CHOOSING ANTISEPTIC AND DISINFECTANT

IN THE NATIONAL HOSPITAL STANDARDS HOSPITAL

ACREDITATION

By: Saida Simanjuntak,SKp,. MARS.

Seminar and Workshop Jakarta Infection And Control Update

(JIPCU)

Jakarta, 2nd-3rd December 2017

OBJECTIONS

The aim of organizing the PCI program

is to identify and reduce the risk of

infection acquired and transmitted

between patients, staff, health

professionals, contractors, volunteers,

students and visitors.

• Increased Morbidity

• Prolonged L.O.S (Length Of Stay) 5-10 Days

• Risk of The Death approximately doubles

• HAIs Are Very Expensive And Constribute Significaly To The Escalating Cost

• Prevention and Infection Control in Hospital

To reduces or prevent the occurrence of the

Nosocomial Infection (hospital acquired

infection)

• Replaces with the new terms is Healthcare

Associated Infections (HAIs)

• World-wide: 1,400,000/day. infected

• ICU infection rate: 25%. death rate 44%

• Great Britain: 5,000 deaths/year.

• Brazil: 50 of newborns infected, 12-52% die.

• Worldwide: 4,500 children die of HAI.

• One surgical site infection may cost up to $15-

$30,000 to treat.

• One blood stream infection cost up to $50,000 to

treat.

• $40 – $75 billion dollars are spent to treat HAIs.

The Big Five

• Central line associated blood stream infection (CLABSI)

• Ventilator associated pneumonia (VAP)

• Surgical site infection (SSI)

• Catheter-associated UTI (CAUTI)

• Clostridium difficile associated disease (CDAD)

1 JUNI 2017

PROGRAM PCI

SURVEILANCE

ICRA

STERILIZATION &

LAUNDRY

HYGIENE & SANITATION

ISOLATION, APD, HAND

HYGIENE

HEALTY SAFETY WORK

Human Resources :

- Committee/PCI

Team

- IPCN

- IPCLN

PCI Training:

- Staff of Hospital

- Px & visitors

- The college

student

Budget

- Personal

protective

equipment

- Disinfectant

- Training

- Germs Chcecking

INTEGRATION OF

ACTIVITIES WITH PMKPManagement

Data System

Definition:Antisepsisi, The process of reducing the number of microorganisms on the skin, mucous membranes, or body tissues using antimicrobial materials

Antiseptic / anti-microbial ingredients:Chemicals used on the skin or other living tissues can inhibit or kill microorganisms (either temporarily or completely), thereby reducing the total number of bacteria.

Definition:

A process for eliminating / destroying microorganisms (viruses, bacteria, parasites, fungi) except endospores in various medical devices or objects using chemical liquids or therma

Decontamination:

a process for removing / destroying microorganisms and impurities that attached to medical devices / objects, to making it safe for subsequent use, including cleaning, disinfection, sterilization.

1 JUNI 2017

• The process that removes all microorganisms except for some bacterial endospores in inanimate objects by boiling, steaming or using chemical disinfectant

Table B1 Microbiology Activity and Potential Utility

Table B1 Microbiology Activity and Potential Utility (continued)

Criteria for choosing an antiseptic for Handwashing:

•Has broad effects, inhibits or damages large microorganisms (gram positive and gram negative, lipophilic virus, bacillus and tuberculosis, fungiserta endospore)•Effectiveness•Early effectiveness velocity•Residual effects, long action after useto reduce growth

Criteria for choosing antiseptic,

•Does not cause skin irritation

•Does not cause allergies

•The results to be achieved in hand hygiene is to

prevent infection, colonization of the patient and

prevent contamination from the patient to the

environment including the work environment of the

officer.

Standard Operating Procedures (SOP ) Decontamination of

Patient Care Equipment as follows:

a) Soak used equipment in water and detergent or enzyme then

cleaned with sponge before disinfection high level (DTT) or

sterilization.

b) Equipment used for infectious patients should be

decontaminated prior to use for other patients.

c) Ensure disposable equipment is disposed of and disposed of

in accordance with proper waste and waste disposal

principles.

d) For used equipment to be reused, after cleaning using

sponge, in DTT with chlorine 0.5% for 10 minutes.

e) Contaminated noncritical equipment can be disinfected

using 70% alcohol. Semicritical equipment is

disinfected or sterilized, while critical equipment must

be disinfected and sterilized.

f) For large equipment such as ultrasound and X-Ray,

can be decontaminated surface after use in isolation

room.

Flow Description:

1. Pre-cleaning:

The process of making inanimate objects safer to be handled

by the officer before being cleaned (eg, inactivating HBV, HBC,

and HIV) and reducing, but not eliminating, the number of

contaminating microorganisms.

2. Cleaning:

Processes that physically remove all dirt, blood, or other body

fluids from the surface of inanimate objects or dispose of a

number of microorganisms to reduce the risk for those who

touch the skin or handle the object.

3. High Level Disinfection (DTT):

The process of removing all microorganisms, except for some

bacterial endospores from objects, by boiling, vaporizing or

using chemical disinfectants.

4. Sterilization:

The process of removing all microorganisms (bacteria,

viruses, fungi and parasites) includes endospores using

high-pressure steam (autoclave), oven, sterilisechemical,

or radiation.

a. High Pressure Vapor Sterilisator (autoclave):

High-pressure steam sterilization is an effective method

of metodesterilization, but also the most difficult to do

correctly. Set the temperature to be at 121 ° C; the

pressure should be at 106 kPa; for 20 minutes for the

tool is not wrapped and 30 minutes for the tool wrapped.

b. Sterilization use dry heat (Oven):

Place the instrument and heat up to 170 ° C, for 1 (one)

hour and then cooled for 2-2.5 hours or 160 ° C for 2

(two) hours.

Standard PPI.7.2

The hospital reduces the risk of infection by

cleaning and sterilizing the equipment

properly and managing it properly

The intention and purpose of PPI. 7.2., & PPI.7.2.1

The risk of infection can be reduced through

decontamination, pre-cleaning, cleaning, disinfection

and sterilization. Cleaning of medical devices carried

out in accordance with the laws and regulations

include:

a. critical, for medical devices used for sterile tissues or

blood systems using sterilization techniques such as

surgical instruments

The intent and purpose of PPI. 7.2., PPI.7.2.1

b. semi-critical, associated with mucosa by using

high-level disinfection (DTT) such as naso gastric

tube (NGT) and endoscopic devices

c. non-critical, for equipment used on the surface of

the body by using low-level disinfection such as

tension meters and thermometers

Element Assessment of PPI.7.2

1. Hospitals establish regulations on

sterilization services according to the laws

and regulations. (R)

2. There is evidence of decontamination flow,

pre-cleaning, cleaning, disinfection, and

sterilization of medical equipment at the

sterilization center in accordance with the

principles of PPI. (D, O, W)

Element Assessment PPI.7.2

3. The hospital coordinates sterilization and

disinfection services outside the sterilization

center. (D, O, W)

4. The hospital ensures the sterilization and

disinfection process outside the uniform

sterilization center. (D, O, W)

TEKNIK PENGAMAN

APD

HAND HYGIENE

THE EXAMPLE CASE

COURTESY : WWW.BBC.CO.UK

• Luka Operasi Terinfeksi MRSA

SETIAP STAF KLINIS HARUS MENCUCI

TANGAN SESUAI STANDAR WHO, DAN

MENERAPKAN FIVE MOMENT FOR HAND

HYGINE

Acknowledgement : WHO World Alliance for Patient Safety