5. Patient Care Processes To Prevent Infections.ppt

MTI, Khyber Teaching Hospital, Peshawar
Method of cleaning, Disinfection and
sterilization
Muhammad Sulaiman
Manager Operation theaters
KTH Peshawar.

Objectives of the Session
By the end of this session you will able to;
1. Understand the basic concepts of cleaning,
disinfection and sterilization.
2. Differentiate between disinfection and
sterilization.
3. Understand Level of disinfection
4. Describe Methods and process used for
instruments & medical devices

Basic Concepts
 Bioburden: The population of viable microorganisms on
devices, instruments, equipment, or products
 Cleaning: The removal of visible dirt (e.g., organic and
inorganic material) from objects & surfaces, normally
accomplished manually or mechanically, using water with
detergents or enzymatic cleaners.
 Decontamination: The process of removing pathogenic
microorganisms from objects so they are safe to handle,
use, or discard. It can be done using physical or chemical
means
 Sterilization: The process used to render an item free
from viable microorganisms, including spores

Level of Disinfection or Sterilization
Required
 Items are classified as:
 Non-critical—come in contact with intact skin but not
mucous membranes
 Semi-critical—come in contact with mucous
membranes or non-intact skin
 Critical—come in contact with sterile areas of the body
including the vascular system

Level of Disinfection or Sterilization
Required

General Guidelines for Handling &
Reprocessing Items
 Instruments or other reusable items require
appropriate handling and processing to:
 Minimize the risk of injury to staff
 Minimize exposure to blood or body fluids for the
housekeeping, transportation, & reprocessing staff
 Ensure that they are not vectors of health care-
associated infections

Major Steps in Reprocessing
Instruments & Medical Devices

Overview of Processing Instruments
and Medical Devices

Types of sterilization
Physical methods:
A. Thermal
a) dry heat
b) moist heat.
B. Radiations
Chemical methods:
a) liquids
b) gases (ethylene oxide)

Physical methods of sterilization
Thermal sterilization
Dry heat Moist heat
10

Dry heat sterilization
 Dry heat in the form of hot air is used to sterilize
oils, petroleum products, and talc.
 Temperature: 160 ºC – 170 ºC for two hours.
 Advantages: It permits the sterilization of
Vaseline, fats and heat-resistant powders, which
cannot be processed by moist heat.
• Disadvantages: Long exposure periods,

Moist heat Steam Sterilization
 Steam sterilization is the most common
sterilization procedure.
• Advantages: This method is considered the most
economical and most rapid. It has no adverse effects
since it does not leave residues from the sterilizing
agent.
• Disadvantages: It is not suitable to apply in
materials that do not support the conditions of the
process. i.e heat sensitive instruments
Time and temperature : (121° C) for 15 minutes

Chemical methods of sterilization
 These methods are used only in the case of
materials that do not tolerate heat, but do tolerate
chemicals.
liquids chemicals Gaseous chemicals

Gaseous chemicals
Chemical sterilization by ethylene oxide:
 Ethylene oxide (EtO) sterilization is performed for
the thermo labile article.
 EtO sterilizers is a special apparatus used the Eto
sterilization sterilization .

Gaseous chemicals sterilization
 Advantages: EtO is a substance with a high level
of diffusion and penetration, which permits high
versatility for the sterilization of heat-sensitive
materials.
 • Disadvantages: It is highly toxic to living things
and can cause local reactions on skin and mucous
membranes and systemic toxic effects with clinical
manifestations such as dyspnea, cyanosis,
gastrointestinal disorders, hemolysis, necrosis,
mutagenesis and carcinogenesis.

Liquid chemical sterilization
 Liquid chemicals Sterilization b chemical agents is
the last method of choice for heat sensitive
instruments .
 These processes are difficult to control, have a
high probability of recontamination during rinsing
or drying, and do not allow later storage.
 Glutaraldehyde

Liquid chemical sterilization
 Glutaraldehyde
• This disinfectant, which can be acidic or alkaline, is
used as a high-level disinfectant and can be used at
a concentration of 2% for sterilization purposes.
The duration of the contact time necessary for
sterilization is approximately 10 hours. It has a wide
spectrum of antimicrobial activity,

Hydrogen peroxide •
This disinfectant is used very little:
In general, hydrogen peroxide at a concentration of
6% is sporicidal but very corrosive when used for
delicate instruments and optical fiber endoscopes.

 Formaldehyde • The use of formaldehyde is
indicated for all materials that are used for
hemodialysis. Sterilization is achieved at 8%
concentration and 24 hours of engagement.
Formaldehyde has been questioned recently due
to its high toxicity.
 Peracetic acid • This agent, which can be
considered as a derivative of hydrogen peroxide,
has microbial activity that was identified at the
beginning of the century.

5. Patient Care Processes To Prevent Infections.ppt

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