Asepsis and sterility

Asepsis

“The absence of pathogens”

Proper cleaning, disinfection, and sterilization provides an environment and equipment that are conducive to the ability to follow the principles of asepsis and the practice of sterile technique

Disinfectant

When most (but not all) microorganisms located on inanimate (non living) surfaces are destroyed

Antisepsis

when most (but not all) microorganisms located on animate (living) surfaces are destroyed

Decontamination

The removal or destruction of gross contaminations including bioburden, blood borne, pathogens, or other potentially infectious materials

Sterilization

Destruction of ALL microorganisms, including spores, on inanimate surfaces

Bioburden

The number of microbes or about of organic debris on a object at any given time

“Gross contamination”

Strike through contamination

Microbial contamination of a sterile field or package. The passage of fluid through a permeable sterile barrier caused by wicking action

Surgically clean

A surgical scrub performed with non sterile tap water from the scrub sink is an aseptic technique that renders your skin “surgically clean” but not sterile

What are the 3 classification of patient care items? Give examples for each

1. Critical- items used for invasive procedures and carry a high potential for causing SSI EX: surgical instruments, implantable items these items MUST be sterilized

2. Semi-critical- items that come into contact with mucous membranes or non-intact skin EX: laryngoscopes, anesthesia and respiratory high level disinfection, sterilization not required, but preferred

3. Non-critical- items that come into contact with a patients intact skin EX: blood pressure cuffs, pulse oximeters, OR transport stretchers required low level disinfection

What role does a surgical tech play in decontamination? What is our part during and after a case? Do we use NS or water?

The surgical techs role is to clean off our instruments throughout the case with sterile water so the instruments are easier to grip for the surgeon. At the end we do a thorough cleaning of our instruments before we send them down to central processing

Disinfectant classifications and examples of each

1. High level- glutaraldehyde and sodium hypochlorite (household bleach)

2. Intermediate level- phenol, alcohol, “quats”

When should the OR be disinfected ? What is TC?

at the begining of the day, in between procedures, and at the end of the day

TC stand for terminal cleaning, which is the more thorough cleaning of rooms after the last case of the day is done

What is the cycle of a surgical instrument between the OR and CP

1. Use in OR

2. Sort and disassemble after case

3. Clean with ultrasonic cleaner machine

4. Decontaminate with washer-sterilizer

5. Inspect instruments

6. Assemble and wrap

7. Sterilize

8. Store

What is an ultrasonic cleaner? What process does it use to clean? How does it work

Cleans areas of instruments that manual or mechanical cleaning cannot reach. It uses cavitation to clean the instruments *high frequency waves travel through the cleaning agent and form microscopic bubbles on the instrument, the bubbles then implode which creates a vacuum. This vacuum dislodged soil and organic material from instrumentation

What is milking an instrument?

lubricating instruments before they are reassembled and prepped for sterilization

What special considerations should be used for powered instruments

Powered instruments must never be submerged in a cleaning solution! Or placed in any type of mechanical decontaminating equipment

What are the different types of packaging used to

1. Woven wrap (Muslim)

2. Non woven (Kim guard)

3. Paper (peel packs)

What is a filter for?

To keep contaminated air out

What is steam sterilization? 5 important parameters that need to be monitored. Why is pressure important?

Exposes each item to direct steam contact at required time, temp, and pressure

• Time

• Contact

• Temperature

• Moisture

• Pressure

Pressure us important because it helps increase the temperature

What is different between gravity and prevacuum sterilizer? What are the minimum temperatures and times that must be met?

1. Gravity - steam enters the top of the autoclave and pushes the air down and out of the sterilizer- min time is 30 minutes min temp is 250

2. Prevacuum- air is removed from the autoclave via vacuum action instead of gravity- min time is 4 minutes min temp is 270

When is immediate-use sterilization used? What can it never be used for?

used for emergency’s if you need to instrument faster. Can never be used on implants

What are the different types of monitoring systems?

1. Mechanical

2. Chemical

3. Biological

What does a chemical indicator dictate?

They verify that the autoclave met the right temperatures for sterilization. It does NOT mean the microorganisms were killed however

What does a Bowie dick test tell us?

Determines if a steam sterilizer is effectively removing air from its chamber

What is the importance of a biological indicator?

Help monitor whether or not the specific requirements for sterilization have been met

What other types of sterilization methods are there besides steam?

• Ethylene oxygen

• Hydrogen peroxide gas plasma

• Ionizing radiation

Principles of sterile technique

• Create and maintain a sterile field

• Recognize and address breaks in sterile technique

• Avoid reaching over the sterile field

• Open and use sterile items properly

• Maintain a good surgical conscience