Chapter 6 Infection Prevention and Control

aseptic technique

Any activity or procedure that prevents infection or breaks the chain of infection.

Bloodborne Pathogens Standard

Any contaminated item must be transported in covered, rigid, puncture proof containers that are properly labeled or color coded.

Cleanliness

Basis of aseptic technique

Four Separate traffic/control dress code requirements

Biohazard = Areas may be contaminated from using equipment, utensils and instruments. PPE is required Unrestricted = Areas include normal traffic areas Semi-restricted = Areas include peripheral support areas to the or, such as CS clean assembly and storage areas. Surgical Srub and hair coverings are required. Restricted = Areas are those where sterile procedures are preformed. Surgical Scrub, hair coverings and masks are required.

Central Service Temperature, Humidity and Air Exchange Requirments

Clean/ Sterile Storage Temp. 75f or lower or 24c or lower Humidity less than 70 percent Air Exchange 4 per hour

Central Service Temperature, Humidity and Air Exchange Requirements

Decontamination 60F to 65F or 16C to 18C humidity is 30 to 60 percent air exchanges are 10 per hour

CS Requirement Review

Decontamination Surgical Scrubs and OSHA required PPE Clean Assembly and Sterile Storage Surgical Scrubs and hair covering Operating Room Surgical Scrubs, Hair covering, masks Non restricted hallways and offices Regular Street attire

Bloodborne Pathogens Standard

Disposal of all sharp items in rigid, puncture proof containers that can be sealed.

15 seconds

During handwashing, hands should be lathered and scrubbed for at least

2 million

Each year approximately how many patients develop a health care infection

Infection prevention and controls goals of CSP

Eliminate and destroy all potentially infectious contaminants present on reuseable 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.

OSHA

Following Standard Precations protocols is required by

Microorganisms

Forms of life which are too small to see with the naked eye. Bacteria, viruses, and fungi are types of microorganisms also called "germs and microbes"

If working or entering the decontamination area one must wear

General purpose utility gloves. A fluid resistant covering with sleeves. Full face protection. Shoe covers.

OSHA provided the BLOODBORNE PATHOGENS STANDARD in 1991

In response to concerns and recognizing the potential for occupational exposure to bloodborne diseases such as hep b and c and HIV.

Fomites

Inanimate objects that can transmit bacteria

Infection

Invasion of human body tissue by microorganisms which multiply and produce a reaction.

Washing hands with soap and water or using an alcohol based hand rub (Hand Hygiene

Is the most important procedure to prevent and control transmission of microorganisms from one person to another or from one site to another.

Five Basic Principles of Asepsis

Know what is Dirty Know what is clean Know what is sterile Keep the three conditions seperate Remedy contamination readily

Principles of asepsis

Know what is dirty, know what is clean, know what is sterile and remedy contamination

Two types of aseptic techniques

Medical asepsis Surgical asepsis

Standard Precautions

Method of using appropriate barriers to prevent transmission of infectious organisms from contact with blood and all other body fluids, non-intact skin, and mucous membrane. It applies to all patients, regardless of diagnosis or presumes infectious status.

Shoe Covers

Necessary to protect shoes from becoming wet and contaminated during cleaning procedures.

Decontamination Area

Negative Air Flow

Examples of contaminated items

OR instruments, used linens and suction machines

Bloodborne Pathogens Standard

Observance of Standard Precautions All patients should be considered infected with bloodborne diseases.

Bloodborne Pathogens Standard

PPE must be available in appropriate sizes, and at no cost to employees.

The main theory of Standard Precautions

Patients may pose a risk of infection whether they have been diagnosed with an infectious disease or not

Bloodborne Pathogens Standard

Physically removing the hazard and developing of work practice controls (policies and procedures) to prevent occupational exposure and transmission of bloodbourne pathogens.

Clean Area

Positive Air Flow

Central Service Temperature, Humidity and Air Exchange Requirements

Preparation and Packaging Temp. 68f to 73f or 20c to 23 c Humidity 30 to 60 percent Air exchanges 10 per hour

Asepsis Surgical Sterile Technique

Procedures performed to eliminate the presence of all microorganisms, and or to prevent the introduction of microorganisms to an area Examples sterilization of instruments, OR techniques which prevent contamination of sterile instruments and supplies

Asepsis Medical Clean Technique

Procedures performed to reduce the number of microorganisms to minimize their spread Ex. hand washing and decontamination

Bloodborne Pathogens Standard

Provision of a clean and sanitary working environment including scheduled cleaning using a hospital germicide (disinfectant) approved by the EPA>

Bloodborne Pathogens Standard

Provisions for medial evaluations and treatment when an employee experiences an exposure incident.

Personal Protective Equipment (PPE

Specialized clothing or equipment worn by an employee for protection against a hazard.

aspesis

The absence of microorganisms that cause disease is called

asepsis

The absence of microorganisms that cause disease.

Traffic Control

The first step in maintaining environmental integrity is to control that enters and passes thru Central Service. ie/ dress code is very important. Outside visitors can either wear scrubs or paper scrubs, depending on facility requirements.

Bloodborne Pathogens Standard

The need to maintain medical as well as training records.

Bloodborne Pathogens Standard

The provision of hep b vaccine at no cost.

General purpose utility gloves

These provide the hands with a protective barrier, and prevent contamination when handling applicable items.

epidemiologically significant microorganisms

Those that most often spread disease.

Fluid Resistant Gowns

To protect themselves from splashes and spills, Central Service Tech assigned to the decontamination area should wear

Primary purpose of Central Service Dept.

To stop the spread of disease-producing microorganisms to the healthcare facility.

Restricted

Traffic Control/Dress Code requirements that apply to the OR

Bloodborne Pathogens Standard

Training upon hire and annually thereafter.

Bloodborne Pathogens Standard

Use of BIOHAZARD labels to identify contaminated items or regulated waste that may be stored or transported in refrigerators, freezers or other containers. Labels are not required when using red bags or containers.

housekeeping

a vital component in the department's overall infrection prevention and control process.

Bloodborne Pathogens Standard

a written EXPOSURE CONTROL PLAN. (the plan) that summarizes the employer's programs for protection of workers from occupational exposure to bloodborne disease. The plan must be reviewed annually and updated whenever new tasks or procedures affecting occupational exposures are instituted.

Work Flow

designed to avoid cross- contamination and insure that items efficiently flow through the process from decontamination to storage.

Common Fomites

door handles, computer pads and keyboards, telephones and other items routinely handled by several people.

Departmental Dress Codes apply to

everyone entering the Central Service Department

wet-mopped daily

floors in the Central Service Department should be

Detergent Disinfectant

kills or prevents the growth of any microorganisms that have not been removed by washing

The presence of water allows

passage of microorganisms

Sterile Packaging

referred to as barrier packaging

Washing physically

removes soil and most microorganisms

Absence of microbes can be obtained by

use of steam, dry heat, ethylene oxzide, or other sterilization methods including peracetic acid, irradiation, ozone, and vapor phase hydrogen peroxide

they harbor bacteria

watches and jewelry should not be worn in the Central Service department or work areas because :

Fluid resistant covering with sleeves

A covering such as a jumpsuit, backless gown, or apron. Made of fluid resistant material to prevent contamination of clothing and to protect CST skin from exposure to blood and body fluids. Arms should be completely covered.

The basic attire worn by Central Service Technicians

A facility-issued scrub uniform Hair covering the covers all head and facial hair except eyebrows and eyelashes. Shoes with non skid soles

Full Face Protection

A full length face shield or combo of googles and mask as a protective barriers during cleaning procedures to prevent mucous membrane exposure from splashes, sprays and aerosolized contaminated fluids.

Fomite

AN inanimate object that can transmit bacteria

Sterility

Absence of all miscrobes