels are never blocked.· NFPA 13
- No corrugated cardboard in sterile storage
- External shipping cartons carry dust, pests, and moisture from uncontrolled environments and shed fiber particulate when handled.· AAMI ST79
- Break out, reconcile, and inspect incoming stock in a separate area
- Remove shipping cartons, reconcile against the packing list, and check each package for integrity, expiration date, and manufacturing date before it enters storage.· AAMI ST79
- An event, not a date, ends sterility for facility-processed packages
- Moisture, tears, broken seals, compression, dropping, and contaminated handling all compromise the barrier regardless of how recently the item was processed.· AAMI ST79
- A manufacturer's printed expiration date is still honored
- Commercially packaged products carry a real expiration date. Event-related sterility applies to packages the facility processed.· AAMI ST79
- Inspect every package immediately before use
- Wetness, holes, tears, seal integrity, soiling, and a changed external indicator. When in doubt, do not use it.· AAMI ST79
- A compromised package is reprocessed from the beginning
- Contents are cleaned, inspected, repackaged, and re-sterilized. Never patch a wrapper, and never move it to a lower-risk shelf.· AAMI ST79
- PAR sets a target level and replenishes the difference
- Exchange carts swap a stocked cart for a used one on a schedule; requisition systems issue only what is asked for; just-in-time minimizes on-hand stock and depends on delivery reliability.· HSPA
- Unit of measure is the classic ordering error
- Each versus box versus case. Getting it wrong produces either a stockout or a storeroom full of an item nobody needed.· HSPA
- The unique device identifier makes a specific device traceable
- It is an FDA-required code on device packaging, alongside catalog and item numbers and the standardized packaging symbols.· FDA
- A substitution is verified as clinically equivalent and communicated before it reaches stock
- The users confirm equivalence and the affected departments are told. Discovering a substitution when the package is opened is a preventable incident.· HSPA
- Rotate stock first in, first out
- Place newly processed packages behind existing stock. Rotation limits handling wear even under an event-related sterility policy.· AAMI ST79
- An item locator system pays off at case-cart build and at recall
- Labeled shelf and bin locations, cart locations, and barcode or RFID records are what let the department find every affected item quickly.· HSPA
- Transport sterile items in closed or covered carts
- Protect against moisture, dust, and compression. Handling damage can breach a sterile barrier without leaving a visible mark.· AAMI ST79
- Apply dust covers only when packages are completely cool and dry
- A cover over a warm package traps moisture and creates condensation inside the very barrier it was meant to protect.· AAMI ST79
- Off-site transport uses sealed, rigid, labeled containers
- They protect against weather and temperature swings, and every package's sterility is reassessed on arrival.· AAMI ST79
- Code carts are resealed with a numbered lock immediately after any use
- Scheduled checks confirm lock integrity and the earliest expiration date on the cart. Restocking never waits for the next scheduled check.· HSPA
- Loaner and consignment items are always processed by the receiving facility
- Inventory, decontaminate, inspect, assemble, and sterilize on receipt regardless of vendor assurances, and decontaminate again before return.· AAMI ST79
- A late loaner set is a scheduling problem to escalate
- Facilities set a required lead time by policy. Compressing a process that has no compressible steps is never the answer.· AAMI ST79
- A recall is executed by lot number, across every location
- Identify affected product and lots, pull them from all storage locations and carts, quarantine, document, and follow the manufacturer's return or destruction instructions.· FDA
- Waste and loss have named, measurable causes
- Damaged packaging, expiration, obsolete PAR entries, over-ordering, poor rotation, and untracked items. Each is preventable and each is a quality metric.· HSPA
Patient Care Equipment and Distribution
5% of the exam- Patient care equipment is noncritical: clean, then low-level disinfect
- Use an EPA-registered hospital disinfectant exactly per its label. High-level disinfectants and liquid chemical sterilants are wrong for noncritical items.· CDC
- The surface must stay visibly wet for the entire labeled contact time
- Contact time runs until the surface dries. A wipe that dries early cleaned the surface but did not disinfect it, so the disinfectant is reapplied.· EPA
- Use can change the category
- A cuff placed over nonintact skin is no longer a noncritical use, and items under contact precautions are disinfected before the next patient, not at end of shift.· CDC
- Remove and discard every single-use component first
- Tubing, suction liners, compression sleeves, probe covers, and pump sets go into the correct waste stream before cleaning begins.· CDC
- Never immerse electrical equipment
- Powered devices are wiped per that model's own instructions for use. Approved-chemical lists are model specific; many controllers cannot survive immersion, autoclaving, or ethylene oxide.· CDC
- A suction liner is single-use and never emptied and reused
- The rigid canister and wall regulator are reusable noncritical equipment. Liquid or semi-liquid blood and other potentially infectious material is regulated medical waste.· OSHA 29 CFR 1910.1030
- Inspect for cleanliness, frayed cords, and damage before distribution
- All three, on every item, every time. Any one of them failing keeps the item in the department.· HSPA
- Portable cord- and plug-connected equipment is visually inspected before use on any shift
- A defect that might expose an employee to injury means the item shall be removed from service until repaired and tested. This is regulation, not preference.· OSHA 29 CFR 1910.334
- A damaged cord is tagged and sent to Biomedical Engineering
- Never taped, never distributed for a short case. Tape is not an insulator, and prior normal operation is neither a repair nor a test.· OSHA 29 CFR 1910.334
- Equipment with a missing or expired maintenance label does not go out
- What standards require is a documented program with an inventory, defined frequencies, pre-use checks, and records; the sticker is the expected evidence that it happened.· HSPA
- Rental and loaned equipment is treated as contaminated on receipt
- Regardless of supplier assurances, it is cleaned, inspected, and tested per its instructions for use before it is distributed.· OSHA 29 CFR 1910.1030
- Decontaminate equipment before servicing or shipping it back
- Where decontaminating a portion is not feasible, a readily observable label must state which portions remain contaminated, and that is communicated before anyone handles or ships it.· OSHA 29 CFR 1910.1030
- Store clean equipment dry, secure, and visibly separated from soiled
- One-way flow applies to equipment exactly as it does to instruments, and processed status must be obvious to the next person.· HSPA
- Check the charge indicator before distribution
- Keep chargeable equipment plugged in while in stock and replace batteries on the manufacturer's schedule through Biomedical Engineering.· HSPA
- Test per the instructions for use before the item leaves the department
- Assemble it with the disposables it needs, transport it clean and protected to the requesting unit, and record the delivery.· HSPA
Professional Development and Human Relation Skills
8% of the exam- A safety issue reported only informally has not been reported
- Formal channels are documented: incident reports, work orders, the load record, an email to a manager. A hallway mention leaves no record and no action.· HSPA
- Service recovery starts with acknowledgment, not blame
- Acknowledge the problem, apologize for the impact, fix what can be fixed now, explain what will change, and follow through.· HSPA
- Apply the minimum necessary standard to patient information
- Access only what the job requires, do not discuss patients where you can be overheard, never photograph records or trays, and dispose of identifiers in confidential waste.· HIPAA
- Give a realistic time, not an optimistic one
- Identify yourself and the department, write down and repeat back what was asked, and commit only to what the process can actually deliver.· HSPA
- Never release an item that has not completed a validated process
- Decline respectfully, explain the reason, offer alternatives, and escalate through the chain of command. Schedule pressure does not change the answer.· AAMI ST79
- Documenting the requester's name does not transfer accountability
- The release decision, and any resulting patient harm, stay with the person who released the item.· AAMI ST79
- Prioritize by clinical need and process constraint
- The open case comes before tomorrow's elective, but nothing jumps ahead of a required process step, and no one's volume decides the order.· HSPA
- Follow the manufacturer's written instructions for use, every time
- They are device specific and FDA reviewed. Facility policy may be more conservative but may never fall below the validated requirement.· FDA
- Report near misses and adverse events honestly
- Honest reporting drives root cause analysis and corrective action. Concealing an error removes the department's ability to prevent the next one.· HSPA
- Decode terms from prefix, root, and suffix
- -ectomy removal, -otomy incision into, -ostomy creation of an opening, -oscopy scope examination, -plasty repair, -orrhaphy suture repair, -pexy fixation, -tome a cutting instrument.· HSPA
- Instruments group into functional families
- Cutting and dissecting, grasping and holding, clamping and occluding, retracting and exposing, suctioning, probing and dilating, suturing, and microsurgical or accessory.· HSPA
- Confirm an eponym by number, etching, or measurement
- Two instruments with the same surname can differ in length, curvature, or serration pattern. Shape alone is not identification.· HSPA
- Task group, quality group, cross-functional team
- One specific job then disband; ongoing improvement of a process; members from several departments solving a problem none of them owns alone.· HSPA
- Accountability is shared for the outcome but assigned for each task
- Roles are identified explicitly and work is prioritized as a group. A task assigned to everyone is a task assigned to no one.· HSPA
- Get recertification requirements from HSPA directly
- Continuing education requirements, deadlines, and fees change and are published by the certifying body. Any prep source quoting them should be checked against HSPA itself.· HSPA
- Maintain competency and current knowledge
- Devices, standards, and sterilization technologies change continually. In-service training, continuing education, and reading revised standards keep practice aligned with the current standard of care.· AAMI ST79
- Describe competencies and volumes, not duties
- A resume and an interview in this field are strongest when they show specific process decisions you have made and the work you actually handled.· HSPA
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