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Chapter 6 infection prevention


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Chapter 6 infection prevention

  1. 1. Infection Prevention and Control Chapter 6
  2. 2. Objectives: As a result of successfully completing this chapter, students will be able to:  Explain the role of Central Service Technicians in a healthcare facility’s infection prevention and control efforts.  Discuss personal hygiene and personal protective equipment precautions that enable Central Service Technicians to protect patients and themselves.  Define the term, “Standard Precautions,” and review its role in preventing the transmission of infectious organisms.  List key elements in the Bloodborne Pathogens Standard published by Occupational Safety and Health Administration (OSHA).
  3. 3. Objectives:  Describe basic environmental concerns as Central Service work areas are designed.  Review environmental aspects of Central Service work procedures that impact infection control:  Traffic control  Work area cleanliness  Workflow  Define the terms, “asepsis,” and “aseptic technique,” and review the five basic principles of asepsis.
  4. 4. Infection Prevention and Control Goals of Central Service  Eliminate and/or destroy all potentially infectious contaminants present on reusable instruments and equipment.  Safely distribute reusable and single-use items required for the delivery of patient care.  Establish and enforce standards for decontamination, disinfection, and sterilization in various healthcare settings.
  5. 5. Medical Devices that have not been properly handled, disinfected or sterilized… …can cause infections in patients and staff
  6. 6. Each Year  Approximately 10% of patients hospitalized develop a healthcare facility- associated infection
  7. 7.  The primary purpose of the Central Service Department is to stop the spread of disease- producing microorganisms in the healthcare facility
  8. 8. Appropriate Attire for Central Service  A facility-issued scrub uniform  Hair covering that covers all head and facial hair except eyebrows and eyelashes  Shoes with non-skid soles
  9. 9. Hand Hygiene  Remove Watches and other Jewelry before entering the work area.  Wash hands with soap and water or use an alcohol- based hand rub
  10. 10. Personal Protective Equipment  Required by OSHA for Technicians in the Decontamination area:  General purpose utility gloves  A fluid-resistant covering with sleeves  Full face protection.  Shoe covers
  11. 11. Fluid-Resistant Gowns (Coverings)  Regular scrub attire splashed with liquid  Fluid-resistant attire splashed with liquid
  12. 12. Standard Precautions  Place emphasis on the use of blood and body fluid precautions for all patients.
  13. 13. OSHA BloodBorne Pathogen Standard  Written Exposure Control Plan  Training upon initial hire and annually thereafter  Hepatitis B Vaccine offered at no cost to employees  Observance of Standard Precautions  Use of Engineering and Work Practice Controls to reduce risks
  14. 14. OSHA BloodBorne Pathogen Standard  Provision of Personal Protective Equipment (PPE) at no cost to the employee  Provision of a clean and sanitary working environment  Use of appropriate Biohazard signs and labels to identify contaminated items  Rigid containers for sharps disposal
  15. 15. OSHA BloodBorne Pathogen Standard  Covered, puncture-proof containers for the transport of contaminated items.  Provision of medical evaluation and treatment if an employee experiences an exposure  Properly maintained medical and training records.
  16. 16. The Physical Design of the Central Service Department  Physical Barriers (walls) between clean and dirty areas  A method to reduce the likelihood that airborne bacteria can be transmitted from the decontamination area to the clean areas S1 S2 S3 DecontaminationArea PackagingArea ProcessingArea Sterile Goods Storage Area t Sterile Goods Issuing Point S1 S2 S3 DecontaminationArea PackagingArea ProcessingArea Sterile Goods Storage Area t Sterile Goods Issuing Point
  17. 17. The Use of Air Pressure to Control Airborne Bacteria Clean Area Positive Air Pressure Decontamination Area Negative Air Pressure Airflow
  18. 18. Controlling Airflow Windows and doors between areas with positive and negative air pressures must be kept closed
  19. 19. Work Area Requirements Decontamination Temperature: 60°F to 65°F (16°C to 18°C) Humidity: 30% to 60% Air Exchanges: 10 per hour Preparation and Packaging Temperature: 68° F to 73° F (20° C to 23° C) Humidity: 30% to 60% Air Exchanges: 10 per hour Clean/Sterile Storage Temperature 75° F or lower (24° C or lower) Humidity: Less than 70% Air Exchanges: 4 per hour
  20. 20. Work Area Requirements (cont.)  Hand washing Sinks  Fixtures and furniture that can be washed
  21. 21. Other Requirements:  Open Rack storage systems should have a solid bottom to prevent contamination during housekeeping tasks
  22. 22. Traffic Control  Traffic control requirements must be enforced for everyone  Dress codes for all areas apply to everyone
  23. 23. Traffic Control Designations  Biohazard – OSHA-required PPE  Unrestricted – Normal Traffic areas, cafeteria, waiting rooms, etc. Street clothes may be worn  Semi-Restricted – Clean assembly and storage areas, access corridors to operating rooms, etc. Surgical scrub attire and hair covering required  Restricted – Areas where sterile procedures are performed. Surgical scrub attire, hair covering, and masks required. *Persons working within the sterile field will have additional requirements
  24. 24. What to Wear CS Dress Requirement Review Decontamination Area Clean Assembly and Sterile Storage Operating Room Non-restricted Hallways and Offices. Cafeteria, etc. Surgical Scrubs and OSHA-required PPE Surgical Scrubs and Hair Covering Surgical Scrubs, Hair Covering, Masks may be required Regular Street Attire
  25. 25. Environmental Cleaning  Floors should be wet-mopped at least daily  Work surfaces should be cleaned at least daily  Light fixture should be cleaned at least every 6 months  Walls cabinets and racks should be cleaned on a regularly scheduled basis
  26. 26. Cleaning Sterile Storage Areas  Remove all sterile items from the cart, rack, or cabinet  Thoroughly clean the unit using the cleaning solution recommended by the healthcare facility.  Allow the storage unit to dry thoroughly.  Carefully place items back in their designated location.  Record the cleaning date in the department’s cleaning log.
  27. 27. Control Microorganisms Entering the Work Areas Clean Routinely
  28. 28. No Food or Drink should be allowed in Central Service work areas.
  29. 29. Workflow Practices
  30. 30. Workflow must be...  …logical  …one way  …defined
  31. 31. Contaminated to Sterile User Sterile Storage Sterilization Inspection & Assembly Decontamination User
  32. 32. Principles of Asepsis  Asepsis – The absence of microorganisms that cause disease  Aseptic Technique – Any activity or procedure that prevents infection or breaks the chain of infection
  33. 33. Medical Asepsis  Procedures performed to reduce the number of microorganisms or minimize their spread
  34. 34. Surgical Asepsis  Procedures performed to eliminate the presence of all microorganisms and/or to prevent the introduction of microorganisms into an area
  35. 35. Principles of Asepsis 1. Know what is Dirty. 2. Know what is Clean. 3. Know what is Sterile. 4. Keep the 3 conditions separate. 5. Remedy contamination immediately.
  36. 36. “Sterile Conscience”  A careless attitude may lead to increased risk of infection
  37. 37. Infection Control...  …manages the growth and transmission of bacteria in the healthcare facility
  38. 38. You Can Manage the Environment by:  Following All Infection Control Protocols  Recognizing Contamination and Correcting the Situation  Paying Close attention to Detail
  39. 39. Controlling the Spread of Microorganisms… …is the responsibility of every Central Service Technician