Section 2b: Infection Prevention (Pg. 121-167)

Infection Prevention Standards for the Practice of Electrolysis (Pg. 121-138)

Preface

American Electrology Association (AEA) has adopted these infection prevention standards for the practice of electrolysis. AEA follows the guideline of the CDC (Center for Disease Control and Prevention. Universal (Blood and Body Fluid) Precautions and Body Substance Isolation are designed to reduce the risk of transmission of blood-borne pathogens and pathogens from moist body substances.

• Electrologists should consider all clients as potentially infectious and adhere to these Standards to minimize the risk of exposure to blood or body fluids and reduce the risk of transmission of infection and disease from client to client, practitioner to client and client to practitioner.

Objectives for Prevention Measures and Standards of Practice

1. Provide a knowledge base of infection prevention and client safety

2. Provide a practical aseptic (germ free) approach

3. Establish guidelines for providing a high quality of client care.

4. Provide standards for professional judgement and decision-making

Definition of Terms

Alcohol-Based Rub (i.e. hand sanitizer): The alcohol-containing preparation designed for application to the hands for reducing the number of viable microorganisms on the hands. In the United States, such prepa- rations usually contain 60% - 95% ethanol or isopropanol. Formulations include foams, gels and liquid rinses. These products do not remove soil, but can be used for hand-antisepsis. → does not replace handwashing*

Antiseptic (ONLY ON SKIN*): A germicide used on skin or living tissue to inhibit or destroy microorganisms. Reduce risk of infection + stop spread of germs. Antiseptic products are not appropriate in any instance for use in cleaning or disinfecting inanimate objects. The Food and Drug Administration (FDA) regulates antiseptics. I.e. Hydrogen peroxide, isopropyl alcohol, witch hazel

Aseptic (Free of Germs) Technique: A set of specific practices used before, during and after a procedure to protect against the spread of of pathogenic microorganisms. Examples of aseptic technique are appropriately timed handwashing, decontamination of inanimate surfaces and instruments, appropriate use of personal protective clothing or barriers, proper containment and disposal of waste and consistent instrument handling which minimize cross contamination and reduce the risk of exposure to pathogens.

*Autoclave (steam/liquid sterilizer): A device used for sterilization by application of pressurized steam and heat. The FDA regulates autoclaves.

*Biological Indicator → Example: spore test autoclave: A commercially prepared device with a known population of highly resistant bacterial spores used to test the method of sterilization being monitored. The biological indicator (BI) is used to demonstrate that conditions necessary to achieve sterilization were met during the cycle being monitored. The FDA regulates biological indicators.

*Chemical Indicator (Color Change, indicates heat): A commercially prepared device used to monitor all or part of the physical conditions of a heat sterilization process by means of a characteristic color change, usually chemically treated paper strips. A chemical indicator does not indicate that sterilization has been achieved and most indicate only that the temperature needed has been attained. Some chemical indicators are capable of "integrating" time at a particular temperature before color change. The FDA regulates chemical indicators.

Cleaning: Not disinfection or sterilization* The removal of visible soil(e.g., organic and inorganic material) from objects and surfaces and is accomplished manually or mechanically using water with detergents or enzymatic products. Thorough cleaning is an absolute must prior to disinfection and sterilization procedures.

Contamination: The result of being soiled, stained, touched, or otherwise exposed to harmful agents, making an object potentially unsafe for use as intended or without barrier techniques. An example is the entry of infectious or toxic materials into a previously clean or sterile environment.

Contraindicate: To advise against or indicate the possible danger of a drug or treatment.

Critical items: (ex. needles) The instruments or objects that come in direct contact with the bloodstream or other normally sterile areas of the body. Critical items must be pre-sterilized, single use and disposable or subjected to sterilization before use.

Decontamination: Blanket term; Use of physical or chemical means to remove, inactivate, or destroy pathogens on a surface or item so that they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use or disposal.

Disinfectant (Product*): A chemical agent used on hard inanimate surfaces and objects to destroy or irreversibly inactivate infectious fungi and bacteria but not necessarily their spores. Chemical disinfectants are classified as "high-level," "intermediate-level" and "low- level" according to their comparative levels of potency and intended uses, but are not a final step in the processing of instruments. Sterilization is final step.

Disinfection (Process* of cleaning something): A process that eliminates many or all pathogenic microorganisms, except bacterial spores, on inanimate objects.

High-Level Disinfection (Minimum or lowest level we can use): The disinfection process that inactivates some, but not necessarily all, bacterial spores. High-level disinfection is the minimum treatment recommended by the CDC in guidelines for the processing of semi- critical instruments. There are commercially available germicides that have been cleared by the FDA as sterilants/disinfectants or simply as "high-level disinfectants." Examples of high-level disinfectants include glutaraldehyde, hydrogen peroxidelperacetic acid-based formula and orthophthaladehyde.

Intermediate-Level Disinfection (strongest): A disinfection process capable of killing TB, broad spectrum of bacteria, viruses, fungi, including Herpes, Staphylococcus, Salmonella, HIV, HBV and inactive AIDS viruses. The EPA regulates intermediate-level disinfectants. Examples of intermediate- level disinfectants include alcohols (70- 90%), quaternary ammonium compounds and phenolics.

Low-level Disinfection (Middle, second to strongest): A process capable of inactivating most some viruses and fungi but not bacterial spores or TB. Like intermediate- level products, low-level disinfectants are regulated by the EPA and are appropriate for disinfecting environmental or medical equipment (non-instrument) surfaces. Examples of low-level disinfectants are quaternary ammonium compounds and certain iodophors or phenolics.

Dry heat sterilizer (no water): An oven-type device specifically designed to sterilize items by exposure to high temperatures for a designated period of time. The FDA regulates dry heat sterilizers.

Electrologist: a person who removes hair by means of an electric current applied with a solid wire filament or electrode.

Electrology: The study of electrolysis.

Electrolysis: Destruction of living tissue in the hair follicle by means of electric current applied with a solid wire filament or electrode. The procedure of electrolysis is also known as electro-epilation.

Environmental surfaces: Surfaces that may contribute to cross- contamination. These surfaces should be properly maintained to minimize their potential role in disease transmission. A low-level disinfectant is used to clean environmental surfaces.

Enzyme Detergent: The solution that helps break down organic soils and fats and suspends particles during cleaning. An enzyme detergent is used as a soaking solution for critical, semi-critical and non-critical instruments and as the detergent used in the ultrasonic device. Temperature and dilution affect the efficacy of enzyme detergents.

Epilator Cords: Insulated cords used to complete a circuit between the epilator and needle, phoresis indifferent applicator/rollers and the indifferent electrode. Epilator cords are non-critical items, Intermediate level disinfectants can be used to clean the cords.

Forceps: a medical tool that is used for grasping or holding things.

Gloves: Coverings for the hands made of various materials, which provide a protective barrier against infections and toxic substances. There are three types of gloves that can be used by electrologists; examination, food-handler, and cleaning/non-medical gloves

Examination gloves: are non-sterile, medical grade, disposable patient examination gloves made of natural rubber latex or synthetic material and are worn during electrolysis treatments and during cleaning procedures to provide a barrier to prevent exposure to potentially infectious materials and other contaminants. The FDA regulates medical grade gloves.

Food-handler gloves: may be worn as a protective disposable barrier over exam gloves during treatment interruption to prevent contamination from touching objects such as knobs, phones, electronic devices, pens, charts etc. These gloves are discarded after each use.

Cleaning and other non-medical gloves: are general purpose, heavy-duty, reusable, puncture resistant utility gloves (e.g., rubber household) that may be used for housekeeping chores such as instrument cleaning and decontamination procedures that involve potential contact with contaminants. These gloves are washed and dried between each use and should be labeled for use by one individual. They should be discarded when showing evidence of deterioration. Utility gloves are not promoted for medical use; therefore, are not regulated by the FDA.

Hand Hygiene: *Plain Soap with warm/room-temp water; The general term that applies to the decontamination process for the removal of soil and transient microorganisms from the hands.

Hospital Disinfectant: chemical germicide with label claims for effectiveness against Salmonella choleraesuis, Staphylococcus and Pseudomonas aeruginosa. Hospital disinfectants may be classified as either intermediate-level or low-level in their spectrum of activity as indicated by label claims. These classes of germicides are regulated by the EPA and are appropriate for environmental or medical surfaces but not as a final step in processing electrolysis instruments.

Indifferent electrode (inactive positive electrode): The stainless steel bar held by the client during electrolysis treatments to complete electric current circuit with galvanic/ electrolysis modality or with the use of a timer delay switch in automatic delivery epilators. Indifferent electrodes are non-critical items.

Instruments: Tools designed to perform a specific function such as grasping, holding or extracting.

Intact skin: Healthy skin in which the natural protective barrier has no breaks, scrapes, cuts, abnormal openings, infection or signs of trauma that allow pathogens to enter.

Lancet: a sharp pointed instrument used for making small openings in the skin. Lancets are single-use and pre-sterilized and must be properly disposed of in a compliant sharps container.

Latex Allergy: A systemic or local allergic response to various latex proteins.

Needle/Probe: The solid wire filament or electrode inserted into the hair follicle for application of electric current during electrolysis procedures. Needles used in electrolysis may come in contact with blood, serum or other material; therefore they should be purchased as pre- sterilized and disposable for one-time use only. Needles should be treated as critical items and properly disposed of in a compliant sharps container.

Needle Holder Cap: The plastic cap holding the shaft of the needle in place on the needle cord. Needle holder caps are considered semi-critical items and may come in contact with blood, serum or other material; therefore the first steps of processing include soaking and cleaning. Heat sensitive caps are white and after initial cleaning are exposed to a high-level disinfectant before reuse. Heat stable caps are black and after initial cleaning should be packaged prior to sterilization.

Non-Critical Items: Instruments or environmental surfaces that will come in contact only with intact skin. If properly cleaned and maintained, these surfaces carry relatively little risk of transmitting infection directly or indirectly to clients.

Non-intact Skin: Areas of the skin that have been opened by cuts, abrasions, dermatitis, acne or other causes which would allow bloodborne pathogens to enter the body.

Packaging: Materials used to contain instruments for sterilization, such as woven or non-woven wraps, paper or film pouches or rigid container systems.

Pathogen (harmful/ minority): A microorganism or substance capable of producing a disease

Phoresis applicators/rollers (galvanic): Made of stainless steel, these items are used to apply current to skin before or after an electrolysis treatment. These items are considered semi-critical and should be sterilized or exposed to a high-level disinfectant.

Plain Soap: A detergent-based cleanser without anti- microbial additives used for the primary purpose of physical removal of dirt, soil and transient microorganisms. Soap is used in handwashing to suspend microorganisms for the purpose of rinsing them off.

Processing: The activity of cleaning, disinfecting or sterilizing contaminated items to render them safe for their intended use.

Protective Disposable Barrier: A disposable, moisture-resistant covering which reduces the potential for contaminating environmental or medical device surfaces that may be difficult or inconvenient to clean and disinfect routinely, e.g., tables and pillows or hard-to-clean surfaces such as light handles and epilator surfaces.

Semi-Critical Items: Items that may come in contact with mucous membranes and non-intact skin but do not ordinarily_ penetrate body surfaces. Semi- critical items require sterilization or exposure to high-level disinfection.

Sharps Container: A specially manufactured and labeled, leak- proof, rigid, puncture resistant, durable plastic container into which needles and lancets are placed after use and designed to be disposed of as an item of regulated medical waste.

Spore: A small usually single-celled reproductive body that is resistant to adverse environmental conditions including heat, drying and chemicals.

Sterility Assurance File: The record containing the sterilizer maintenance and use log and culture report from each biological indicator.

Sanitation: Reduces the level of bacteria

Sterilization (Kills ALL Bacteria): The process of destroying all forms of microbial life (including spores). The recommended methods of sterilization of instruments and items used in the practice of electrolysis are the dry heat sterilizer or the autoclave. These methods are standardized and should be routinely monitored for effectiveness.

Thermolysis = high frequency: Destruction of living tissue in the hair follicle by means of alternating current applied with a solid wire filament or electrode.

Tweezers: The instrument used during electrolysis treatments to remove the hair from the follicle, Tweezers used in electrolysis may come in contact with blood, serum or other material and should be sterilized before each use. They should be treated as critical items.

Ultrasonic cleaner: *Uses protein enzyme detergent. The processing unit using ultrasonic waves transmitted through the cleaning solution in a mechanical process known as cavitation. The sound waves produce tiny air bubbles on instrument surfaces, which scrub tightly adhering or embedded particles from solid surfaces. Ultrasonic cleaning is particularly effective in removing soil deposits from hard- to-reach areas.

Infection Prevention

Section 1: Hand Hygiene

Hand hygiene is considered one of the most important procedures for preventing the transmission of infection.

• Hand-washing uses plain or non-antimicrobial soap, which are detergent based cleansers that have no bactericidal activity.

• Adding soap to a partially empty soap dispenser can lead to bacterial contamination of soap; therefore, liquid products are to be stored in closed containers and dispensed from either disposable containers or containers that are washed and dried thoroughly before refilling.

Hand-sanitizer or Alcohol based products containing 60-95% alcohol are most effective.

• Refer to manufacturer guidelines to know adequate amount of product to use; however if hands feel dry after rubbing together for 10-15 seconds, an insufficient volume of product was likely applied.

• Alcohols are not appropriate for use when hands are visibly soiled or contaminated

• After 5-10 uses of alcohol-based products, handwashing with soap and water is needed to remove a build-up of emollients.

Standard Practice for Hand Hygiene:

1. Hands are cleansed by washing with plain soap and warm water (wet hands first, then apply soap) OR by hand antisepsis with hand sanitizer (if hands are not visibly soiled):

   1. Before and after treatment of client

   2. Before donning gloves and immediately after gloves are removed

2. Hands are washed thoroughly with plain soap and warm water:

   1. When visibly soiled

   2. Immediately if bare-handed contact with blood, body fluids, secretions, excretions, non-intact skin, mucous membranes or contaminated equipment occurs

Handwashing technique with liquid soap and warm water includes:

1. Wet hands with warm running water and apply plain soap in the amount recommended by the manufacturer.

2. Vigorously rub hands together for at least 15 to 30 seconds, covering all surfaces of hands especially between fingers and fingernail areas.

3. Rinse hands thoroughly under warm water.

4. Dry hands thoroughly with a clean disposable paper towel.

5. Turn off faucet with paper towel.

6. Dispose of paper towel in appropriate trash.

Hand antisepsis achieved by using hand-sanitizer includes:

1. Apply the manufacturer recommended amount to palm of one hand

2. Vigorously rub hands together, covering all surfaces, especially between fingers and fingernail area.

3. Continue rubbing hands together for 15-25 seconds until the alcohol dries.

Hand Hygiene Continued (Pgs 150-159)

1. True or False: Its okay to put soap on dry skin.

   1. FALSE; When soap is applied to dry hands, the soap embeds in the pores, blocking the water from entering the pore and ultimately leaving a soapy residue even after thorough rinse.

2. True or False: The more soap, the better.

   1. FALSE; always go with manufacturer recommended use

3. True or False: The warmer the water, the more effective the handwash.

   1. FALSE; Repeated exposure to hot water removes the skins protective oils, thereby increasing the risk of dermatitis, dryness and subsequent skin breakdown.

4. True or False: Rubbing hands together for 10 seconds is adequate handwashing length.

   1. FALSE; At least 15-30 seconds needed

5. True or False: The alcohol in an antiseptic handrub kills microbes and cleans the hands

   1. Partially FALSE; Does kill most microbes quickly, but is not sufficient in removing organic debris and visible soil from hands. Thus, hand washing would be required in many situations

6. True or False: Wearing gloves provides complete protection against acquisition of HBV and Herpes.

   1. FALSE; Greatly reduces risk, however small defects in gloves or contamination of hands during glove removal poses risk to pathogens

7. True or False: I don’t need to use hand hygiene between patient procedures since I’m wearing gloves.

   1. FALSE; Use of gloves does not eliminate need for handwashing and hand hygiene does not eliminate need to wear gloves.

Normal Bacterial Skin Flora

• In 1938, bacteria recovered from the hands were divided into two categories: transient and resident.

• Transient flora: colonizes the superficial layers of the skin, is more responsive to removal by routine hand washing. The organisms more frequently associated with health care associated infections.

• Resident flora: are attached to deeper layers of the skin and are more resistant to removal. Resident flora are less likely to be associated with such infections.

• The hands of HCWs may become persistently colonized with pathogenic flora (i.e. staph, bacilli, or yeast)

How Does Disease Spread? Fecal-Oral, Respiratory, Saliva, Blood

1. Diseases spread through fecal-oral transmission; through the ingestion of even the tiniest particles of fecal material. Thus handwashing after using the toilet is extremely important. Examples: Salmonella, Shigellosis, HPA, Parasites

2. Disease spread through indirect contact with respiratory secretions (coughing and sneezing). Thus, illness may be partially controlled by hand hygiene. Examples: Influenza, Common Cold, Strep, RSV

3. Diseases may also be spread when hands are contaminated with saliva. Examples: Mono, EBV

4. Diseases may also be spread through contact with blood. Examples: HBV (can live for 7 days on inanimate dry object), Hepatitis C, HIV

Transmission of pathogens travel the following routes:

a. Direct contact with either blood, oral fluids, infected skin lesions, or fecal matter

b. Inhalation of airborne microorganisms that can remain suspended in the air for long periods

Agents used for hand hygiene

1. Plain (non-antimicrobial) soap: Detergent-based product excellent for removing grit, grime, dirt, soil, and other organic compounds. Do not contain antimicrobial agents or contain low concentrations that serve as preservatives. Washing with plain soap can remove loose transient flora (not resident flora). Can be associated with skin irritation and dryness.

2. Liquid antimicrobial hand soap: will usually contain the antimicrobial ingredient triclosan

3. Triclosan: usually used in formulation of .25% to 1.0% concentration, although up to 2.0% are well tolerated and do not cause skin reactions. It is more effective against gram-positive bacteria than gram-negative bacteria, is active against mycobacteria, but has little activity against fungi. Studies show it reduces bacterial counts on hands.

4. Alcohol Based Hand Antiseptics: have excellent germicidal activity against gram positive and gram negative bacteria, including multi-drug resistant pathogens mycrobacterium TB, and various fungi. They are flammable.

Hand Hygiene for the electrologist consists of:

1. Handwashing with either pain soap and water or an antiseptic hand wash

2. Decontaminating hands by using an antiseptic rub or antiseptic hand wash

Indications for hand hygiene are as follows:

• Hand wash visibly soiled hands, after using restroom, and before/after eating (avoid eating in treatment room)

• Decontaminate hands before and after treating each patient

• Decontaminate before regloving after removing gloves that are torn, cut or punctured

• Decontaminate after contact with patients intact skin, after contact with body fluids or excreations, mucous membranes, non intact skin, if hands are not visibly soiled

• Decontaminate hands after contact with inanimate objects in the immediate vicinity of the patient

• Decontaminate hands before leaving the treatment room, after blowing or wiping the nose

Section 2: Gloves

Gloving policies applicable to electrologists;

• Gloves prevent heavy contamination of hands; this is considered important because hand-washing or hand antisepsis may not remove all potential pathogens when hands are heavily contaminated

  • Gloves are not sterile;

  • Petroleum can eat at gloves; do not use after handwashing

The following caveats regarding use of gloves must be considered:

• Gloves cannot provide complete protection against hand contamination

• Bacterial flora colonizing on patients may be transmitted to the hands of approx. 30% of HCWs who wear gloves during patient contact

• Wearing gloves does not provide complete protection against acquisition of infections cause by HBV and Herpes

Thus, hands should always be washed after removing gloves; and gloves should not be washed or reused between clients.

• Washing gloves can cause wicking - enhanced penetration of liquid through holes of gloves that would not otherwise leak

Standards of Practice for Use of Gloves:

1. Gloves are worn during hand contaminating activities:

   1. A fresh pair of non-sterile, medical grade disposable examination gloves are worn during the treatment of each client or when contact with blood or other potentially infectious materials could occur

   2. Exam or utility gloves are worn during the procedures of soaking, cleaning, rinsing, drying and packaging of tweezers and other contaminated instruments

2. Decontaminate hands in accordance with hand hygiene standards before putting on gloves and immediately after gloves are removed

3. When treatment session is iterrupted:

   1. Use a protective barrier; or

   2. Remove and discard gloves;

      1. decontaminate hands before touching items or surfaces

      2. decontaminate hands before regloving with a fresh pair of gloves and resuming treatment

4. Torn or perforated gloves are removed immediately; hands are decontaminated then re-gloved with fresh gloves.

5. After each treatment gloves are removed and disposed of in appropriate receptacle (biohazard trashcan when blood is present)

Section 3: Needles

Needles and other sharps must be disposed of in a CDC compliant sharps container. Do not overfill container. When the sharps container is ¾ full, seal it securely and follow state and local health regulations for disposal.

Standard Practice for Needles:

Needles are:

1. Single ude, pre-sterilized, and disposable

2. Stored in a manner that will maintain sterile condition, away from wetness and humidity extremes

3. Not recapped, bent or otherwise manipulated by hand prior to disposal to avoid accidental puncture or injury

4. Placed in puncture resistant sharps container:

   1. immediately after use

   2. when opened and found damaged

   3. when contaminated before use

   4. when not used before pre-printed expiration date

Section 4: Decontaminating Electrolysis Instruments and Other Items

Prevention Measures for Cleaning

cleaning is the basic first step for all decontamination because it physically removes debris and reduces the number of microorganisms present. Cleaning is the removal of organic material or soil from objects and is normally done by using detergent and water. Generally, cleaning is designed to remove rather than kill microorganisms. Immediate decontamination of instruments after use is an important step and providing protection and prevention of the transmission of pathogens.

ultrasonic cleaning units, used with enzyme detergents are examples of appropriate devices, used to clean, electrolysis instruments and items. A meticulous physical cleaning is always done before disinfection or sterilization.

Prevention measures for disinfecting

Chemical disinfectants are regulated by the Food and Drug Administration FDA for medical instrument uses or the Environmental Protection Agency EPA for environmental surface uses.

Disinfectant products are divided into two major types: hospital and general use. Hospital type disinfectants are the most critical to infection prevention and are used on medical and dental instruments, floors, walls, bed, linens, toilet seats, and other surfaces. General disinfectants are the major source of products using households, swimming pools, and water purifiers.

Non-critical equipment and environmental services are cleaned, and then treated with either intermediate level, or low level disinfectants. Intermediate level kills mycobacteria, most viruses, and bacteria with a chemical germicide registered as a “tuberculocide” by the EPA. Low level disinfection kills some viruses and bacteria with a chemical germicide registered as a hospital disinfectant by the EPA.

Standards of practice for decontaminating, electrolysis instruments, and other items

Electrolysis instruments

1. In different electrodes, cords for epilator, and Eye shields are:

2. Cleaned, dried and subjected to intermediate level disinfection before initial use, and after each treatment. Replaced when showing signs of wear and tear.

3. Tweezers, phoresis applicators/rollers and caps are processed:

4. Before initial use and after use on a client. After a 24 hour period when packaging is opened, even if instruments are unused. When contaminated before use such as dropped or placed on the surface, not protected by a barrier.

Processing protocols for tweezers, for phoresis applicators/rollers and needle holder caps.

Instruments and items are:

1. Accumulated in a covered holding container by submersion and a solution of a protein dissolving enzyme detergent and water (following manufacturers instructions for dilution), rinsed and drained

2. Placed in the basket of covered ultrasonic cleaning unit containing a fresh solution of a protein dissolving enzyme detergent (Following manufactures instructions for dilution and ultrasonic running items). Basket is removed from ultrasonic unit, red and drained

3. Air dried on a clean, disposable, absorbent, non-shedding cloth and an area protected from exposure to contaminants

4. Packaged individually or in small multiples as required for one client encounter. Packaging for the sterilization process includes woven or non-woven wraps, paper or film, pouches, or rigid container systems.

5. Placed in an auto clave or dry heat sterilizer with chemical biological indicators, loading and running the sterilizer according to manufacturers instructions. If dry heat sterilizer are used, heat, sensitive, needle holder caps are subjected to a high-level disinfectant, rinsed and dried.

6. Stored, after processing, and a clean, dry, covered container, drawer, or closed cabinet, which prevents the contents from coming into contact with dust, moisture, unnecessary, touching, and soil.

Section 5: Sterilization

Prevention measures for sterilization

Instruments that can penetrate soft tissue during electrolysis procedures are the needle and tweezers. To assure the highest level of client, safety needle should be pre-sterilized, disposable, and single use only. Tweezers should be thoroughly cleaned and sterilized before initial use and after use on each client to reduce the risk of transmission of infection and disease. Needle holder caps are considered semi critical items. For this reason they should be processed in the same manner as tweezers. All caps TOLERATE auto clave sterilization, if dry heat sterilization is used electrologist encourage to use heat stable caps.

Do not use:

The glass speed sterilizer should not be used in the practice of electrolysis since it is no longer cleared to market by the FDA.

Isolyser = Glass Bead Sterilizer

Household bleach is not labeled for disinfecting instruments

Standards of practice for sterilization

Methods of sterilization:

• Dry heat: the following time temperature relationships are recommended.

A) one hour at 340 degrees F (170 degrees C)

B) two hours at 320 degrees F (160 degrees C)

• Auto clave (steam under pressure): The following time pressure relationship is recommended

A) 15-20 minutes at 121 degrees C (250 degrees F and 15psi (pounds per square inch) for packaged instruments and items

• Follow the sterilizer manufacturer instructions for the unit you have if times and temperatures differ from those given

Use of sterilizers:

1. The temperature and exposure time for using dry heat sterilizers and auto clave relates only to the time of exposure after attainment of the specific temperature and does not include a penetration or heat up leg time. Exposure time does not include drying and cool downtime.

2. You sterilizers that are regulated by the FDA

3. Chemical indicator should be used on each package, and optionally, placed inside packages containing multiple instruments. Chemical indicator should be visible on the outside of each package sterilize and indicates that instruments/items have been exposed to a sterilization process, but it does not guarantee sterility.

4. Biological indicator should be used no less than once a month according to manufacturers instructions to ensure proper mechanical functions of sterilizer. Lab report should be filed in a permanent sterility assurance file.

Packaging for sterilization

The packaging material should be able to withstand the physical conditions of the selected sterilization process

Section 6: Environmental Control and Housekeeping

Prevention measures for environmental control, and housekeeping

Hospital grade disinfectants registered with the EPA should be used for environmental surface cleaning. Product labels give the EPA registration number and should give adequate safety and precautionary information.

Environmental surfaces are non-critical. Countertop should be a smooth nonporous material and should be clean daily, taking special care in the areas where the procedures of cleaning and sterilizing instruments and items takes place. Items on countertops should be maintained in a sanitary manner, sinks, and toilet facilities should be clean daily. Non-critical equipment, environmental services, Knobs, telephones, and treatment tables in the treatment room should be cleaned and disinfected on a regular basis. Floors and carpets should be vacuumed and cleaned regularly. Walls, blinds and curtains should be cleaned when visibly soiled.

Standards of practice for environmental control

A proper hygienic environment should be the goal of the electrologist and electrology instructor. Most microorganisms found on environmental services are nonpathogenic, but conscientious disinfection techniques control cross infection.

Each treatment room:

1. Is kept clean, well lighted, and well ventilated

2. Has an available sink with hot and cold, running water, liquid soap, and disposable paper towels

Treatment table surfaces are:

1. Made of materials that can be washed with detergents and treated with disinfectants

2. Covered with fresh, disposable paper, drapes, or barrier before each client treatment in the following manner: when body areas are treated and Bear 🐻 skinCovered with fresh, disposable paper, drapes, or barrier before each client treatment in the following manner: when body areas are treated and bare skin may come in contact with the treatment table surface. The surface must be covered with an appropriate sized fresh disposable paper, drape or barrier.

Follow a septic technique for dispensing products. Follow manufactures recommendations for use.

Standards of practice for housekeeping:

1. An intermediate level or low level hospital grade disinfectant registered within Environmental Protection Agency EPA is used for cleaning non-critical environmental surfaces

2. All other environmental services in the treatment room are kept in a state of visible Cleanliness by cleaning with water and detergent; and using a hospital grade disinfectant/detergent designed for general housekeeping purposes as indicated on the product label

Section 7: Client Considerations

The client skin should be examined for signs of infection or rashes prior to each treatment. Treatment should be delayed if actual or potential signs or symptoms of infection or present. The practitioner should refer the client to an appropriate physician evaluation of health, history or skin examination indicates.

Cleansing the skin with soap and water prior to treatment serves to physically remove dirt. Soil and contaminating microorganisms wiping with an antiseptic will help to inhibit or destroy microorganisms. An FDA regulated ant septic should be chosen that does not cause irritation to skin surface.

Client considerations

Standard precautions should be consistently used for all clients

During the initial consultation: inappropriate health history should be obtained from each client. Each client should be informed of the following: possible causes of hair growth; physical and medical conditions which may influence the outcome of the electrolysis treatments; possible side effects of treatments; recommended post treatment care.

The client health status and contraindications to treatment should be evaluated upon each client visit.

Electrolysis treatment should be postponed when the electrologist or client suspects any contraindication is present, referring the client to a physician is appropriate when suspected contraindications are observed

Section 8: Pre and Post-Treatment

Prevention measures for pre-and post treatment

Skin cleansing products are used to remove make up and other debris from the skin prior to an electrolysis treatment. Soap and water or an alternative skin cleansing product is appropriate for pre-treatment skin cleansing.

Anti septic are antimicrobial products regulated by the FDA and applied to the skin to reduce possibility of infection.They slow or stop the growth of germs and help prevent infections in minor cuts scrapes and burns antiseptics can irritate the skin; therefore they should be you sparingly some commonly used antics or isopropyl alcohol 60 to 70%, benzalkonium chloride and which Hayes 🌷they slow or stop the growth of germs and help prevent infections in minor cuts scrapes and burns antiseptics can irritate the skin; therefore they should be you sparingly. Some commonly used antics are isopropyl alcohol 60 to 70%, benzalkonium chloride and witch hazel with 14% alcohol. While astringent are not affective antiseptics, they are appropriate to use and post treatment.

Standards of practice for pre-imposed treatment

1. Before treatment, the skin site should be cleansed with a skin cleansing product, followed by an antiseptic skin preparation. Skin should be dry before proceeding with the electrolysis treatment.

2. After treatment, the skin site should be wiped with an antiseptic product or an astringent followed by a skin protectant product

3. Client should be instructed on appropriate post treatment care to promote healing of the treated skin site.

Section 9: HBV Vaccination and Hepatitis C

The CDC states that healthcare workers may be at risk for hepatitis B virus (HBV) exposure, a major infectious occupational hazard, if their tasks involve contact with blood or blood contaminated body fluids; therefore, such worker should be vaccinated. The risk of acquiring HBV infection from occupational exposures is dependent on the frequency of a needle through the skin and mucosa exposures to blood or blood products. Risks among healthcare professionals vary during the training and working career, but are often highest during the professional training Period. For this reason, the students vaccination for HBV should be completed before electrolysis training begins.

Section 10: Procedures for Potential Exposures to Hepatitis, HIV and other Blood-Borne Pathogens

Prevention measures for potential exposures:

Careful clinical skills should be practiced, and standard precautions followed to Prevent puncture injury or mucous membrane exposure to blood. Proper management of exposure is necessary, including first aid measures, medical following up, including collection and testing of blood of source person and exposed person, necessary, prophylaxis, and written documentation.

Standards of practice for potential exposures to hepatitis, HIV, and other blood-borne pathogens:

Healthcare workers who have needle punctures through the skin or mucous membrane exposure to blood and other body fluids are at risk for infection, including HBV, HCV and HIV infection. The CDC concludes in a continuing study that, while HIV infection is a real risk to healthcare workers, the risk is low and can be minimized by taking appropriate precautions. Identified risk factors for HIV and HCV transmission are almost identical to those for HBV transmission. Despite the similarities and modes of transmission, the risk of HBV infection in healthcare Settings for exceeds that for HIV or HCV infection.

The following steps should be taken when a puncture injury has occurred:

1. Remove and discard gloves

2. Wash exposed surface with running water and soap if wound is bleeding allowed to bleed after thoroughly cleaning the wound apply and antiseptic product

3. Immediately contact practitioners, Personal physician for appropriate consultation and post exposure strategies

4. Document the exposure, including: date and time of exposure; details of the procedure being performed, including where, and how the exposure occurred; details of the exposure, including the type and amount of fluid or material and the severity of the exposure

Section 11: Standard Precautions as recommended by the CDC

Prevention measures for standard precautions

These precautions should be performed universally for all clients. Standard precautions are intended to prevent mucus membrane and non-intact skin exposures of healthcare workers to blood-borne pathogens. In addition, immunization with HPV vaccine is recommended as an important adjunct to standard precautions for healthcare workers who have accidental exposures to blood.

The following standard precautions are appropriate for the care of all clients during electrolysis treatment:

1. Wash hands or use hand before and after each client contact

2. Gloves, blood, body, fluids, secretions, exertions, contaminated items, mucus, membranes, and non-intact skin.

3. Take care to prevent puncture injuries when using instruments during and after procedures when cleaning instruments and when disposing of use needles.

4. Use adequate procedures for routine care, cleaning, and disinfection of environmental surfaces, and other frequently touch surfaces

5. Follow appropriate sterile procedures with instruments used in the treatment of electrolysis

6. Clean skin pre-and post treatment with appropriate products to prevent infection

Electrolysis procedures do not typically generate splashes or sprays of blood and body fluids; however, electrologist may choose to utilize the following:

1. Wearing mask and eye protection, or a face shield to protect mucous membranes of the eyes, nose and mouth during procedures and clients care that may result in splashes of sprays of blood and body fluids

2. Wearing gown to protect skin and prevent swelling of clothes during procedures that may result in splashes or sprays of blood and body fluids. Remove soiled gown as promptly as possible and wash hands.