Transcript cleaning
Infection Prevention Title & Control How clean is your house? Decontamination of equipment and the environment Anita Watson Lead Nurse Infection Prevention and Control NHS North Lancashire Title Decontamination Decontamination of the environment and reusable medical devices is essential to reduce the risk of transmission of infection to staff and residents There must be systems in place to ensure that reusable medical devices have been effectively decontaminated. Equipment MUST always be cleaned prior to maintenance service, repair or return to the manufacturer. Title Decontamination Guidelines • Manufacturers’ guidelines must always be checked prior to carrying out decontamination. • Protective clothing must be worn to reduce the risk of cross contamination and exposure to chemicals. Three processes of decontamination Title Decontamination is the combination of processes, including cleaning, disinfection and sterilisation used to render a reusable item safe for use on clients or handled by staff. Title Cleaning The removal of deposits by washing with hot water and a neutral detergent, followed by thorough drying with disposable paper towels. This removes dirt, grease and organic matter. Cleaning must always take place prior to disinfection or sterilisation. Title Disinfection Kills or inactivates organisms but not all bacterial spores. A chlorine releasing agent, for example Hypochlorite, is suitable for disinfection. Title Sterilisation Removes all organisms including spores. This is absolute; an item of equipment is either sterile or not sterile. Title Risk Assessment The level of decontamination required is determined by the type of equipment and the risk it poses for transmission of infection. Manufacturers’ guidelines must always be followed. Title Decontamination and re-processing of equipment Low risk • Items in contact with intact skin. Cleaning • Removal of accumulated deposits, by washing with a cleaning solution. This reduces the number of organisms and removes dirt, grease and organic matter. Medium risk • Items that do not penetrate the skin, but are in contact with mucous membranes or non-intact skin. • Low risk items contaminated with virulent organisms. Disinfection • Partial removal or destruction of organisms, except spores. This reduces the number of organisms present. High risk • Items in contact with broken skin/ mucous membranes, or introduced into sterile body areas. Sterilisation • Complete removal or destruction of all organisms including spores. Cleaning must always proceed disinfection and sterilisation. 5.7 Title Decontamination environment Decontamination must take place in a suitable environment. The care home should have a safe environment for the effective decontamination maintenance and storage of equipment which ensures that dirty and clean equipment never come into direct or indirect contact. Title Decontamination area Separate area - to prevent cross contamination. • Double stainless steel sink unit - equipment can be washed and then rinsed. • A hand wash sink which must not be used for washing equipment. • Alcohol hand gel - quick, easy, convenient method to rapidly disinfect hands if access to hand washing facilities is not available. • A drying area must be available Title Storage Area • There must be a storage area for clean equipment which has been labelled to show that it has been cleaned. This must be a secure area protecting against the elements, pests and rodents and large enough for the volume of equipment. Title Soft furnishings Recliner chairs etc.- prior to purchasing ensure that equipment is able to be cleaned. Title Mattresses, cushions and seating products Check weekly for signs of leakage into the foam no staining must be visible the equipment must be impermeable to fluids. To test - place a paper towel beneath the cover, press down on the mattress or cushion for 10 seconds, pour 50ml of water onto the area, press down for a further 30 seconds. Remove and examine the paper towel for signs of leakage through the cover. Ensure that covers are placed correctly onto the cushion or mattress after cleaning. Title Hospital mattress Enclosed in a wipeable cover - clean with detergent Dry thoroughly with disposable paper towel. Store dry. Specialist beds - take care to avoid “electrics”. Specialist mattresses and cushions - launder cover in washing machine following manufacturers’ instructions. Ensure it is dry prior to replacing on the foam. Check mattress/cushion for signs of staining and also test cover for permeability. Title Lifting and transfer equipment Examine for signs of wear e.g. chipped or rusted surfaces the item must be condemned and not reused. Clean as instructed. Use steamer if necessary for intricate areas. Dry with disposable paper towel and store dry. Slings and slide sheets - launder in washing machine following manufacturers’ instructions Title Cleaning toilets and raisers etc Clean with a neutral detergent and hot water and disposable cloths or disposable detergent wipes. During outbreak follow by disinfection using chlorine releasing agent diluted to a concentration of 1,000 parts per million. Dry with disposable paper towelling. Label with clean indicator tape. Store dry. Title Cleaning commodes Do not forget to clean underneath and foot rests. Must be examined for signs of wear for example chipped or rusted surfaces. If found the item must be condemned and not reused Title Title Infection Prevention Title & Control Cleaning a body fluid spillage • • • • • Protective clothing Hypochlorite granules 1% hypochlorite solution Orange bag N.B carpets and soft furnishings will have to be steam cleaned. Title Everyone’s responsibility to ensure safe reuse. Be careful of “single patient use”. Remember careful consideration before purchasing equipment! Single use means single use. Title • Any Questions? • Anita Watson • [email protected] • 01524 519440 Title Title Legionnaire’s disease is a form of lung infection spread through the air via contaminated water droplets/aerosols Title • True • Legionnaire’s disease is a form of lung infection caused by the bacteria Legionella. Common sources are air conditioning unit, cooling towers, swimming pools and spas. Title • Which disease with less severe symptoms is caused by the same bacteria as Legionnaire’s disease? Title • Pontiac fever is a mild flu like illness caused by Legionella bacteria. As with Legionnaire’s disease, symptoms can include fever, headaches and muscle aches, but Pontiac fever does not cause pneumonia. Pontiac fever normally clears up without treatment within 2-3 days. Title How is Legionnaire’s disease spread? • Person-to-person • Airborne from water source • Inoculation Title • Legionella bacteria grow and multiply within warm moist environments. Breathing in aerosols from a contaminated water system, for example, showers and spa pools is the most likely root of transmission. Person-to-person spread does not occur. Title For at least how many minutes should you run a shower every day to protect yourself and patients from Legionella bacteria? • 1 • 2 • 3 Title • Legionella like to colonise and contaminate hot water systems, spa baths and showers. Before using the shower, allow the hot water to run for at least 2 minutes every day before use. Title • Cleaning is a process that aims to remove contamination from reusable medical devices and equipment • True or false Title • True Title What is the essential first step in preparing reusable medical devices for disinfection? Title • Cleaning Title What process makes a reusable medical device free from viable microbes including bacterial spores and viruses? • Cleaning • Disinfection • Sterilisation Title • Sterilisation Title Disinfection is used to decontaminate what type of items? • High risk • Medium risk • Low risk Title • Medium risk Title • What types of micro-organisms are part of our essential normal skin flora, but are potentially dangerous during invasive procedures? Title • Resident Title • Why should wristwatches, rings and jewellery be removed before washing your hands? Title • Because they attract micro-organisms that can be transferred to patients/clients and may cause infections. Title • Handwashing is the cornerstone for preventing the spread of infection Title • True Title What reason do health and social care workers give when challenged for not washing their hands? • Not enough time • Lack of facilities • I wear gloves so my hands don’t need to be washed Title • All of the above Title • The thumb, fingertips and between the fingers are most frequently missed during hand washing Title • True Title • What is the key reason for drying hands thoroughly after hand washing? Title • You should dry your hands because micro-organisms are more easily transferred on wet or damp surfaces Title What is the most effective method for drying hands after washing? Title Paper towels – paper towels rub away transient micro-organisms and dead skin cells and remove bacteria from deeper layers of the skin by friction Title How many moments are there in The World Health Organization’s (WHO) activity that aims to add value to any hand hygiene improvement strategy? Title 5