Chapter 3 Sterilization

The HCS requires that manufacturers label the containers of hazardous chemicals

1. Name of the chemical 2. Manufacturer information 3. Physical hazardous of the chemicals 4. Health hazards of the chemical 5. Safety precautions 6. Storing, Handling, and disposal of the chemical

The general steps in the sanitization procedure of instruments are as follows:

1. Rinse the instrument to prevent organic material from drying on the instrument 2. Decontaminate the instrument with a chemical disinfectant to remove pathogenic microorganisms, making the instrument safe to handle 3. Clean the instruments to remove all organic matter 4. Thoroughly rinse the instruments to remove all detergent residue 5. Dry the instrument to prevent stains on the instrument 6. Lubricate hinged instrument to make the instrument function well and last longer

Guidelines for sanitizing instruments

1. Wear gloves during the sanitization process 2. Handle instruments carefully 3. Follow instructions on labels of chemical agents 4. Use a proper cleaning agent- A low sudsing detergent with a neutral pH should be used to clean the instrument 5. Use proper cleaning devices- A stiff nylon brush should be used to clean the surface of the instrument, A stainless steel wireless brush can be used to clean grooves, crevices, or serrations. NEVER USE STEEL WOOL OR OTHER ABRASIVES TO REMOVE STAINS (damage to the instrument can occur) 6. Carefully inspect the instrument for defects and proper working conditions 7. Lubricate hinged instruments (any one that is hinged must be sanitized and lubricated before going in autoclave)

Spore

A hard, thick-walled capsule that some bacteria form by losing moisture and condensing their contents to contain only the essential parts of the protoplasm of the cell.

Hazard Communication Standard (HCS)

A requirement of the occupational safety and health administration(OSHA) PURPOSE is to ensure that employees are informed of the hazards associated with chemicals in their workplace.

Material safety data sheet (MSDS)

A sheet that provides information regarding a chemical, its hazards, and measure to take to prevent injury and illness when handling the chemical.

Detergent

Agent that cleanses by emulsifying dirt and oil.

Disinfectant

Agent used to destroy pathogenic microorganisms, however it does not kill the resistant bacterial spores. Disinfectants are generally applied to inanimate objects.

Clostridium Botulinum

Causes Botulism (attacks nervous)

Clostridium Tetani

Causes tetanus (attacks muscle)

Sterilization Strips

Commercially prepared paper or plastic strips that contain a thermolabile dye that change color when exposed to steam under pressure for a certain length of time

Sterilization Pouches

Consist of a combination of paper & plastic, Paper makes up one side of the pouch, & a plastic film makes up the other side -Most pouch have a peel apart seal on one end that is used to later open the pouch for removal of the sterile item -The other end of the pouch is open and is used to insert the item into the pouch

Autoclave Tape

Contains a chemical that changes color if it has been exposed to steam -Because the tape is place on the outside of the pack it cant tell if the steam has been penetrated through the center of the pack -Does not insure that the item has been sterilized

Filling The Water Resevoir

Distilled water is used to fill the water resevoir of the autoclave. Normal tap water contains minerals such as chlorine, which have corrosive effects on the stainless-steel chamber of the sutoclave

Autoclave

Is dependable, efficient, and economical and can be used to sterilize items that are not harmed by moisture or high temperature. -Consist of an outer jacket surrounding an inner sterilization chamber. Under pressured distilled water is converted to steam, which fills the inner sterilization chamber

Sterilization Paper

Is disposable & inexpensive wrapping material Disadvantage- it is difficult to spread open for removal of the contents. It has a MEMORY and tends to flip back easy, so it may not open flat to provide a sterile field

Semicritical Item

Item that comes in contact with non intact skin or intact mucous membranes, such as flexible fiberoptic sigmoidscope

Critical Item

Item that comes in contact with sterile tissue or the vascular system

Noncritical Items

Items that comes in contact with intact skin but not with mucous membranes, including stethoscopes, blood pressure cuffs, tuning forks, percussion hammers, & crutches.

Drying the load

Must be allowed to dry before removing from the autoclave

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.

Disinfection

Process of destroying pathogenic microorganisms, but it does not kill bacterial spores

High-Level Disinfection

Process that destroys all microorganisms with the exception of bacterial spores Used to disinfect SEMICRITICAL ITEMS

Sanitization

Process to remove organic matter from an article and to reduce the number of microorganisms to a safe level as determined by public health requirements. -removes blood -removes body fluids -removes tissues

Wrapping Articles

Purpose: protect them from recontamination during handling and storage.

HCS

Requires that each container of hazardous chemical be labeled by a manufacturer with a warning to alert the user that the chemical is dangerous. Label must include the possible hazards of the chemical and the steps that can be to protect against those risk.

Muslin

Reusable woven fabric that is available in different sizes -Flexible and easy to handle & is considered the most economical sterilization wrap because it can be reused -Used to wrap large packs, tray setups for minor office surgery -Memory free so it lies flat when opened

Loading the autoclave

Steam must penetrate every fiber and reach every surface of the item at a required temperature and for a specified time To accomplish all packs must be positioned in the chamber to allow free circulation & penetration of steam - Jars and glassware should be place on their sides in the autoclave with their lids removed

Sterilization Methods

Sterilization involves the use of physical or chemical methods. Each method of sterilization has advantages & disadvantages. PHYSICAL METHODS -Steam under pressure (Most common method using in autoclave)

During the sterilization process

The steam penetrates the materials in the sterilization chamber. The materials are cooler, so the steam condenses into moisture on them, giving up its heat -Heat serves to kill all microorganisms & their spores -Usually operated at at approximately at a temperature of 250 degrees f.

Intermediate-Level Disinfection

Used to disinfect noncritical items A COMMON INTERMEDIATE-LEVEL DISINFECTANT IS ISOPROPYL ALCOHOL which is frequently used in the form of alcohol wipes

Low-Level Disinfection

Used to disinfect surfaces such as examining tables, laboratory counter tops, and walls

Daily Maintenance

Wipe the interior of the autoclave & the trays with a damp cloth