ClinicalStandard Procedures for Preventing the

Spread of Infection

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

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

Infection Control

A state in which pathogens are absent or reduced.

Two principal types◦ Medical Asepsis ◦ Surgical Asepsis

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

Medical 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

Surgical Asepsis

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

Three Levels of Hygiene

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.

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

Sanitization

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)

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

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

Disinfection

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

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

Sterilization

Autoclave tape demonstrates that an item was brought to the correct temperature

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.

Sterilization