• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Chapter 10  disinfection
 

Chapter 10 disinfection

on

  • 719 views

 

Statistics

Views

Total Views
719
Views on SlideShare
719
Embed Views
0

Actions

Likes
0
Downloads
33
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Chapter 10  disinfection Chapter 10 disinfection Presentation Transcript

    • Chapter 10
    • As a result of successfully completing this chapter, readers will be able to:  Define the term, “disinfection,” and explain how disinfection differs from sterilization  Review factors that impact the effectiveness of a disinfectant  Discuss the relationship between the risk level (intended use) of the device to be disinfected and the selection of a disinfectant  Explain disinfectant activity levels as they relate to the resistance of microorganisms to germicidal agents: ◦ high-level disinfection ◦ intermediate-level disinfection ◦ low-level disinfection
    •  Review factors which affect the chemical action of and other important selection considerations for disinfections  Provide basic information about the types of disinfectants commonly used in healthcare facilities: quaternary ammonium compounds, phenolics, alcohol, halogens, glutaraldehyde, ortho-phthalaldehyde, and formaldehyde  Review safety requirements that should be followed when using chemical disinfectants  Define the term, “thermal disinfection,” and note key points to ensure that it is occurring
    •  Disinfectant - A chemical used on inanimate objects such as medical instruments to kill all microorganisms , except spores  Antiseptic – A chemical used on living tissue such as skin, to slow the growth of microorganisms  Sterile – Free from all living organisms  Disinfection – The destruction of nearly all pathogenic microorganisms on an inanimate surface. Disinfection is accomplished using chemical or heat processes
    • Reduces the number of microorganisms on an object
    • Disinfectants are designed to be used at a specific strength
    •  Excessive Moisture – Excessive moisture can cause disinfectant solutions to become diluted. Lowering the concentration of the chemical disinfectant can reduce its ability to kill microorganisms  Type and number of microorganisms present
    •  Direct Contact with the Item  In order to be effective, disinfectants must make direct contact with all surfaces being disinfected  Time  Disinfectants must be allowed time to work  Check manufacturer’s instructions for the correct exposure time required to achieve the desired biocidal effect
    •  Temperature of the Disinfectant  pH  Hardness of the Water  Material Compatibility  Positioning of the Device(s) being disinfected
    •  Should be based on: ◦ The intended use of the device ◦ The degree of disinfection required for the device ◦ Risk levels are based on the Spaulding Classification System
    •  Items introduced directly into the bloodstream or other normally sterile areas of the body  Surgical Instruments, Implants, etc.
    •  Items which come in contact with intact mucous membranes  Fiberoptic Endoscopes, Cystoscopes, etc.
    •  Come in direct contact with the patient’s unbroken skin  Crutches, Blood Pressure Cuffs, equipment, etc.
    • Table Modified from Favero and Bond, 1991 Classification of Patient Care Items CriticalSterilizationSterile body cavity Semi-criticalHigh-levelMucous membranes Non-criticalLow levelIntact skin Item ClassDestruction Method Body Contact
    •  High-level  Intermediate-level  Low-level
    •  Process that uses a sterilant for a shorter contact time that needed for sterilization  High-level disinfection kills all microorganisms, except bacterial spores
    •  Process that utilizes a agent that kills viruses, mycobacteria, fungi, and vegetative bacteria, but not bacterial spores
    •  Process that utilizes a agent that kills vegetative forms of bacteria some fungi and lipid viruses
    •  Lipid Virus – A virus whose core is surrounded by a coat of lipoprotein. Viruses included in this structural category are generally easily inactivated by many types of disinfectants, including low-level disinfectants  Non-lipid Virus – A virus whose core is not surrounded by a lipid envelope. These viruses are generally more resistant to inactivation by disinfectants
    • Table Modified from Favero and Bond, 1991 Hierarchy of Disease Producing Agents Low-Level DisinfectionLipid or medium sized viruses (Hantavirus, Herpes Simplex Virus) Low-level DisinfectionGram Positive & Negative Vegetative Bacteria Intermediate-level DisinfectionFungi Intermediate-level DisinfectionNonlipid and small viruses (Poliovirus) High Level DisinfectionMycobacteria SterilizationBacterial spores Extended Sterilization TimesPrions Destruction MethodOrganism Producing Disease
    •  Types of devices being disinfected  Whether items can be disassembled  Manufacturer’s recommendations  Positioning of the device  Process Quality Assurance Tests  Shelf Life and Use Life  Preparation required (mixing, etc.)  Reuse factors  Additional inspections required by the manufacturer
    •  A detailed overview of common chemical disinfectant characteristics can be found on pages 161 – 169 in the text.
    • Low-Level Disinfectant Advantages: ◦ Bactericidal, fungicidal and virucidal against lipophilic viruses ◦ Built-in Detergent Properties
    •  Disadvantages: ◦ Not sporicidal ◦ Generally not tuberculocidal or virucidal against hydrophilic viruses ◦ Not Compatible with Soap ◦ Absorbed or Neutralized by Cotton or Charcoal ◦ Not effective against some gram-negative organisms commonly found in hospitals
    • Advantages: ◦ Broad Spectrum of use; bactericidal for gram- negative and gram- positive bacteria, fungi, and tuberculocidal against lipophilic viruses. ◦ Residual Activity* (can also be a disadvantage) Disadvantage s: ◦ Not sporicidal ◦ Inactivated by organic material ◦ Corrosive to Rubber and some Plastics
    •  Advantages: ◦ Rapid bactericidal agent against vegetative microorganisms, tuberculocidal, fungicidal, and virucidal ◦ Fast-Acting ◦ Non-Staining ◦ Leaves No Residue  Disadvantages: ◦ Requires a minimum 5 minute wet contact. ◦ No residual activity ◦ Volatile, flammable ◦ Inactivated by Organic Soil ◦ Can dissolve lens mountings on certain optical instruments ◦ Tends to harden and swell plastic tubing ◦ Not sporicidal
    •  Chlorine  Iodophors
    •  Advantages: ◦ Effective against Gram- Positive and Gram- Negative Microorganisms, Tuberculocidal, Fungicidal, and Virucidal ◦ Rapid-Acting  Disadvantages: ◦ Inactivated by Organic Matter ◦ Corrosive to Metals ◦ Not Sporicidal ◦ Stains fabrics, plastics and other synthetic materials ◦ Relatively Unstable
    •  Advantages: ◦ Bactericidal, Tuberculocidal, and Virucidal ◦ Rapid-Action against vegetative bacteria  Disadvantages: ◦ Corrosive to Metals ◦ Detrimental to Rubber and some Plastics ◦ May burn tissue ◦ Stains fabrics and other materials ◦ May require long contact time to kill some fungi
    •  Advantages: ◦ Kills vegetative bacteria (within 2 minutes) ◦ Bactericidal (gram-positive and gram-negative), tuberculocidal, fungicidal, virucidal, sporicidal (For sterilization (killing spores) the soak time ranges 6-10 hours).  Disadvantages: ◦ Noxious odors, good ventilation required ◦ Unstable (14-28 product life) ◦ Dilution of product reduces activity ◦ Vaporizes ◦ No cleaning ability ◦ Rinsing Required ◦ Employee Health Concerns
    •  Advantages: ◦ Fast-acting ◦ User-friendly ◦ Compatible with a wide range of endoscopes and medical devices ◦ Requires no activation or mixing  Disadvantages: ◦ Does not have sterilant label claim ◦ Improper rinsing can cause staining of patient tissues ◦ Patient with a history of bladder cancer should not be exposed to items processed by OPA
    •  Advantages: ◦ Bactericidal, tuberculocidal, fungicidal, and virucidal ◦ Sporicidal (as 8% Formaldehyde/70% alcohol)  Disadvantages: ◦ Inactivated by organic material ◦ May stain fabrics, plastics, and other synthetic materials ◦ Not sporicidal ◦ Carcinogen (1PPM, 8 hour TWA) ◦ Irritating fumes
    •  Follow manufacturers’ instructions  Use appropriate containers  Cover the containers  Wear gloves  Reuse only those products labeled for reuse  Watch expiration dates  Test as necessary  Rinse thoroughly  Dispose of according to established guidelines
    •  A Log Book should be maintained for high-level disinfectants  (See page 171 of the text for a sample log book page)
    •  Wear PPE  Use an exhaust hood when necessary  Develop a spill plan  Provide an eyewash/shower and other first aid supplies  Provide easy access to a phone and phone numbers for emergencies  Provide yearly staff training  Monitor disinfectants (including air quality)
    •  Thermal Disinfection – Disinfection accomplished by heat  Check spray arms and nozzles of mechanical washer/disinfectors daily to insure they are working correctly  Medical washers and washer/disinfectors are regulated by the FDA