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Care and Handling of Ophthalmic Microsurgical Instruments Test Your Knowledge

Nursing Contact Hours Upon submission of a post-test, the registration fee, and achievement of a passing score of 80% or higher, 3.5 nursing contact hours will be awarded to participants. These contact hours may be used toward recertification for the Certified Registered Nurse in Ophthalmology (CRNO) designation. Nursing contact hours are provided by the American Society of Ophthalmic Registered Nurses (ASORN). ASORN is accredited as a provider and approver of nursing continuing education by the American Nurses Credentialing Center's Commission on Accreditation. ASORN is provider-approved by the California Board of Registered Nursing CEP #11901. JCAHPO Continuing Education Credits Approval of Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO) continuing education credits has been requested. JCAHPO requires an annual renewal of approval. Please check the current status of JCAHPO approval for this independent learning activity on the ASORN Web site at www.asorn.org, or contact the ASORN office at 415.561.8513 for more information. Submitting the Post-Test The post-test is included in Appendix D of this publication. Please make copies of the post-test as needed. The post-test is also available on the ASORN Web site at www.asorn.org, and you may request it from the ASORN office by calling 415.561.8513. The appropriate credits will be awarded for successful completion of the activity. Successful completion is defined as a score of 80% or higher. Participants who do not achieve a minimum score of 80% or higher may retake the test within 30 days. An additional processing fee of $10 is applicable. Disclaimer The American Nurses Credentialing Center's Commission on Accreditation (ANCC-COA) and the American Society of Ophthalmic 44

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Registered Nurses (ASORN) recognize this activity as continuing education for nurses. This recognition does not imply approval or endorsement of any commercial products by the ANCC-COA or ASORN.

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Care and Handling of Ophthalmic Microsurgical Instruments

Registration, Post-Test, and Evaluation Form

To receive continuing education credits for this activity, read the entire book, complete the post-test and evaluation form, and submit with your payment of $30 (ASORN members and affiliates) or $40 (non-members) to: ASORN, P.O. Box 193030, San Francisco, CA 94119-3030; or by fax to 415.561.8531. Continuing education credits will be awarded to individuals who achieve a score of 80% or higher. Participants who do not achieve a minimum score of 80% or higher may retake the test within 30 days. An additional processing fee of $10 is applicable. Upon successful completion of this test, I would like (choose one): Nursing Contact Hours JCAHPO CECs Name_____________________________________ Degree/Certification _________ Address_____________________________________________________________ City__________________ State/Country__________Zip or Country Code ________ Daytime Phone Number _____________________E-mail Address ______________ RN# _________________________State of Licensure_____________ Exp Date____ Payment: Check (payable to ASORN) Visa MasterCard CC# ____________________________Exp Date _____ Cardholder Name _______________________________

Required: Cardholder's billing address (if different from above address) Address_____________________________________________________________ City__________________ State/Country__________Zip or Country Code ________ 46

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Name: ____________________ Test Responses: Circle the most appropriate response for each test question that follows below.

1.

Microsurgical instrument life may be increased by a. proper care and handling b. using stronger and more reliable material c. ophthalmic surgeons being responsible for the instruments d. sterility being maintained at all times

2. Titanium is commonly used in microsurgical instruments because a. it is harder, stronger, and non-magnetic b. these instruments cost less and require less time to sterilize c. it is magnetic and has been heat-treated d. larger instruments can be made with tips and teeth 3. First steps of "care and handling" with a new instrument would be to a. rinse and use a cleaner b. soak in a disinfectant and sterilize c. wrap and sterilize d. inspect and test 4. The instrument manufacturing process that includes a finishing procedure designed to enhance corrosion resistance but that interferes with the surface integrity of stainless steel is a. heating, brushing, and sandblasting b. grinding, polishing, and brushing c. crushing, brushing, and sandblasting d. brushing, heating, and crushing 5. Manual cleaning of gem blades requires the nurse or technician to a. use an alkaline pH detergent greater than 7.0 b. soak in a milk bath for 12 hours c. follow the manufacturers' guidelines d. use only a washer or sterilizer 6. Necessary components for effective steam sterilization are a. sterile water, instruments, and mineral deposits b. heat, steam, pressure, and time c. heat, saline, detergent, and time d. heat, water, instruments, and time

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Name: ____________________ 7. The most frequently used method of sterilization in health care facilities is a. liquid chemical sterilization b. ethylene oxide sterilization c. steam sterilization d. dry heat sterilization 8. The most common material used for producing microsurgical instruments is a. titanium b. stainless steel c. vitallium d. polypropylene 9. During the mechanical test used for the visual inspection of new fine-tipped forceps, the nurse or technician should ensure that a. the teeth have a cutting edge b. the forceps teeth will have a large space c. the teeth will be moveable when locked d. the teeth will mesh perfectly 10. The first responsibility when unpacking new instruments is to a. make sure the instruments are decontaminated b. wrap and sterilize the instruments c. remove each instrument from the container d. check the shipping carton for damage and make sure all wrapping is intact 11. The most available and effective chemical agent for heat- and moisture-sensitive instruments is a. gas plasma sterilization b. ethylene oxide sterilization c. cold sterilization d. liquid chemical sterilization 12. Dry heat sterilization is best defined as sterilization by oxidation with a. a high temperature and a short exposure time b. low heat and a long exposure time c. low heat and a short exposure time d. a high temperature and a long exposure time 48

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Name: ____________________ 13. Interrupting the drying cycle during the sterilization process will cause a. dulling of sharp edges b. tip damage to fine instruments c. condensation on the instruments d. the prevention of rust and staining 14. Physical decontamination is the a. complete elimination of all bloodborne pathogens b. final step of the sterilization process c. use of chemical agents to neutralize or arrest microbial proliferation d. conditions capable of killing all organisms 15. Manual cleaning of instruments is best performed with a a. detergent with a pH greater than 7.0 b. soft plastic-bristle brush c. saline or chlorinated solution d. cleaner that is abrasive 16. Steam sterilization is best defined as a. moist heat in the form of saturated steam, under pressure and time b. steam that must be free of solid, liquid, or vapor contaminants c. moist heat that leaves no harmful residue d. heated air capable of killing microorganisms 17. The ideal time to clean instruments on the sterile field is a. before the start of the case b. when taking the instruments to the decontamination area c. it is not necessary while the field is sterile d. as soon after use as possible 18. Cold sterilization is best defined as a chemical disinfectant bath a. requiring a short period of time for sterilization b. whose solution temperature must be 210° F c. requiring 10­12 hours of soaking d. taking only 10 minutes to kill all bacterial spores

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Name: ____________________ 19. The advantage of glutaraldehyde sterilization is that a. it is inexpensive and safe for lenses b. it releases no toxic fumes when heated c. monitoring the sterilization process is effective d. it is easy to maintain the solution concentration 20. Chemical indicators are process challenge devices that a. guarantee the item is sterile b. detect correct packaging c. respond to physical conditions within the sterilizer d. are used externally only 21. The color change of an indicator strip during steam sterilization indicates that the a. cycle temperature has reached 150° C b. cycle results will be available in 24 hours c. cycle length is 10 minutes d. cycle met sterilization conditions 22. The best way to sterilize light pipes and laser probes is with a. steam sterilization b. ethylene oxide gas processing c. dry heat sterilization d. liquid chemical sterilization 23. Improper care and handling, decontamination, and sterilization that lead to poor surgical outcomes from intraocular exposure to toxins are known collectively as a. endophthalmitis b. iritis c. TASS d. cystoid macula edema 24. One of the main etiologies in TASS is a. using disposable items b. ultrasonic cleaning after each use of instruments c. reuse of irrigation cannulas d. using distilled water to rinse instruments

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Care and Handling of Ophthalmic Microsurgical Instruments Evaluation

Please evaluate this educational activity based on how well each objective was met. As a result of this offering I am able to: · · · · · ·

Very Well 4 Moderately Well 3 Fairly Well 2 Not at All 1

Describe the care and handling process of new ophthalmic microsurgical instruments. State the differences between steam, gas, and cold sterilization procedures. Describe how ophthalmic instruments are decontaminated for safe handling. Explain the role of ultrasonic cleaning

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Discuss why lubrication is important to the care of ophthalmic instruments. Describe proper storage procedures for ophthalmic instruments.

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Very Well The content supports the objectives Independent study was an effective teaching method. This activity helped me to achieve personal objectives. This activity contributed to my professional development. 4 4 4 4

Moderately Well 3 3 3 3

Fairly Well 2 2 2 2

Not at All 1 1 1 1

Did you perceive a financial or commercial bias associated with this educational activity? Yes No The time required to complete this activity and take the test was: ______ Additional comments:

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