AHS II Infection Control

1. AHS IIInfection Control Mrs. Splawn

2. Autoclave

3. Autoclave • The autoclave was invented in 1879 by Charles Chamberland. • The benefits of sterile surgery were starting to catch on and doctors needed a more reliable way to sterilize their instruments besides heating them in the fire. • The benefits of the autoclave were quickly evident, and it became an indispensable part of every doctor’s office and hospital. • The autoclave is not quite as common, with the introduction of single-use needles and other instruments, but it is still a necessary part of any medical or lab setting.

4. Autoclave • A piece of equipment that uses steam under pressure or gas to sterilize equipment and supplies. • Kills all microrganisms

5. Autoclave One of the simplest autoclaves looks a great deal like a pressure cooker. It is a large pot with a gauge on top and bolts that fasten the top to the pot. • The idea behind this is that water inside a pressurized container can be heated above the boiling point. It will only reach 212 degrees Fahrenheit (100 Celsius) in an open container. However, in a pressurized autoclave, the water will reach much higher temperatures. • Most doctor’s offices have a small autoclave in their labs, and these are used to sterilize small batches of instruments. This sort of autoclave is usually on a cart and is similar in size to a microwave oven. It can also be wheeled around to where it is needed.

6. Smaller Autoclave

7. Autoclave • Hospitals use a large autoclave that looks similar to a dishwasher. • A hospital autoclave can process large numbers of surgical instruments in one cycle, keeping up with the constant demand from the operating rooms and emergency department. • An autoclave should ideally be a one-touch instrument. That is, the technician should be able to load the machine, press a button to begin the cycle, and the machine does the rest.

8. Autoclave

9. Autoclave Procedure • Before equipment or supplies are put into autoclave, they must be prepared properly. • Items must be washed and rinsed • Oily substances must be removed with alcohol or either. • Left on residue bakes and sticks to equipment

10. Autoclave procedure

11. Autoclave wrapping • Items that are to remain sterile must be wrapped before they are autoclaved • The wrap must be a material that will allow for the penetration of steam during the autoclaving process • Muslin, autoclave paper, special plastic or paper bags, and autoclave containers are used.

12. Autoclave wrapping

14. Autoclave indicators • Tape • Sensitivity marks on bags or wraps • Indicator capsules • Indicators change appearance during process because of time and temperature leading to sterilization

15. Autoclave indicators

16. Loading the autoclave • Space between pieces • No articles should come in contact with sides of autoclave • Length of time and amount of pressure varies • Wet surfaces permit rapid infiltration of organisms so make sure items dry prior to removing

17. 30 Day Rule • Items usually remain sterile for 30 days after autoclaving. • If not used in 30 days and cloth still intact…remove tape, replace with newly current dated tape, and re-sterilize (or re-autoclave).

18. Chemical Disinfection • Chemical used in aseptic control. • Many chemicals do not control viruses and spores always so sterilization does not occur with chemical disinfection • Chemical are used to disinfect instruments that do not penetrate body tissue

20. Ultrasonic cleaning • Uses sound waves to clean • The sound waves produce millions of microscopic bubbles in a cleaning solution • When the bubbles strike the object being cleaned, the bubbles explode…this process is known as cavitation • Cavitation drives the cleaning solution onto the article and residue is easily and gently removed

21. Ultrasonic cleaning

22. Sterile Technique • Sterile: free from all organisms • Sterile Technique: procedure that keep an object or area free from living organisms. • Contaminated: organisms and pathogens are present.

24. Principals of Sterile Technique • Clean, uncluttered work environment • Sterile object must never touch a non-sterile object • Sterile objects cannot touch skin or clothing • Any area below waist is considered contaminated • Sterile items must be held away from and in front of the body and above the waist

25. Principals continued • Never reach across the top of a field • Sterile field must be kept in constant view • Never turn your back on the sterile field • Avoid coughing, sneezing, or talking over the sterile field due to airborne pathogens • A two inch border around the sterile field is considered contaminated. • Therefore, two inches around the sterile field must not be used as sterile

26. Principles cont. • Moisture of a sterile package contaminates it. • Must be kept dry

27. Drop Technique • Gauze pads, dressings, small items • Wrapper partially opened and held upside down over sterile field • Items drop onto sterile field

28. Mitten Technique • Used for bowls, drapes, linen and other similar items. • Wrapper opened and its loose ends are graspes around the wrist with the opposite hand. • In this way, mitten formed around the hand that is still holding the item. • With the mitten hand, the item can be placed on the sterile tray…book 386

29. Transfer forceps • Cotton balls, small items, articles that cannot be removed by drop or mitten techniques • Sterile pick-ups are used

30. Sterile Package • Sealed Edge or Tab pointing toward you. • Open corner moving it away from you. Careful not to reach across top. Reach around the package instead. • Raise side flaps individually with one hand • Do not touch inside of package

31. Sterile Gloving • Open sides • Inside of folded area of first glove • Under cuff of second glove • To remove, without touching skin, pull downward over one hand, causing glove to go inside out. • Insert bare fingers inside second glove, pull it down over the other glove and dispose

33. Sterile Dressing Change • Non-sterile gloves to remove old dressing • Wash hands • Open container • Don gloves • Clean Wound from center outward in circular motion • Apply dressing • Wash hands • Secure with tape opposite from body action

34. Sterile dressing change

35. Airborne Precautions • Standard precautions used. • Droplets suspended in air or dust • Private room • Door closed • Air circulated to outside • Anyone entering must wear mask • Patient must wear surgical mask during transport • Measles, chicken pox, TB, shingles

36. Droplet precautions • Used when patient suspected to be infected with pathogens transmitted by large particle droplets expelled during coughing, sneezing, talking, laughing, • Flu, bacterial pneumonia, strep • Private room, masks when within 3 feet of patient required but recommended even if in room • Surgical mask during transport

37. Contact precautions • Used with any suspected or known infectious disease • Stomach bug, respiratory infection, wound infection, conjunctivitis • Private or semiprivate • Gloves • Gown • Daily disinfecting of room • Patient care equipment left in room

38. Reverse Isolation • Protecting patient • Immunosuppressed patients • Frequent disinfection of room • Gowns, gloves, mask • All supplies brought in are clean, disinfected or sterile • Specialty purifiers • All efforts aimed at protecting patient from pathogens