10.5 Disinfection Principles

Disinfectant

A chemical used on inanimate objects such as medical instruments to kill all microorganisms, except spores.

Disinfection

The destruction of nearly all pathogenic microorganisms on an inanimate surface.

Spaulding system

A system used to determine the level of microbial destruction required for medical devices and supplies. Each level is based on the risk of infection associated with the area of the body where the device is used.

High Risk

___ is assigned to CRTTICAL ITEMS

Intermediate Risk

___ is assigned to SEMI-CRTICAL ITEMS

Low Risk

___ is assigned to NON-CRITICAL ITEMS

Critical Items

Items introduced directly into the bloodstream or other normally sterile areas of the body. Examples are surgical instruments, implants, vascular cannulas and hypodermic needles. All medical devices in this category must be sterile.

Semi-critical items

These are devices used on nonintact skin or mucous membranes. Any device in this category required HLD. Examples are endotracheal tubes and airways, rectal instruments, and vaginal instruments.

Non-critical Items

These are items that only come in contact with intact skin. Examples are a blood pressure cuff and stethoscope. These required cleaning with a low-level disinfectant.

Intermediate to low-level disinfectants

Phenolics are classified as:

Ortho-phthalaldehydes

Which of the following would be the best choice for high level disinfection of instruments?

organic matter

When using high-level disinfectants it is important to remember they may be deactivated by

True

Documentation log sheets should be maintained when using a high-level disinfectant.. True or False?

endoscopes

Glutaraldehyde is an HLD used for semi-critical devices, such as __________ and ultrasonic probes.

antiseptics

These chemicals are used on animate (living tissue) to slow the growth of microorganisms.

heat

Thermal disinfection is accomplished using

Glutaraldehyde & ortho-phthalaldehyde

What would be a high level disinfectant?

Critical Item

Implant

^^Critical item^^

^^Surgical instrument^^

@@Critical item@@

@@Needles@@

Semi-critical item

endotracheal tubes

==Semi-critical item==

==rectal instruments==

%%Semi-critical item%%

%%Fiberoptic endoscopes%%

^^Semi-critical item^^

^^Cystoscope^^

Non-critical item

Crutches

^^Non-critical item^^

^^Blood pressure cuffs^^

%%Non-critical item%%

%%Stethoscope%%

==Non-critical item==

==Table top==

Non-critical item

Thermometer

Non-critical item

Hydrotherapy tank

%%Non -critical item%%

%%Bedpan%%

5-10 minutes

How long must alcohol remain in wet contact with an item to achieve a reasonable level of disinfection?

Lipid Virus

A virus whose core is surrounded by a coat of lipoprotein. Viruses included in this structural category are generally easily inactivated by many types of disinfectants, including low-level disinfectants.

Nonlipid Virus

A virus whose core is not surrounded by a lipid envelope. These viruses are generally more resistant to inactivation by disinfectants.

High-Level Disinfection

Process that uses a sterilant for a shorter contact time than needed for sterilization. It kills all microorganisms, except bacterial spores.

Intermediate-Level Dinsinfection

Process that utilizes an agent that kills viruses, mycobacteria, fungi, and vegetative bacteria, but not bacterial spores.

Low-Level Disinfection

Process that utilizes an agent that kills vegetative forms of bacteria some fungi and lipid viruses (but not bacterial spores).

%%LLD%%

%%Used on equipment that comes into contact with the skin such as the furniture in the surgical suite, floors and walls, and IV stands. These environmental disinfectants include quaternary ammonium compounds, phenolics, alcohol, chlorines, and iodophors.%%

Quaternary ammonium compounds

What low-level disinfectant is incompatible with soap?

IMLD

These disinfectants include alcohol, iodophor, and chlorine

Alcohol

An intermediate level disinfectant that is tuberculocidal, bactericidal, virucidal, and fungicidal, but not sporicidal. It causes protein denaturation, lysis, and metabolic interruption of cells

Chlorine

An intermediate-level disinfectant that is a halogen. It is effective against gram-positive and gram negative microorganisms, tuberculocidal, and fungicidal, and virucidal. IT kills microorganisms by oxidation of enzymes.

Iodophors

An intermediate-disinfectant that is a halogen. It is bactericidal, tuberculocidal, and virucidal. It penetrates the cell walls and membranes of microorganisms and interfere with DNA synthesis.

HLD

Most but not all microorganisms are killed using this disinfectant. It is used on semi-critical areas of the body and on semi-critical instrumental.

Glutararldehyde

A high-level disinfectant/sterilant that kills microorganisms by alkylation or protein. It is a clear liquid that turns colors when activated.

Formaldehyde

Is available in different concentrations as a low, intermediate, and high-level disinfectant.

Before the first case of the day

The recommended practice to damp dust the surgical lights, furniture, and fixed equipment in the operating suite is