Biguanide
chlorhexidine scrub and solution
organisms chlorhexidine kills
bacteria, enveloped virus, some fungi, spores
benefits chlorhexidine
good antiseptic and disinfectant, nonirritating to tissue, nontoxic, commonly used in scrub
disadvantages chlorhexidine
ineffective in hard water and organic material, long contact time (over 5 minutes)
alcohols
isopropyl alcohol
organisms alcohols kills
bacteria, enveloped viruses
advantages of alcohol
broad spectrum, noncorrosive, inexpensive
disadvantage of alcohol
tissue irritant, ineffective with organic material, can rust instruments
important to remember when using hydrogen peroxide
tissue irritant, dilute 50% with water
instrument milk
soak to lubricate and prevent rust on instruments
disease
any process that detrimentally interferes with the functioning of an organism, includes abnormality in structure and function
microbe
aka micro-organisms, a living organism too small to be seen by the unaided eye
pathogen
microbe capable of causing disease
infection
detrimental results of invasion and multiplication of a pathogen in body tissue
normal flora
microbes usually found in healthy animals
resistance
sum of all factors contributing to the ability of an animal to overcome invasion by pathogens; immunity
sepsis
presence of pathogens or their by-products in blood or tissue of patients
asepsis
complete absence of living pathogenic microbes
sterile
complete absence of microbes and their spores
non-sterile
not sterile, may or may not be contaminated with microbes
surgical asepsis
body of techniques designed to maintain an object or area as free as possible of all microbes as possible. used whenever body tissues are penetrated.
medical asepsis
body of techniques used to reduce the number of microbes and the transmission of pathogens (antibiotics)
contaminated
in reference to surgery, anything that has not been sterilized
sanitation
any cleansing measure intended to prevent disease and promote health, destroy 98-99% of all microbes
disinfection
application of an agent that possesses the property of destroying or inhibiting the growth of microbes on inanimate objects, destroy about 99% of microbes
antiseptic
inhibits or prevents growth of microbes on living tissue
sterilization
process to rid an object of 100% of all microbes and their spores
cold sterilization
immersion of an object into a disinfectant solution to reduce level of contamination
transmission
passage of micro-organisms from one host to another
infectious
ability of a micro-organism to invade a host
contagious
describes the ease of which a microbe is able to invade a new host
microbes - most to least resistant
1.protozoal cyst
2. bacterial spore
3. nonenveloped virus
4. TB organisms
5. enveloped virus
6. fungi
7. vegetative bacteria
sanitation
reduction of micro-organisms to a safe level: controls 99% of micro-organisms
methods of sanitation
1. Dry Heat Methods
2. Moist Heat Methods
3. Filtration
4. Ultrasonic vibration
dry heat methods sanitation
Drying: includes clothes dryer, exposure to dry. circulating air greatly reduces micro-organism number
moist heat methods sanitation
denatures microbial proteins
1. hot water - used to clean surfaces, can combine with detergents to make more effective
2. boiling - for greater than 10 minutes will destroy most bacteria and viruses, but not their spores. addition of calcium carbonate can
filtration sanitation
Air - includes use of masks, air duct filters, special cage tops, efficacy influenced by humidity, air velocity
includes HEPA filter that can almost me completely sterilizing.
ultrasonic vibration sanitation
coagulates proteins and disrupts cell walls
includes ultrasonic cleaner that help clean instruments
disinfection
-using chemicals to destroy or prevent the growth of micro-organism on inanimate objects
-controls 99%-100% of micro-organisms
-Most methods describes in sanitation can sometimes be considered disinfection
sterilization
to eliminate all micro-organisms by death or inactivation, controls 100% microbes
only applies to inanimate objects
Physical methods of sterilization
1. dry heat
2. moist heat
3. radiation
4. filtration
dry hear sterilization
works via oxygen
1. incineration - destroys objects by exposing to hot fire
2. hot air oven - 1 hour exposure, 340�F
moist heat sterilization
denatures microbial protiens
1. Boiling for at least 3 hours
2. steam under pressure - autoclave, most common and least expensive
radiation sterilization
destroys cell enzymes and DNA
-use of gamma or UV radiation can be used to sterilize surgical supplies that cannot tolerate high temperatures (gloves, suture materials)
filtration sterilization
blocks particles via filter - sometimes HEPA can sterilize
ideal surgery suite
1. have a door
2. cabinets off the floor with doors
3. be free from clutter
4. no floor mats
5. be easy to clean
6. not to be used for dirty surgery, ie abscess repair, anal gland flushes
7. only to be used for clean surgeries, ie sterile
8. maintain the
cleaning surgery suite
1. dedicate specific equipment (mops and brooms) for surgical suite (do not use elsewhere)
2. clean physical debris first by sweeping, mopping, and/or using wet vacuum
3. clean between surgeries
4. final thorough cleaning at the end of all surgeries
5. wi
care and cleaning of instruments
1. presoaking
2. decontaminating
3. ultrasonic cleaning
4. wrapping
5. sterilizing
presoaking instruments
-immediately after surgery
-rids instrument of blood and other debris (organic debris)
-use distilled water, +/- detergent
decontaminating
-manual cleaning, detergent solution, soft bristle brush, distilled water
-open all instruments
-dry on absorbent surface
-check instrument function after drying
ultrasonic cleaning
-place instruments in ultrasonic cleaner with distilled water and enzymatic cleaner with surfactant for about 3-6 minutes
-cleaner provides a scrubbing effect using cavitation-formation of tiny bubbles
-lubricate instruments before wrapping to help preven
wrapping instruments
-follow recipe for pack provided by hospital
-wrap material: paper or cotton
-secure with indicator tape, label and date
-pack should weigh under 12 lbs and not exceed 20"X20"X20" in size
-shelf life 2 weeks, peel away pouch 7 weeks
Sterilizing instruments
autoclave - use of heat and steam under pressure to kill microbes, sterility dependent upon length of time at desired temperature and pressure
Autoclave temperature and pressure
temperature: 250-270 degrees F
common pressure range: 15-27 psi
other types sterilization
cold sterilization, ethylene oxide sterilization
Equipment Cleaning
1. Non-movable (permanent equipment) - surgery lights, table, radiographic view box - wiped down daily or as needed
2. movable - anesthetic machine, monitoring devices heating pads, iv drip stand/fluid pump, suction unit, cautery unit, laser, kick bucket,