13:4-13:6 METHODS OF INFECTION CONTROL
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 !
• 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
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