Disinfection vs Sterilization

1. Definitions

• Surgical Asepsis: Also known as sterile technique, it is the method used to prevent contamination during invasive procedures that enter body cavities.

2. Disinfection

• Definition: Disinfection is the process used to kill blood-borne pathogens and inhibit the growth of organisms that cause infection.

• Products: Commonly used disinfection products in facilities include:

  • Clorox wipes

  • Sani wipes

• Effectiveness: Disinfection is effective against many blood-borne pathogens, including:

  • HIV

  • Hepatitis B

• Limitations:

  • Does not kill all spores; therefore, items remain not completely sterile.

  • Disinfected items still carry some microbes.

Examples of Use

• Disinfection is commonly applied to:

  • IV poles

  • Pumps

  • Surfaces such as bedside tables

3. Sterilization

• Definition: Sterilization uses methods such as steam under pressure, gas, or radiation to kill all pathogens and their spores.

• Application: Sterile equipment and supplies are utilized during sterile procedures that may occur at:

  • Bedside

  • Operating rooms

• Indicators: For sterile equipment:

  • Indicator tape shows black marks every half inch.

  • Wetness can be indicated by a discolored line, known as a strike through.

• Precautions: Always check expiration dates and packaging integrity; an item is no longer considered sterile if:

  • A peel-apart pack is opened

  • The expiration date has passed.

4. Key Differences Between Disinfection and Sterilization

• Disinfection: Reduces pathogens but does not completely eliminate them. Items may still be contaminated.

• Sterilization: Completely eradicates all microbes and spores, achieving a sterile status.

5. Principles of Sterile Technique

• Consequences of Contamination: Contamination can lead to the introduction of pathogens into sterile areas or surgical sites.

• Sterile Field Definition: An area that is free from all microorganisms where additional sterile items can be placed until needed.

• Relation to Surgical Procedures: For instance, poor sterile technique during surgery may result in wound contamination, risking patient safety.

Example Scenario

• If a nurse drops a sterile dressing onto a bedside table:

  • The dressing is contaminated and must be replaced to prevent pathogen introduction to a patient's open wound.

6. Guidelines for Sterile Technique

• General Principle: Sterile items must only touch other sterile items to remain considered sterile.

• Contamination Rules:

  • Anything that touches an unsterile item is considered contaminated.

  • Unsterile items touching sterile items contaminate both.

7. Setting Up a Sterile Field

• Outer Area Contamination: The outer one inch of a sterile drape is considered contaminated due to necessary handling.

• Visibility: Anything below the surface of the drape table is deemed unsterile as it cannot be seen and might touch unsterile surfaces.

• Wetness: If the sterile field becomes damp, it is no longer sterile as pathogens can transmit through moisture.

8. Adding Items to a Sterile Field

• Action Steps: When adding items:

  • Open the peel-apart package and drop contents into the sterile field without touching the one-inch border.

  • Pour sterile liquids by holding the bottle label against your palm to avoid obscuring the label and pour from 4 to 6 inches above the basin to prevent splashing.

• Safety Protocols: Maintain visual contact with the sterile field and do not touch the back of the sterile field to prevent contamination.

9. Handling of Sterile Gloves and Equipment

• Gloves: After donning sterile gloves, keep them in the safety zone:

  • Position: Above waist level, below eyelid level, and within peripheral vision.

  • Hands outside this zone are considered contaminated.

• Needles and Sharps: Handle needles, syringes, and lancets with care to maintain sterility; dispose of used sharps in designated containers.

10. Conclusion

• Emphasis on Surgical Asepsis: Consistently applying sterile technique practices is imperative for patient safety in any healthcare setting. Acknowledging that clean does not equal sterile is crucial in maintaining rigorous standards for infection prevention.