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BIOSAFETY IN HOSPITAL ENVIRONMENT
Dr.T.V.Rao MD
10/22/2018 Dr.T.V.Rao M D 1
HOSPITALS ARE COMPLEX
ENVIRONMENTS
NEED SAFETY
• Hospitals are representative of complex environment in
which different aspects including patients, staff,
equipment, services, and information are interfaced.
Maintaining a safe environment reflects a level of
competent healthcare that must be fulfilled for patient
safety. In this context, the clinical engineer plays an
important role in providing safe environment within
hospital. In general, many factors affect hospital
environment internally and externally
10/22/2018 Dr.T.V.Rao M D 2
WHO has classified
infection control
practices
• WHO has classified
infection control practices
into two main categories:
standard precautions and
additional (transmission-
based) precautions. These
category items are
Standard precautions
include the following items
• Hand washing and
antisepsis (hand hygiene)
Dr.T.V.Rao M D 10/22/2018 3
Hand Washing a Great step in Saving
Lives
10/22/2018 Dr.T.V.Rao M D 4
WHO has classified
infection control
practices
• Use of personnel
protective equipment
when handling blood,
body substances, and
secretions
• Appropriate handling
of patient care
equipment and soiled
linenDr.T.V.Rao M D
10/22/2018 5
Safe Practices in
Hospitals a
Priority
• Prevention of
needlestick / sharp
injuries
• Environmental
cleaning and spills-
management
• Appropriate handling
of waste
10/22/2018 Dr.T.V.Rao M D 6
Additional (transmission-
based) precautions while
ensuring standard
precautions include
• Airborne
precautions
Droplet precautions
Contact precautions
Dr.T.V.Rao M D 10/22/2018 7
10/22/2018 Dr.T.V.Rao M D 8
CLEANING THE
ENVIRONMENT THE GREAT
PRIORITY
• Cleaning is an
essential first step
prior to any
disinfection process
to remove dirt, debris
and other materials
10/22/2018 Dr.T.V.Rao M D 9
Neutral detergent
solution is essential
•The use of a neutral detergent
solution is essential for effective
cleaning. It removes dirt while
improving the quality of
cleaning by preventing the
build-up of biofilms and thus
increasing the effectiveness of
chemical disinfectants.
10/22/2018 Dr.T.V.Rao M D 10
Concentration of the
detergent matters
• If disinfectants are used, they must
be prepared and diluted according
to the manufacturer’s instructions.
Too high and/or too low
concentrations reduce the
effectiveness of disinfectants. In
addition, high concentrations of
disinfectant may damage surfaces
10/22/2018 Dr.T.V.Rao M D 11
Start Cleaning from
Clean to less clean
areas
• Cleaning should always
start from the least soiled
areas (cleanest) first to the
most soiled areas (dirtiest)
last and from higher levels
to lower levels so that
debris may fall on the floor
and is cleaned last
10/22/2018 Dr.T.V.Rao M D 12
Discarding after the
use of Diluted
Disinfectant
solutions a Priority
Detergent and/or
disinfectant solutions must
be discarded after each use.
10/22/2018 Dr.T.V.Rao M D 13
high risk areas such as operating rooms and intensive care units
require special ventilation systems through filtration systems
(e.g., HEPA filters) and pressure relationship to adjacent areas.
In general, clean atmosphere reduces the risk of airborne
infection, and dangerous of gases explosion.
Stop Dry
Sweeping and
stop use of
Brooms
• Avoid cleaning methods that
produce mists or aerosols or
disperse dust, for example
dry sweeping (brooms, etc.),
dry mopping, spraying or
dusting.
• Start Using vacuum Cleaner
10/22/2018 Dr.T.V.Rao M D 14
Regular Surveillance not essential
But essential in times of Outbreaks of Infection
•Routine bacteriological
monitoring to assess the
effectiveness of
environmental cleaning is
not required, but may be
useful to establish the
potential source of an
outbreak and/or for
educational purposes
10/22/2018 Dr.T.V.Rao M D 15
Environmental
cleaning to be done as
guided by Standard
Operative procedures
• Require cleaning according to
written protocols (for example,
daily, weekly, after each patient
use, etc.). This should include
the use of appropriate personal
protective equipment, cleaning
methods conforming to the
type/s of surface and cleaning
schedules, etc.
10/22/2018 Dr.T.V.Rao M D 16
10/22/2018 Dr.T.V.Rao M D 17
Cleaning and Sterility of Medical and other
equipment
• Schedules and
procedures should be
consistent and updated
on a regular basis and
education and training
must be provided to all
cleaning staff. Please
refer to the
manufacturer’s
instructions for medical
equipment to ensure that
the item is not damaged
by the use of
disinfectants.
10/22/2018 Dr.T.V.Rao M D 18
High hand-touch surface
Any surface with
frequent contact with
hands
• Requires special attention
and more frequent
cleaning. After thorough
cleaning, consider the use
of appropriate disinfectants
to decontaminate these
surfaces.
10/22/2018 Dr.T.V.Rao M D 19
Minimal touch surface
(floors, walls, ceilings, window
sills, etc.)
• Minimal contact with
hands. Not in close
contact with the patient
or his/her immediate
surroundings
• Requires cleaning on a
regular basis with
detergent only or when
soiling or spills occur.
Also required following
patient discharge from
the health care setting.
10/22/2018 Dr.T.V.Rao M D 20
Surface contaminated
with blood and body
fluids
• Any areas that are visibly
contaminated with blood or
other potentially infectious
materials
• Requires prompt cleaning
and disinfection
• All spills must be carefully
cleaned up and the surface
cleaned and disinfected
according to hospital policy
10/22/2018 Dr.T.V.Rao M D 21
Water Quality
• Water is a strategic
energy resource that
should be used and
managed properly. In
hospitals, water is a
necessary utility which
is obtained from
outside sources. This
utility may serve as a
medium for the spread
of infections from
outside sources to the
hospital
Dr.T.V.Rao M D 10/22/2018 22
Quality check of the
Water a priority in
Health care
2
3
• A complete chemical analysis of
water is required to establish
quality levels. This analysis may
be performed by local public
health agencies or by hospital
staff. If the hospital has storage
water tanks, they should be
cleaned regularly and the
quality of water should be
sampled periodically to check
for bacterial contamination.
10/22/2018
Dr.T.V.Rao M D
The risks of poor
healthcare HVAC
• Healthcare HVAC
breakdowns and poor
performance are very
serious problems. That’s
because patients’ lives
can be at risk if
temperatures and
humidity deviate from
safe levels.
Dr.T.V.Rao M D
10/22/2018 24
High humidity: a huge
healthcare HVAC
problem
• High heat and humidity
are unpleasant for
healthy people. Yet these
conditions are especially
harmful to those with
respiratory problems.
They also are dangerous
to those recuperating
after surgery at a
rehabilitation center or
nursing home.
Dr.T.V.Rao M D 10/22/2018 25
High Humidity helps to
spread bacteria
• High humidity promotes
the spread of bacteria.
This is a concern at any
location, but it’s even
more troublesome at
healthcare facilities where
people often have
compromised immune
systems
10/22/2018 Dr.T.V.Rao M D 26
Purpose of
HVAC
• The purpose of HVAC
system is to provide and
maintain environmental
conditions, including
proper airflow, heating, and
cooling within a certain
area or the entire hospital.
Installation of HVAC is one
of the most important
factors by which the
architect can combat
bacterial infection, and at
the same time create
environmental comfort.
Dr.T.V.Rao M D 10/22/2018 27
HVAC system
•HVAC system is designed to
meet specific values of
temperature, relative
humidity, and air changes
frequency within different
areas in hospital based on
standards of design,
10/22/2018 Dr.T.V.Rao M D 28
High Risk areas need
special attention
2
9
• High risk areas such as operating
rooms and intensive care units
require special ventilation
systems through filtration
systems (e.g., HEPA filters) and
pressure relationship to adjacent
areas. In general, clean
atmosphere reduces the risk of
airborne infection, and
dangerous of gases explosion.
10/22/2018
Dr.T.V.Rao M D
• Program File Created by Dr.T.V.Rao MD for benefit of
Medical and Nursing professionals in the Developing
countries with Resources from WHO and Google
•Email
•doctortvrao@gmail.com
10/22/2018 Dr.T.V.Rao M D 30

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BIOSAFETY IN HOSPITAL ENVIRONMENT by Dr.T.V.Rao MD

  • 1. BIOSAFETY IN HOSPITAL ENVIRONMENT Dr.T.V.Rao MD 10/22/2018 Dr.T.V.Rao M D 1
  • 2. HOSPITALS ARE COMPLEX ENVIRONMENTS NEED SAFETY • Hospitals are representative of complex environment in which different aspects including patients, staff, equipment, services, and information are interfaced. Maintaining a safe environment reflects a level of competent healthcare that must be fulfilled for patient safety. In this context, the clinical engineer plays an important role in providing safe environment within hospital. In general, many factors affect hospital environment internally and externally 10/22/2018 Dr.T.V.Rao M D 2
  • 3. WHO has classified infection control practices • WHO has classified infection control practices into two main categories: standard precautions and additional (transmission- based) precautions. These category items are Standard precautions include the following items • Hand washing and antisepsis (hand hygiene) Dr.T.V.Rao M D 10/22/2018 3
  • 4. Hand Washing a Great step in Saving Lives 10/22/2018 Dr.T.V.Rao M D 4
  • 5. WHO has classified infection control practices • Use of personnel protective equipment when handling blood, body substances, and secretions • Appropriate handling of patient care equipment and soiled linenDr.T.V.Rao M D 10/22/2018 5
  • 6. Safe Practices in Hospitals a Priority • Prevention of needlestick / sharp injuries • Environmental cleaning and spills- management • Appropriate handling of waste 10/22/2018 Dr.T.V.Rao M D 6
  • 7. Additional (transmission- based) precautions while ensuring standard precautions include • Airborne precautions Droplet precautions Contact precautions Dr.T.V.Rao M D 10/22/2018 7
  • 9. CLEANING THE ENVIRONMENT THE GREAT PRIORITY • Cleaning is an essential first step prior to any disinfection process to remove dirt, debris and other materials 10/22/2018 Dr.T.V.Rao M D 9
  • 10. Neutral detergent solution is essential •The use of a neutral detergent solution is essential for effective cleaning. It removes dirt while improving the quality of cleaning by preventing the build-up of biofilms and thus increasing the effectiveness of chemical disinfectants. 10/22/2018 Dr.T.V.Rao M D 10
  • 11. Concentration of the detergent matters • If disinfectants are used, they must be prepared and diluted according to the manufacturer’s instructions. Too high and/or too low concentrations reduce the effectiveness of disinfectants. In addition, high concentrations of disinfectant may damage surfaces 10/22/2018 Dr.T.V.Rao M D 11
  • 12. Start Cleaning from Clean to less clean areas • Cleaning should always start from the least soiled areas (cleanest) first to the most soiled areas (dirtiest) last and from higher levels to lower levels so that debris may fall on the floor and is cleaned last 10/22/2018 Dr.T.V.Rao M D 12
  • 13. Discarding after the use of Diluted Disinfectant solutions a Priority Detergent and/or disinfectant solutions must be discarded after each use. 10/22/2018 Dr.T.V.Rao M D 13 high risk areas such as operating rooms and intensive care units require special ventilation systems through filtration systems (e.g., HEPA filters) and pressure relationship to adjacent areas. In general, clean atmosphere reduces the risk of airborne infection, and dangerous of gases explosion.
  • 14. Stop Dry Sweeping and stop use of Brooms • Avoid cleaning methods that produce mists or aerosols or disperse dust, for example dry sweeping (brooms, etc.), dry mopping, spraying or dusting. • Start Using vacuum Cleaner 10/22/2018 Dr.T.V.Rao M D 14
  • 15. Regular Surveillance not essential But essential in times of Outbreaks of Infection •Routine bacteriological monitoring to assess the effectiveness of environmental cleaning is not required, but may be useful to establish the potential source of an outbreak and/or for educational purposes 10/22/2018 Dr.T.V.Rao M D 15
  • 16. Environmental cleaning to be done as guided by Standard Operative procedures • Require cleaning according to written protocols (for example, daily, weekly, after each patient use, etc.). This should include the use of appropriate personal protective equipment, cleaning methods conforming to the type/s of surface and cleaning schedules, etc. 10/22/2018 Dr.T.V.Rao M D 16
  • 18. Cleaning and Sterility of Medical and other equipment • Schedules and procedures should be consistent and updated on a regular basis and education and training must be provided to all cleaning staff. Please refer to the manufacturer’s instructions for medical equipment to ensure that the item is not damaged by the use of disinfectants. 10/22/2018 Dr.T.V.Rao M D 18
  • 19. High hand-touch surface Any surface with frequent contact with hands • Requires special attention and more frequent cleaning. After thorough cleaning, consider the use of appropriate disinfectants to decontaminate these surfaces. 10/22/2018 Dr.T.V.Rao M D 19
  • 20. Minimal touch surface (floors, walls, ceilings, window sills, etc.) • Minimal contact with hands. Not in close contact with the patient or his/her immediate surroundings • Requires cleaning on a regular basis with detergent only or when soiling or spills occur. Also required following patient discharge from the health care setting. 10/22/2018 Dr.T.V.Rao M D 20
  • 21. Surface contaminated with blood and body fluids • Any areas that are visibly contaminated with blood or other potentially infectious materials • Requires prompt cleaning and disinfection • All spills must be carefully cleaned up and the surface cleaned and disinfected according to hospital policy 10/22/2018 Dr.T.V.Rao M D 21
  • 22. Water Quality • Water is a strategic energy resource that should be used and managed properly. In hospitals, water is a necessary utility which is obtained from outside sources. This utility may serve as a medium for the spread of infections from outside sources to the hospital Dr.T.V.Rao M D 10/22/2018 22
  • 23. Quality check of the Water a priority in Health care 2 3 • A complete chemical analysis of water is required to establish quality levels. This analysis may be performed by local public health agencies or by hospital staff. If the hospital has storage water tanks, they should be cleaned regularly and the quality of water should be sampled periodically to check for bacterial contamination. 10/22/2018 Dr.T.V.Rao M D
  • 24. The risks of poor healthcare HVAC • Healthcare HVAC breakdowns and poor performance are very serious problems. That’s because patients’ lives can be at risk if temperatures and humidity deviate from safe levels. Dr.T.V.Rao M D 10/22/2018 24
  • 25. High humidity: a huge healthcare HVAC problem • High heat and humidity are unpleasant for healthy people. Yet these conditions are especially harmful to those with respiratory problems. They also are dangerous to those recuperating after surgery at a rehabilitation center or nursing home. Dr.T.V.Rao M D 10/22/2018 25
  • 26. High Humidity helps to spread bacteria • High humidity promotes the spread of bacteria. This is a concern at any location, but it’s even more troublesome at healthcare facilities where people often have compromised immune systems 10/22/2018 Dr.T.V.Rao M D 26
  • 27. Purpose of HVAC • The purpose of HVAC system is to provide and maintain environmental conditions, including proper airflow, heating, and cooling within a certain area or the entire hospital. Installation of HVAC is one of the most important factors by which the architect can combat bacterial infection, and at the same time create environmental comfort. Dr.T.V.Rao M D 10/22/2018 27
  • 28. HVAC system •HVAC system is designed to meet specific values of temperature, relative humidity, and air changes frequency within different areas in hospital based on standards of design, 10/22/2018 Dr.T.V.Rao M D 28
  • 29. High Risk areas need special attention 2 9 • High risk areas such as operating rooms and intensive care units require special ventilation systems through filtration systems (e.g., HEPA filters) and pressure relationship to adjacent areas. In general, clean atmosphere reduces the risk of airborne infection, and dangerous of gases explosion. 10/22/2018 Dr.T.V.Rao M D
  • 30. • Program File Created by Dr.T.V.Rao MD for benefit of Medical and Nursing professionals in the Developing countries with Resources from WHO and Google •Email •doctortvrao@gmail.com 10/22/2018 Dr.T.V.Rao M D 30