Module 4- INFECTION PREVENTION.pdf

Regulation and standards INFECTION PREVENTION Introduction Infection prevention is an evidenced-based practice that prevents and controls the spread of microorganisms in both healthcare and the community sittings. The main aim is to prevent the healthcare workers as well as the patients from catchin...

Regulation and standards INFECTION PREVENTION Introduction Infection prevention is an evidenced-based practice that prevents and controls the spread of microorganisms in both healthcare and the community sittings. The main aim is to prevent the healthcare workers as well as the patients from catching avoidable infection. The central sterile supply officers, service significant role in the prevention of surgical site infection and healthcare associated infection. Understanding the importance of the CSSD officer’s role will have an impact on surgery successful rate, the length of hospital stay or hospital readmission due to infection that may lead to death. This online module provides the returning science students with an overview of Infection Control and an understanding of “standard precautions” and environmental standards to reduce the transmission of infectious agents. Learning Objective 1. Understand the infection control and its role in the CSSD. 2. Understand the role The Role of central sterile supply officers in implementing the infection prevention. 3. Explain the “chain of infection” and routes of transmission. 4. Demonstrate proper hand hygiene and PPE 5. Understand basic Principles Of Asepsis. Learning Outcomes By the end of this module the student should be able to: 1. Demonstrate the use of appropriate personal protective equipment (PPE). 2. Educate the central sterile supply officers on the importance of proper hand hygiene. 3. Understand the Personal Hygiene and Attire of each zone. Sharing Our Stories How our acquired knowledge related to Reusable Medical Devices has an impact on Surgical Site infection (SSI) “CSSD as profession was a taboo to me and to other healthcare personals it was based on acquired knowledge or experience from a former CSSD works or an OR Nurses. It was not an interesting topic to me until I had a surgical site infection postoperatively. Regulation and standards I decided to enroll myself in the CSSD program by the Saudi Council and worked as central sterile supply officers in one of the most prestigious Healthcare organizations in the Kingdom of Saudi Arabia. During my clinical experience I realized that CSSD has a great impact in preventing surgical site infection during postoperative such as my pervious condition” —A Science who later became a central sterile supply officers. History and the Advancement of the Central Sterile Supply Department. The concept of CSSD was eveoled during the world war II but it wasn't untill 1928 when the american College of Syrgeon stablished a Central Sterile Supply Department within their Hospital. This stablishment was well defind by the Nuffield Provincial Hospital Trust in United Kingdom. 1982 1955 • American College of Surgeon • Combridge Military Hospital Belfast NufRield Provincial Hospital Trust (UK) CSSD was stablished in every hospital The development of the Central Sterile Supply was based in the needs of the hospitals of aseptic technique and properly Reprocessed Medical Devices during the medical procedures. Although that some items are sterile from the source and labeled as single use most of the reusable medial devices must be thoroughly reprocessed as per the Association for the Advancement of Medical Instrumentation (AAMI) and the infection Prevention and control Standers. The Role of central sterile supply officers in preventing Infection 1. Process instruments and equipment in accordance with the AMMI standers to make them safe for handling and prepare them for a biocidal process. 2. Ensuring that sterile supplies maintain sterility and record event related sterility. 3. Inspect surgical instruments to ensure safety usage and functionality 4. Keeping detailed records of number of sterilized items, including Autoclave cycle numbers, lot/batch numbers, expiration dates for future tracking of items that has been sterilized, and stored. Regulation and standards Why Infection is a concern in CSSD? In 2011, the Centers for Disease Control and Prevention (CDC) reported that approximately one of every 25-hospitalization patient, or 722,000 contracted a Hospital Acquired Infection (HAI). Of those approximate of 25,000 patients died during their hospital stay. Most of theses infection may have been preventable. The plan of the CDC is to decrease 17 percent in select surgical site infections (SSI). A surgical Site Infection (SSI) is an infection that occurs postoperatively on the surgical wound where they operation was done and according to the CDC three out of 100 surgeries will develop these infections every year. Trends in surgical site infections (SSI) in hospitals, 2006 – 2014 Source: CDC’s National Healthcare Safety Network (NHSN) Reference: Berríos-Torres, SI. et al., Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection. JAMA Surg, 152(8): (2017):784-91. CDC Top HAI Causing Pathogens Coagulase-negative staphylococci Enterococcus species Escherichia coli Pseudomonas aeruginosa Enterobacter species Klebsiella oxytoca Methicillin resistant staphylococcus aureus Staphylococcus aureus Candida species Clostridium difficile Klebsiella pneumoniae Acinetobacter baumannii Vancomycin resistant staphylococcus aureus Tuberculosis (TB) Reference: http://www.cdc.gov/HAI/organisms.html Regulation and standards The Chain of infection Infectious agent (pathogen) Susceptible host Reservoir Portal of entry into a host Portal of exit from the reservoir Mode of transmission 1. Infectious agent (pathogen) is defined as the pathogen that causes the infectious disease e.g. virus, bacteria, fundi or prions. 2. Reservoir is the second element in the chain of infection. It's the filed or the environment where the agent can live and survive. 3. Portal of exit is the path that the agent uses to leave the reservoir. Example for the port of exit is a) the skin, b) blood, c) respiratory track and d) Transplacenta. 4. Mode of transmission is defined as the pathway that the pathogen takes to spread and this is can be via two methods: a) Direct contact and b) Indirect method. Direct contact is the result of transferring the microorganisms from and infected patient to uninfected patient via blood transfer or body fluid. Indirect contact is the result of transferring the microorganisms via contaminated items/objects or contaminated hands of healthcare worker to uninfected patient. 5. Portal of entry into a host is the path that the infectious agent takes to enter into the suspected host. Slimier to the portal of exit this can be via a) the skin, b) blood, c) respiratory track and d) Transplacenta. 6. Susceptible host is the six link of the chain of infection and its defined as the susceptibility of the person to fight the infection or to get infected. Regulation and standards This is an example with the pictures. No references available The basic Principles Of Asepsis The principles of asepsis in infection prevention are based on the knowledge of the nature and characteristics of the microorganisms and their ability in producing the disease. This includes the microorganism’s method of transmission within the healthcare environment. In general, there are two types of Aseptic Technique: Regulation and standards Medical Asepsis: I. known as Clean Technique II. Procedures carried to reduce the number of the microorganisms III. e.g Hand Hygiene and decontamination of equipment Surgical Asepsis: I. Known as Sterile technique II.Procedures carried to eliminate the presents of all the microorganisms III. e.g. Sterilization of Surgical Instruments Basic principles of asepsis is of reprocessing reusable medical devises are divided into five principles: I. know what is dirty e.g. Opend surgical instruments II. Know what is clean Manual/ Mechanical cleaning removes soil andmost of the microorgnism III. Know what is sterile IV. Keep the three conditions separate V. Remedy contamination immediately Sterility is deRind as the absence of all microbes Must Separate the dirty, clean and sterile If layout not deRind must be corrected immediately e.g. DeRind Layout of the CSSD If dirty, clean and sterile items are mixed the situation must be corrected immediately Cleanliness is the basis of the aseptic technique e.g. Used suction machine e.g. any times clean via manual or michanical washing E.g. Steam Sterilization or Low Temperature Sterilization Personal Hygiene and Attire CSSD personals must adhere to the PPE as required per OSHA as illustrated below Regulation and standards Hand Hygiene a.Handwa shing 4060 sec b. Hand rub 20-30 sec Head Cover a. covers the head and ears Gloves a. Approved for the CSSD. b.Must be think with longer cuffs Mask a. Protects the mouth Fluidresistant gown a. Protects the skin Goggles /Face shield a. Protects they eyes Long Sshoe Covers a. To protect the shoes from contami nation Managing the Central Sterile Supply Department’ Environment The important step to maintain the CSSD environment is to control the traffic throw the main three zones and to strictly maintain the proper heating, ventilation, and air conditioning (HVAC) systems. Decontamination Zone Negative pressure (- 5 Pascal) ± 5% Preparation & Packaging Zone Positive pressure (+ 5 Pascal) ± 5% Sterilization Zone Positive pressure (+ 5 Pascal) ± 5% 10 air changes per hour at least 10 air changes per hour at least 4 air changes per hour at least Temperature 18 °C to 20 °C 20 °C to 23 °C 20 °C to 24 °C Humidity Relative humidity 30% to 70% Humidity up to 70% Air Pressure Air Changes 30% to 70% Time to complete the Module: 1 to 2 days Regulation and standards Key points: The CSSD personal has a major role in maintain infection prevention and the process of preventing and controlling infection. Their role is to protecting the lives of the healthcare workers and the patients. At the end of this module, the students will be able to: • Understand the infection control and its role in the CSSD. • • • • Understand the role of central sterile supply officers in implementing the infection prevention guidelines. Explain the “chain of infection” and routes of transmission. Demonstrate proper hand hygiene and PPE for the CSSD as per the OSHA. Understand basic Principles Of Asepsis. Regulation and standards References I. II. Centers for Disease Control and Prevention. (2016, January 7). Transmission-based precautions. Centers for Disease Control and Prevention. Retrieved August 27, 2022, from https://www.cdc.gov/infectioncontrol/basics/transmission-based-precautions.html Centers for Disease Control and Prevention. (2016, January 7). How infections spread. Centers for Disease Control and Prevention. Retrieved August 27, 2022, from https://www.cdc.gov/infectioncontrol/spread/index.html III. Centers for Disease Control and Prevention. (2016, January 7). Transmission-based precautions. Centers for Disease Control and Prevention. Retrieved August 27, 2022, from https://www.cdc.gov/infectioncontrol/basics/transmission-based-precautions.html IV. Centers for Disease Control and Prevention. (2019, July 22). Air. Centers for Disease Control and Prevention. Retrieved August 27, 2022, from https://www.cdc.gov/infectioncontrol/guidelines/environmental/background/air.html