13:4-13:6 METHODS OF INFECTION CONTROL

J.J.NELSON RN, CMA

OBJECTIVES for 13:4-13:6

• Demonstrate basic principles of sterilization.• Recognize recommendations for indicators and

biological monitors.• Follow procedure for wrapping, loading and

running an autoclave.• Identify and demonstrate principles of chemical

disinfection.• Describe principles of cleaning with ultrasound.• Formulate decisions in use of chemical

disinfection, ultrasounic cleaning and autoclaving.

Put to memory:

• What is antisepsis?

• What is disinfection?

• What is sterilization?

• How do you know when to use what?

13:4 Autoclave Wrapping• The most common means of sterilization is

autoclaving.• An autoclave uses steam under pressure to

create a high heat to kill all pathogens.• However once autoclaved how does an

instrument maintain it’s sterilization??????• Instruments must be prepared so the outer

layer is allowed contact with contaminated surfaces (shelves or drawers) but interior remains sterile. How?????

13:4 A Wrapping items for Autoclave

• Instruments are prewashed, rinsed and dried.• With gloves you correctly insert instrument

into a wrap or envelope. – Single wrap=1-2 day–Double wrap 4 weeks– Envelopes (bags) 6 months– Event sterilization

• Wrap or seal envelope.

Event Sterilization

• http://www.infectioncontroltoday.com/articles/2002/04/time-versus-event-preserving-sterile-package-inte.aspx

What wrap/envelope to choose?

Muslin is also an option. The wrap must allow for steam penetration but not pathogen entrance.

• How do you know it has been through autoclave????

• Indicator tape or Indicators on the bag/envelope (circles or arrow that darken after autoclaving)

Wrapping techinque

• Use information sheet for details:• Linen is fan folded prior to insertion into

wrap. Why?• Hinged instruments are left open (not

locked). Why? • When using envelopes the handle is inserted

first. Why?• Label wrap/envelopes with contents, size,

date and your initials.

What is a biological monitor and whyis it important?

13:4 B Operating an Autoclave

• Items are usually washed, rinsed, dried and properly packaged prior to going into autoclave.

• Can you think of when an instrument is not wrapped or put in an envelope?

• Load the autoclave correctly. • Position jars, basins on side or upside down

Autoclaving cont.

• Follow manufacturers directions exactly

• Add distilled water• Length of time in autoclave

begins when the temperature is reached.

• Safety!!

Care of items after autoclaving

Contamination is likely if: Package has

evidence of wet Package has tears or

rips Check date.

Store items in dry area

P.S. Dry Heat Autoclaving i

• Is an option.

13:5 Chemical Disinfection• Why disinfect instead of autoclave?• Prep instruments by wash, rinse and dry.• Brush serrated edges and keep hinged

instruments open (not locked) • Use “milk bath” for preventing rust and as a

Teflon coating.• Solutions vary based on manufacture. READ

for time requirements for disinfecting vs. sterilization.

Chemical Disinfection cont.

• Container is labeled with chemical name, date mixed and your initial.

• Container needs a tight lid.• Leave space between instruments.• Use gloves to avoid chemical exposure.• Dry instrument and place in clean, dry area.• Dispose of chemical per MSDS.• Change solution when it expires or appears

“dirty”.

13:6 Ultrasound • Using sound waves to clean instruments

(antiseptic technique). The instruments remain contaminated throughout the entire procedure.

• Soundwaves cause cavitation which breaks debris from instrument.

• Our solution is Cavi-Clean. The bottle recommends one ounce (30 mL) of solution to one gallon (4000mL) of tap water. For our tank we need to use one half ounce (15 mL) to two quarts (2000mL ) of water.

Remember:• Wash instruments prior to inserting in US• Have tank nearly full • Change solution when it appears dirty (floaties)• Do not overcrowd instruments. Articles must be

submerged in solution for cavitation to occur.• Check that the US is working. How? Why not

peek into it?• When cleaning unit: – Use gloves– Wipe clean – Disinfect

Special uses of the US • Special solutions are

added to beakers.• Make sure beakers do

not fall over by using bands

• Assure the beakers are not “etched” prior to using. Discard if they are etched