Chapter 3 Sterilization and Disinfection

Container label sheet

1.name of the chemical 2.manufacturer information 3. physical hazards of the chemical 4.Health hazards of the chemical 5.Safety precautions 6.Storing, handling, and disposal of the chemical

Disinfectant

A disinfectant is an agent used to destroy pathogenic microorganisms: however it does not kill the resistant bacterial spores. Disinfectants are generally applied to inanimate objects

Using the proper cleaning agent

A low-sudsing detergent with a neutral pH should be used to clean the instruments. These cleaners are usually come in a powder or liquid form, and must be diluted with water before use. Never substitute laundry detergent or dishwasher detergent.

A critical item

An item that comes in contact with sterile tissue of the vascular system

sterilization strips

And indicator strip should be placed in the center or a wrapped pack, because the center is the hardest to penetrate

Timing the load

Approximately 15 psi with temp of 250. The length of time required for sterilization varies according to the item being sterilized. Sterilizing time should not begin until the desired temp is reached.

Biologic indicators

Best means available of determining the effetiveness of the sterilization procedure.The CDC recommends that medical office personnel use a biologic indicator to monitor all autoclaves at least once a week.

Sterilization pouches

Consists of paper and plastic: paper makes up one side of the pouch, and plastic film makes up the other side. When an article has been inserted this end is sealed with hear or adhesive tape. They provide good visibility of the contents on the plastic side. Most manufacturers include a sterilization indicator on the outside of the pouch.

Filling the reservoir of the autoclave

Distilled water must be used to fill water reservoir

Muslin

Flexilbe and easy to handle and is considered the most economical sterilization wrap because it can be reused. B/c of its durability, muslin is frequently used to wrap large packs, such as setups for minor office surgery.

Ethylene oxide gas sterilization

Frequently is used in the medical manufacturing industry for producing prepackaged, pre sterilized disposable items, such as syringes, sutures, catheters, and surgical packs.

Alcohol

Frequently used as a disinfectant in the medical office. types are ethyl alcohol and isopropyl alcohol. The disinfecting action of alcohol is increased by the presence of water; a 70% solution of alcohol is recommended.

Spore

Hard thick walled capsule, represents a resting and protective stage of the bacterial cell and are more resistant to drying, sunlight,heat,and disinfectants than is the vegetative form of the bacterium.

Wearing gloves during the sanitization process

Heavy duty gloves should be worn over the disposable gloves to provide protection from the irritation effects of chemical agents, and accidental punctures or cuts from sharp instruments

MSDS requirements

Identification, composition,physical and chemical properties, fire and explosion data, reactivity date, health hazard data, emergency first aid procedures, precautions for safe handling and use, control measures.

Health hazards of the chemical

Include the potential of the chemical to cause irritation to tissue, cancer, a sensitivity reaction, or a toxic or corrosive reaction

Cold sterilization

Involves the use of a chemical agent for an extender length of time. Only chemicals that are designated starlets by the U.S. Environmental Protection Agency (EPA) can be used for sterilizing articles. Item must be completely submerged in the chemical for a long time 6 to 24 hours. Prolonged immersion can damage the. Cold sterilization should be used only when autoclave, gas, or dry heat oven is not indicated or is unavailable.

Lubricate hinged instruments

Lubricate box locks, screw locks, scissor blades, and any other moving part of each instrument

Drying the load

Microorganisms move quickly though the moisture on a wet wrap and onto the sterile article inside resulting in contamination

Loading the autoclave

Packs should be packed loosely as possible inside the autoclave, with approximately 1 to 3 inches between small packs and 2 to 4 inches between big packs. Jars and glassware should be placed on their sides with lids removed.Packs that contain layers of fabric, such as dressings, should be placed in a vertical position. Sterilization pouches should be positioned on their sides to maximize steam circulation, on the autoclave tray paper size up

High level Disinfection

Process that destroys all microorganisms with the exception of bacterial spores.

Wrapping articles

Protect them from recontamination during handling and storage. They should be made of a substance that is not affected by sterilization process and should allow steam to penetrate while preventing contaminates, such as dust, insects, and microorganisms, from entering during handling or storage. It should not tear or puncture easily and should allow the sterilized package to be opened without contamination of the contents. A wrapper should be used if it is torn or has a hole.

Material safety data sheet

Provides more detailed information that the container label regarding the chemical, its hazards, and measures to take to prevent injury. The HCD requires the current meds to be kept on file for each hazardoud chemical used or stored in the workplace. Companies that manufacture and distribute hazardous chemicals must provide an meds with every product.

Sanitization

Sanitization is a process that removes organic material and reduces the number of microorganisms to a safe level as determined by public health requirements.

Handling and storing packs

Should be handled carefully and as little as possible. **If wrapped article is crushed, compressed, or dropped, the sterility of the contents cannot be assumed, and the pack must be resterilizes. **This is known as event-related sterility meaning that sterile pack is considered sterile indefinitely, unless an event occurs that interferes with the sterility of the article

Purpose of the HCS

TO ensure the employees are informed of the hazards associated with chemicals in their workplace

Sterilization and disinfection

The agent selected depends on the intended use of the article.

Carefully inspecting each instrument for defects and proper working conditions

The blades of an instrument should be straight and not bent, the tips of an instrument should approximate tightly and evenly when the instrument is closed.

Name of the chemical

The name of the chemical must be clearly indicated on the label

Manufacturer information

The name, address, and emergency phone number of the company the manufactures the chemical must be stated on the label

Labeling of hazardous chemicals

This label must include the possible hazards of the chemical and the steps that can be taken to protect against those risks.

Dry heat oven

Used to sterilize articles that cannot be penetrated by steam or may be damaged by it. Dry heat is less corrosive than moist hear for instruments with sharp edges, it does not dull the sharp edges. A longer exposure time is required because micoorganisms and spores are more resistant to dry heat more than to moist heat because dry heat penetrates more slowly and unevenly than moist heat. 350 for 1 to 2 hrs.

Maintaining the autoclave

You should wipe the autoclave down with a damp cloth with mild detergent every day.

Glutaraldehyde

agent of choice for semi critical items that cannot be exposed to hear such flexible fiberoptic sigmoidoscopes. Brand names such as cider, and matricide. Must work in a well ventilated area, utitilty gloves and fate goggles must be worn, Should be stored in room temperature.

Semi-critical item

an item that comes in contact with non intact skin or intact mucous membranes, such as a flexible fiberoptic sigmoidoscope. frequently used disinfectant is 2% glutaraldehyde.

Autoclave

dependable, efficient, and economical and can be used to sterilize items that are not harmed by moisture or high temps. Consists of an outer jacket surrounding an inner sterilizing chamber. Under pressure, distilled water is converted to steam, which fills the inner sterilizing chamber.

Autoclave tape

ensures the item has been sterilized. it merely indicates that an article has been in the autoclave and that a high temperature has been attained.

Chlorine and chlorine compounds

inactivates tuberculosis bacteria, hepitis B +C, human immunodeficiency virus and many bacteria in 10 mins at room temperature. B/c of this household bleach is recommended by OSHA for decontamination of blood spills

Physical and chemical properties

include boiling point, vapor pressure, odor, solubility in water, appearance, evaporation, specific gravity, vapor density, ph, melting point, freezing point, odor threshold.

Physical hazards of the chemical

include the potential of the chemical to catch fire, explode, or rescue with other chemical materials

Sanitizing articles before disinfecting them.

initial rinse, decontamination with a chemical disinfectant, cleaning, rinsing, drying, checking for working order. Any organic matter left of the instrument during disinfection will prevent the disinfectant from getting to the surface to kill the microorganisms.

Sterilization indicators

most reliable indicators check for the attainment of the proper temperature and indicate the duration of the temperature. Most common sterilization indicators are chemical indicators and biologic indicators.

Use life

period of time a disinfecting solution is effective after it has been activated.

Sterilization

process of destroying all forms of microbial life, including bacterial spores. An object that is sterile is free of all living microorganisms and spores. The device most commonly used to sterilize articles in the medical office is the autoclave

Using the proper cleaning device

should be used for manual cleaning of surgical instruments. A stiff nylon brush should be used to clean the surface of the instrument. A stainless steel wire brush can be used to clean grooves, cervices, or serrations. A stain on an instrument often can be removed by using a commercial instrument stain remover. Never use steel wool or other abrasives to remove stains could damage the instrument.