Clinical

1. Clinical Standard Procedures for Preventing the Spread of Infection

2. Infection Control • Break the chain of infection • Most effective method is to control the mode of transmission • If microorganisms can’t get from the reservoir to the susceptible host, no infection will occur

3. Infection Control • First line of defense – Personal Cleanliness • Must prevent the carrying of infectious organisms between home and work • May leave scrubs or lab coat at work • Wash clothes regularly • Practice good personal hygiene • Keep shoes clean

4. Asepsis A state in which pathogens are absent or reduced. • Two principal types • Medical Asepsis • Surgical Asepsis

5. Medical Asepsis Killing germs after they leave the body • Purpose: to reduce the number of microorganisms • Washing hands • Disinfecting countertops after testing • Providing and using a tissue when you cough or sneeze • Disinfecting all items that come in contact with patients (ex waiting room, exam bed, stethoscope, etc) • Disposing of garbage frequently • Making sure waiting area is well ventilated • Keeping small groupings of seating in waiting area • Removing samples to the storage area quickly and handling them with gloves • It is also good to encourage staff who are ill not to come into work

6. Surgical Asepsis Destroying pathogens before they can enter the body • AKA Sterilization • Uses physical and chemical processes to remove all life from any equipment and instruments that will come in contact with patients • Once items have been sterilized, it is important to practice sterile technique – avoid touching any part of the item that is considered sterile

7. Three Levels of Hygiene • Sanitization: Removal of some of the gross contaminants and some microorganisms from instruments, skin, and so on • Disinfection: More thorough removal of contaminants than sanitization but less thorough than sterilization • Sterilization: Highest level of medical hygiene

8. Sanitization • First step in the cleaning process • Removes some pathogenic organisms, blood and tissue debris • Often all that is needed to clean objects that only come in contact with intact skin • Sanitizers are specially formulated, nonabrasive, low-sudsing detergents with a neutral pH • Objects should be sanitized immediately so fluids don’t dry on.

9. Sanitization • Procedure • Rinse thoroughly in cold water • Make sure you clean all surfaces • Use gloves • Avoid “sharps” • Place each instrument to dry - they should not touch

10. Disinfection • The second step in the cleaning process • Disinfectants come in various strengths • Low-level: kill most bacteria and some fungi, inactivate some viruses • Useful for linens, instruments that contact intact skin etc • Intermediate: effective against most viruses and fungi, kill most bacteria, not effective against spores • Useful for items that come in contact with a patient’s mucous membranes (ex specula)

11. Disinfection • High Level: Used for articles that need the highest possible level of pathogen reduction, but cannot withstand the sterilization process • Used for anesthetic, respiratory and endoscopic equipment

12. Disinfection • Methods of disinfecting • Ultraviolet: environmentally safe and wide range • Moist Heat: Boiling to a temperature of 100°C for 30 min (does not kill all pathogens) • Antiseptics and disinfectant chemicals: • disinfectants (bleach) are more wide range but are also often too harsh for use on human tissue – antiseptics are gentler (isopropyl alcohol, betadine) • Disinfectants are bactericidal, antiseptics are bacteriostatic

13. Sterilization • Last step in cleaning process • Methods • Chemical sterilization: used for heat sensitive equipment • Involves the use of a substance known as a sterilant (chlorine, Cidex) • Dry heat: objects are exposed to temperatures of 160°C to 170°C for at least 2 hours • Used for objects that cannot withstand moisture • Gas sterilization: toxic gasses that kill all life in a gas chamber • Only used with extreme caution and for items that cannot be sterilized any other way

14. Sterilization • Steam Autoclave: uses pressurized steam at 121°C to 132°C for 30 or 40 min • Items can be autoclaved wrapped if they are to be stored for longer periods of time • Autoclave indicators may be included to demonstrate sterility

15. Sterilization • Autoclave tape demonstrates that an item was brought to the correct temperature

16. Sterilization • Chemical and biological indicators can be used to show that the appropriate temperature was reached for the appropriate length of time, and to prove sterilization was achieved.