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Phiếu Ôn Cấp Tốc Kỳ Thi HSPA Sterile Processing (CRCST) (2026)

Phiếu Ôn Cấp Tốc miễn phí, in được cho kỳ thi HSPA Sterile Processing (CRCST): 186 điểm trọng tâm nhất, chia thành 7 phần theo các lĩnh vực nội dung của kỳ thi, mỗi phần kèm trọng số đã công bố.

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  • 400 câu hỏi luyện tập HSPA Sterile Processing (CRCST) miễn phí trên cùng nội dung, câu nào cũng có giải thích.
  • Cập nhật lần cuối: tháng 8 năm 2026.
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Trong sách hướng dẫn Sterile Processing Technician (CRCST): Mỗi chương trong bảy chương đều khép lại bằng bảng số liệu phải thuộc, danh sách bẫy đề và một tình huống giải sẵn. Luyện tập ở đây vẫn miễn phí.

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Departmental Considerations

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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

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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

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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

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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

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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

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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

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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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