Transcript Chapter10 Infection control

Chapter 10
Infection Control and
Safe Handling of
Hazardous Agents
Edited by Dr. Ryan Lambert-Bellacov
INFECTION CONTROL
• Development of the Germ Theory of Disease:
The identification of microorganisms as a cause
of infectious disease is a surprisingly recent
development. Pasteur was the originator of the
theory. In one experiment, he successfully
immunized chickens against chicken cholera.
Edited by Dr. Ryan Lambert-Bellacov
INFECTION CONTROL
• Micoorganisms and Disease: Since the days of
Pasteur, thousands of pathogenic, or diseasecausing, microorganisms have been identified.
Bacteria, fungi, viruses, and protozoa are
examples of microorganisms that can be
harmful.
INFECTION CONTROL
• Asepsis and Sterilization: The preparation of
parenteral products, especially those for IV
administration, requires special aseptic
techniques, equipment, and procedures to
minimize contamination. Various types of
sterilization are available to kill
microorganisms from medical instruments,
devices, and surfaces.
Usually describe bacteria by
the shape
Edited by Dr. Ryan Lambert-Bellacov
INFECTION CONTROL
• Contamination: Accidental exposures require
immediate treatment, cleanup, reporting to the
supervisor, and completion of an incident
report. Contanination can occur in a pharmacy
by three primary means: touch, air and water.
ASPTIC TECHNIQUE AND
USP CHAPTER 797
Aseptic technique is used for the preparation
of parenteral admixtures, combinations of
fluids and/or medications or nutrients,
which are administered using bolus (i.e.,
push) or other intravenous (IV) methods.
Table 10.1 summarizes the steps in detail.
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
1. Remove all jewelry (e.g., watches,
rings, bracelets, necklaces.
Table 10.1
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Aseptic Technique
2. Put on non-shedding coats, gowns,
or coveralls (hospital scrubs); head
and facial hair covers; face masks; and
shoe covers. Note that it is important
to follow the sequence of items
indicated in this step.
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
3. Scrub hands and arms to the elbows
thoroughly with an antiseptic cleanser
(e.g., povidone-iodine or chlorhexidine
gluconate).
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
4. Clean the laminar flow hood with
isopropyl alcohol. The alcohol must
remain in contact with the surface for
30 seconds prior to compounding any
sterile product.
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
5. Place only essential materials under
the airflow hood—no paper, pens, or
labels. Remove the selected syringe(s)
from its overwrap, attach a needle,
then discard the waste.
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
6. Scrub again and glove.
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
7. Swab or spray needle-penetration
closures on vials, injection ports, and
other materials.
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
8. Prepare the sterile product by
withdrawing the medication from vials
or ampules and introducing it into the
IV container.
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Aseptic Technique
9. Complete a quality check of the
product for container integrity and
leaks, solution cloudiness, particulates,
color of solution, and proper
preparation of product.
Table 10.1
Aseptic Technique
10. Present the product, the containers
and devices used, and the label to a
pharmacist for verification of the
product preparation.
Table 10.1
Edited by Dr. Ryan Lambert-Bellacov
Handling Issues
Safety Note!
• When working in the pharmacy lab clean
room, it is important to wear appropriate
sterile gear, including face mask, full head
covering, scrubs or gown with back closure,
and gloves.
Edited by Dr. Ryan Lambert-Bellacov
Figure 10.2
Figure 10.3
Handling Issues
Safety Note!
• Coughing and talking should be directed
away from the hood.
Edited by Dr. Ryan Lambert-Bellacov
HANDLING AND DISPOSAL
OF HAZARDOUS AGENTS
• Receipt and Storage of Hazardous
Agents: Hazardous drugs should be
delivered directly to the storage area,
inventoried, and, if necessary, refrigerated.
Access to storage areas and work areas for
hazardous materials should be limited to
specified trained personnel.
Edited by Dr. Ryan Lambert-Bellacov
HANDLING AND DISPOSAL
OF HAZARDOUS AGENTS
• Protective Clothing: A disposable, lintfree, nonabsorbent, closed-front gown with
cuffed sleeves should be worn. Hair and
shoe covers should be worn to reduce the
potential for particulate contamination.
Other protective clothing would include eye
protection, mask, and use of latex gloves
when disposing of damaged packages.
HANDLING AND DISPOSAL
OF HAZARDOUS AGENTS
• Technique for Handling Hazardous
Agents: Hazardous drugs such as cancer
chemotherapy require special techniques,
equipment, and procedures to protect the
health of the employee.
• Hazardous Agent Spills: Accidental
exposures require immediate treatment,
cleanup, reporting to the supervisor, and
completion of an incident report.
HANDLING AND DISPOSAL
OF HAZARDOUS AGENTS
• Procedures in Case of Exposure: Any
body area exposed should be flooded with
water and thoroughly cleansed with soap
and water. Dispose of contaminated
garments appropriately in specially
designated biohazard materials containers.
Edited by Dr. Ryan Lambert-Bellacov
HANDLING AND DISPOSAL
OF HAZARDOUS AGENTS
• Hazardous Oral Dose Forms: The
counting and pouring of these drugs should
be done carefully, and contaminated
equipment such as counting trays should be
immediately cleaned with detergent and
rinsed. Compounding with any of these
drugs should be done in a protected area
away from drafts and traffic.
Handling Issues
Safety Note!
• With hazardous drugs, inject a volume of air
that is no more than 75% of the amount of
drug to be withdrawn.****
Edited by Dr. Ryan Lambert-Bellacov
Handling Issues
Safety Note!
• Back in the Game Sports Medicine is a
clinic dedicated to the treatment of physical
injuries to the body. Caring for an injured
body involves more than making the
diagnosis; it's about understanding and
treating the cause to prevent future injuries.
The clinic addresses variety of injuries to
Edited by Dr. Ryan Lambert-Bellacov