Infection Prevention and Control

Chapter 6

Objectives:

As a result of successfully completing this chapter, students will be able to:

Explain the role of Central Service Technicians in a healthcare facility’s infection prevention and control efforts.

Discuss personal hygiene and personal protective equipment precautions that enable Central Service Technicians to protect patients and themselves.

Define the term, “Standard Precautions,” and review its role in preventing the transmission of infectious organisms.

List key elements in the Bloodborne Pathogens Standard published by Occupational Safety and Health Administration (OSHA).

Objectives:

Describe basic environmental concerns as Central Service work areas are designed.

Review environmental aspects of Central Service work procedures that impact infection control:

Traffic control Work area cleanliness Workflow

Define the terms, “asepsis,” and “aseptic technique,” and review the five basic principles of asepsis.

Infection Prevention and Control Goals of Central

Service

Eliminate and/or destroy all potentially infectious contaminants present on reusable instruments and equipment.

Safely distribute reusable and single-use items required for the delivery of patient care.

Establish and enforce standards for decontamination, disinfection, and sterilization in various healthcare settings.

Medical Devices that have not been properly handled, disinfected or

sterilized…

…can cause infections in patients and staff

Each Year

Approximately 10% of patients hospitalized develop a healthcare facility-associated infection

The primary purpose of the Central Service Department

is to stop the spread of disease-producing

microorganisms in the healthcare facility

Appropriate Attire for Central Service

A facility-issued scrub uniform

Hair covering that covers all head and facial hair except eyebrows and eyelashes

Shoes with non-skid soles

Hand Hygiene

Remove Watches and other Jewelry before entering the work area.

Wash hands with soap and water or use an alcohol-based hand rub

Personal Protective Equipment

Required by OSHA for Technicians in the Decontamination area: General purpose

utility gloves A fluid-resistant

covering with sleeves Full face protection. Shoe covers

Fluid-Resistant Gowns (Coverings)

Regular scrub attire splashed with liquid

Fluid-resistant attire splashed with liquid

Standard Precautions

Place emphasis on the use of blood and body fluid precautions for all patients.

OSHA BloodBorne Pathogen Standard

Written Exposure Control Plan

Training upon initial hire and annually thereafter

Hepatitis B Vaccine offered at no cost to employees

Observance of Standard Precautions

Use of Engineering and Work Practice Controls to reduce risks

OSHA BloodBorne Pathogen Standard

Provision of Personal Protective Equipment (PPE) at no cost to the employee

Provision of a clean and sanitary working environment

Use of appropriate Biohazard signs and labels to identify contaminated items

Rigid containers for sharps disposal

OSHA BloodBorne Pathogen Standard

Covered, puncture-proof containers for the transport of contaminated items.

Provision of medical evaluation and treatment if an employee experiences an exposure

Properly maintained medical and training records.

The Physical Design of the Central Service

Department

Physical Barriers (walls) between clean and dirty areas

A method to reduce the likelihood that airborne bacteria can be transmitted from the decontamination area to the clean areas

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The Use of Air Pressure to Control Airborne Bacteria

Clean Area

Positive Air Pressure

Decontamination Area

Negative Air Pressure

Airflow

Controlling Airflow

Windows and doors between areas with positive and negative air pressures must be kept closed

Work Area Requirements

Decontamination Temperature: 60°F to 65°F (16°C to 18°C)Humidity: 30% to 60%Air Exchanges: 10 per hour

Preparation and PackagingTemperature: 68° F to 73° F (20° C to 23° C)Humidity: 30% to 60% Air Exchanges: 10 per hour

Clean/Sterile StorageTemperature 75° F or lower (24° C or lower)Humidity: Less than 70% Air Exchanges: 4 per hour

Work Area Requirements (cont.)

Hand washing Sinks

Fixtures and furniture that can be washed

Other Requirements:

Open Rack storage systems should have a solid bottom to prevent contamination during housekeeping tasks

Traffic Control

Traffic control requirements must be enforced for everyone

Dress codes for all areas apply to everyone

Traffic Control Designations

Biohazard – OSHA-required PPE

Unrestricted – Normal Traffic areas, cafeteria, waiting rooms, etc. Street clothes may be worn

Semi-Restricted – Clean assembly and storage areas, access corridors to operating rooms, etc. Surgical scrub attire and hair covering required

Restricted – Areas where sterile procedures are performed. Surgical scrub attire, hair covering, and masks required. *Persons working within the sterile field will have additional requirements

What to WearCS Dress Requirement Review

Decontamination

Area

Clean Assembly and

Sterile Storage

Operating Room

Non-restricted Hallways and Offices. Cafeteria, etc.

Surgical Scrubs and OSHA-required PPE

Surgical Scrubs and Hair Covering

Surgical Scrubs, Hair Covering, Masks may be required

Regular Street Attire

Environmental Cleaning

Floors should be wet-mopped at least daily

Work surfaces should be cleaned at least daily

Light fixture should be cleaned at least every 6 months

Walls cabinets and racks should be cleaned on a regularly scheduled basis

Cleaning Sterile Storage Areas

Remove all sterile items from the cart, rack, or cabinet

Thoroughly clean the unit using the cleaning solution recommended by the healthcare facility.

Allow the storage unit to dry thoroughly.

Carefully place items back in their designated location.

Record the cleaning date in the department’s cleaning log.

Control Microorganisms Entering the Work Areas

Clean Routinely

No Food or Drink should be allowed in Central Service work

areas.

No Food or Drink

Workflow Practices

Workflow must be...

…logical …one way …defined

Progression from Contaminated to

Sterile

User

Sterile Storage

Sterilization

Inspection & Assembly

Decontamination

User

Principles of Asepsis

Asepsis – The absence of microorganisms that cause disease

Aseptic Technique – Any activity or procedure that prevents infection or breaks the chain of infection

Medical Asepsis

Procedures performed to reduce the number of microorganisms or minimize their spread

Surgical Asepsis

Procedures performed to eliminate the presence of all microorganisms and/or to prevent the introduction of microorganisms into an area

Principles of Asepsis

1. Know what is Dirty.2. Know what is Clean.3. Know what is Sterile.4. Keep the 3 conditions separate.5. Remedy contamination

immediately.

“Sterile Conscience”

A careless attitude may lead to increased risk of infection

Infection Control...

…manages the growth and transmission of bacteria in the healthcare facility

You Can Manage the Environment by:

Following All Infection Control Protocols

Recognizing Contamination and Correcting the Situation

Paying Close attention to Detail

Controlling the Spread of Microorganisms…

…is the responsibility of every Central

Service Technician