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Instrument Decontamination Methods for Prevention of infection


Instrument Decontamination Methods for Prevention of infection Dr. Aidah Abu Elsoud Alkaissi An Najah National University Instrument Decontamination Methods for ... – PowerPoint PPT presentation

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Title: Instrument Decontamination Methods for Prevention of infection

Instrument Decontamination Methods for Prevention
of infection
  • Dr. Aidah Abu Elsoud Alkaissi
  • An Najah National University

Instrument Decontamination Methods for Prevention
of infection
  • Instrument should be immediately submersed in
    water or a germicidal solution at the close of
    the procedure to prevent blood and other
    substances from drying on the surface or in the
  • The cleaning method should be economic and must
    be provide protection fromcross-contamination
    damage to the instrument and injury to the worker
  • Washed and sterilized instruments are inspected,
    reassembled(To fit together the parts or pieces
    of) into sets, placed in containers or wrapped
    and sterilized stored for future used

Mechanical Washing
  • During surgical procedure instrument should be
    kept as free of body substances (bioburden) as
    possible by wiping off the gross material with a
    moistened sponge
  • Sterile water is selected because saline causes
    corrosion and deterioration of the instrument
  • All instruments that can be immersed are placed
    in a basin, disassembled or box locks opened
  • and covered with water or a detergent/germicidal

Mechanical Washing
  • Mathods may be selected for decontamination of
    instruments and equipment
  • To cover and transport all items used during the
    surgery to a centralized location for processing.
  • The cover should be watertight and remain intact
    during transport to the central decontamination
  • Examples of covers include case carts (A small
    wheeled vehicle typically pushed by hand),
    plastic bags impervious (Incapable of being
    penetrated) surgical drapes (To cover, dress, or
    hang with or as if with cloth in loose folds)
  • Soiled instruments should be handled by gloved

Mechanical Washing
  • Appropriate apparel for personnel in the central
    decontamination area includes scrub attire, cap
    and mask, protective eye wear, a waterproof apron
    or coverall suit and long, cuffed, heavy-duty
    rubber gloves
  • Upon arrival the instruments are uncovered,
    arranged loosely in an open mesh tray with the
    lightest instruments on the top and placed
    directly into a washer sterilizer

Mechanical Washing
  • If gross debris is present a hand prewash in a
    detergent/germicide solution is recommended
  • When decontaminated instruments are removed from
    the washer-sterilizer they transported to the
    ultrasonic cleaner

Instrument decontamination
  • When a centralized area is not available,
    autoclave in the substerilizing room, the other
    involves a thorough hand washing
  • The later is time consuming, less efficient and
    higher in labor expense

Ultrasonic Cleaning
  • Once the terminal strilization is complete the
    second phase of instrument processing with an
    ultrasonic cleaner may begin
  • This process removes tenacious soil that remains
    on instruments after they have been mechanically
    or manually washed
  • By cavitation process debris and material are
    removed from all surfacesof the instrumantation
  • Most manufactures instructions warn against
    placing instruments to dissimilar metals (as
    stainless steel, coppar titanium) in the
    ultrasonic cleaner at the same time

Ultrasonic Cleaning
  • Ultrasonic cleaning is not recommended for some
    delicate instruments, chrome-plated instruments
  • Then instrument are inspected and all movable
    parts are lubricated with an antimicrobial, water
    souble lubricant to protect against rusting,
    staining (To discolor, soil, or spot), or
  • Instruments then rearranged into sets, placed in
    containers or wrapped and sterilized or stored
    for future used

Sterilization Methods for Prevention of Infection
  • Methods of sterilization of surgical items must
    result in complete destruction of microbial life,
    including spores, and the absence of toxic
    residue on the objects as well as little or no
    deterioration or damage to treat and moisture
    sensitive instruments

Sterilization Methods for Prevention of Infection
  • Steam sterilization
  • Saturated steam under pressure is recognized as
    the safest most practical means of sterilizing
    surgical supplies, fluids , the majority of
    instruments and other inanimate (Not having the
    qualities associated with active, living
    organisms. See Synonyms at dead) objects

Theory of microbial destruction
  • Microorganisms destroyed by moist heat through a
    process of denaturation (To change the nature or
    natural qualities of) and coagulation of the
    enzyme-protein system within the bacterial cell
  • Microorganisms are killed at a lower temperature
    when moist heat is used than when dry heat is used

Theory of microbial destruction
  • When steam comes in contact with a cold object,
    condensation takesplace immediately
  • As the steam condenses it gives off latent heats
    and wets the object

Principles and mechanismof steam sterilization
  • In conventional steam sterilizer, the
    sterilization process may be divided into 5
  • Loading phase, in which the objects are packaged
    and loaded in the sterilizer
  • Heating phase, in which the steam is brought to
    the proper temperature and allowed to penetrate
    around and through the objects in the chamber
  • Destroying phase, or the time-temperature cycle,
    in which all microbial life is exposed to the
    killing effects of the steam
  • Drying and cooling phase, in which the objects
    are dried and cooled, filtered air is introduced
    into the chamber, the door is opened and the
    objects are removed and stored
  • Testing phase in which the efficiency of the
    sterilization process is checked

High speed (flash) sterilization
  • Referred to a flash sterilizer, adjusted to
    operate at 132 degree
  • It can be used for sterilizing packs and
  • Most frequently used in the operating room for
    urgently neededunwrapped instrument
  • Please read figure 5.10

Prevacuum, high-temperature sterilization
  • Accomplished by mean of an air-blasted
    (destructive force ), oil-sealed rotary pump,
    protected by a condenser and coupled with an
    automatic control mechanism
  • Please read Figure 5.11

Boiling water (nonpressure)
  • Boiling does not sterilize instruments
  • Heat resistant microorganism, bacterial spores
    and certain viruses can withstand (resist or
    confront with resistance)
  • boiling water at 100 degree for many hours

Dry Heat Sterilizatin
  • Rarely used in hospitals today
  • As the proteins become dry during exposure to dry
    heat, their resistace to denaturation increases,
    for this reason, at a given temperature,, dry
    heat sterilization is much less effective than
    moist heat

Chemical Sterilization
  • New material that cannot be heat sterilized are
    continually being introduced for use in
    hospitals, they require the use of other methods
    of sterilization
  • Restricted to ethylene oxide ( a gaseous
    chemosterilizer) and aqueous glutaraldehyde ( a
    liquid chemosterilizer)
  • Refered to as cold sterilization
  • This term refers to the maximum temperature of 54
    C to 60 of gaseous sterilization as compared
    with 121 C to 132 C temperature of steam

Gaseous chemical sterilization
  • to sterilize of heat-labile and moisture
    sensitive items as intricate (having many
    complexly arranged elements), delicate surgical
    instruments, large pieces of equipment used in
    the hospital, plastic and porous (able to absorb
    fluids) materials, all of which are difficult to
    steam sterilize without deterioration and damage

Gaseous chemical sterilization
  • Ethylene oxide is the most frequently used gas,
    odor similar to ether
  • Has inhalation toxicity similar of ammonia gas,
    kept as a liquid
  • Item that can be steam sterilized should never be
    gas sterilized

Liquid chemical sterilization
  • Destroy all forms of microbial life, including
    bacterial and fungal spores, tuercle bacilli and
  • Aqueous glutaraldehyde and aqueous formaldehyde
  • aqueous formaldehyde rarely used because it takes
    12-24hto be effective
  • Aqueous glutaraldehyde 2 useful in the
    disinfection of lensed instruments such as
    cystoscope and bronchoscopes because it has
    minimal deleteriuos (Harmfu) effects on the lens
    cement and noncorrosive
  • Instruments must be free of bioburden and
    completely immersed an activated Aqueous
    glutaraldehyde solution for 10 hto acheive
  • Following immersion instruments must be rinsed
    thoroughly with sterile distilled water before
    being used
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