Summary

In study session V you have learnt

  • Decontamination is the use of physical or chemical means to remove, inactivate, or destroy pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, for use, or for disposal. Disinfection is a chemical or physical process that destroys pathogens such that an item is safe to handle for its intended use.
  • A disinfectant is a chemical agent that destroys most pathogens but may not kill bacterial spores. Disinfectants are used on inanimate objects only and not on living tissue. Chemicals used to kill microorganisms on skin or living tissue are known as antiseptics. The broad category of disinfection may be subdivided into high-level, intermediate-level, and low-level disinfection according to the anti-microbial activity of the disinfectant.
  • A number of disinfectants are commercially available in most countries including Ethiopia, four disinfectants; chlorine, glutaraldehyde, formaldehyde and hydrogen peroxide are routinely used for high level disinfectants. Liquid chlorine is available under different brand names
  • Boiling instruments in water for 20 minutes will kill all vegetative forms of bacteria, viruses, yeast and fungi, boiling will not kill all endospores reliably.
  • Cleaning is a process usually involving detergent or enzymatic presoak that physically remove all visible dust, soil blood or other body fluids from inanimate objects as well as removing sufficient number of microorganisms to reduce risks for those who touch the skin or handle the object. After decontamination of soiled instruments in 0.5% chlorine solution for 10 minutes, they must be cleaned to remove organic materials or chemical residue.
  • Sterilization is a process which achieves the complete destruction or killing of all microorganisms, including bacterial spores. Sterilization is principally accomplished by steam under pressure (Autoclaving), dry heat (Hot Air Oven) and using chemical sterilant.
  • Spaulding classification is a strategy developed by Dr. Earle H. Spaulding for reprocessing contaminated medical devices. The system classifies devices as critical, semicritical, or noncritical based on the risk from contamination of a device to a patient.
  • Three different levels of disinfection are applied based on this risk scheme. A speculum (endoscopes) has contact with mucous membranes and therefore needs to be cleaned and then undergo high-level disinfection. A blood pressure cuff has contact with intact skin and only needs cleaning.
  • Equipment that will enter or contact anybody area that is normally sterile must be sterile at the time of use, and aseptic techniques must be employed to maintain sterility. For example a needle used for entry into tissue is critical and needs to be sterile.
  • Equipment that will contact mucous membranes but would not ordinarily penetrate body surfaces should be free from contamination but need not be sterile. This equipment would include laryngoscope blades, oral and nasal airways, face masks, breathing circuits and connectors, self-inflating resuscitation bags, esophageal stethoscopes and esophageal/nasopharyngeal/rectal temperature probes (Spaulding's "Semi-critical" items).
  • Equipment that does not ordinarily touch the patient or that touches only intact skin should be cleaned with a disinfectant at the end of the day and whenever visibly contaminated. This equipment includes noninvasive blood pressure cuffs and tubing, pulse oximeter probes and cables, stethoscopes, electrocardiographic cables, skin temperature sensors, head straps, blood warmers, the exterior of the anesthesia machine, the exterior of monitoring equipment and equipment carts.
  • The reuse of disposable (single-use) equipment is not recommended. Syringes and needles are sterile, single-patient use items.
  • Preservative-free ampoules, vials and prefilled syringes are single-patient, single-dose items. The labels of all rubber-stopped vials should be checked for the presence of preservative agents because some vials are single-dose preparations.
  • All infusions (fluids and containers) and administration sets (IV tubing and connections) are single-patient use.


Last modified: Wednesday, 16 November 2016, 7:23 AM