Unit E Master Outline

Unit F: Infection Control

Program Area: Health Occupations Education

Course Title: Allied Health Sciences II Number: 7212

Unit Title: Health Care Systems

Suggested Time for Instruction: 10 hours

Course Percent: 4%

Unit Evaluation: 50% Cognitive and 50% Performance

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Competency: 2H06. Apply infection control measures in a clinical setting.

Specific Objectives:

2H06.01 Analyze principles of infection control.

2H06.02 Maintain sterile technique and isolation.

Summer 2000 F.1 Unit F Master Outline

Unit F: Infection Control

2H06 Apply infection control measures in a clinical setting.

2H06.01 Analyze principles of infection control.

A. Basic principles (disease transmission) 1. Microorganism 2. Pathogen/non-pathogen 3. Bacteria 4. Protozoa 5. Fungi 6. Rickettsiae 7. Viruses 8. Aerobic/anaerobic 9. Endogenous/exogenous/nosocomial/opportunistic 10. Chain of infection 11. Asepsis B. Handwashing * C. Standard precautions 1. HBV/HIV 2. OSHA regulations

2H06.02 Maintain sterile technique and isolation.

A. Sterilization 1. Use of autoclave 2. Wrapping instruments for autoclave * B. Disinfection 1. Chemical disinfection 2. Boiling water 3. Ultrasonic unit C. Using sterile technique 1. Principles 2. Opening sterile packages 3. Sterile gloving * 4. Sterile dressing change D. Isolation 1. Types of isolation 2. Donning and removing isolation garments *

Unit F Infection Control

Summer 2000 F.2 Competency 2H06: Apply infection control measures in a clinical setting.

Materials/Resources

Simmers, Louise. Diversified Health Occupations. Delmar Publishers, 4th edition.

National HOSA. HOSA Handbook, Section B. Published annually by the Health Occupations Students of America, Flower Mound, Texas.

GloGerm Kit -May be purchased from: School Health Corporation 865 Muirfield Drive Hanover Park, IL 60103 1-800-323-1305 x 176

Microslides and Viewers may be purchased through various science catalogs. For example:

Schoolmasters Science 745 State Circle, Box 1941 Ann Arbor, MI 48106 Phone orders: 1-800-521-2832

Carolina Biological Supply Co. 2700 York Road Burlington, NC 27215 1-800-334-5551 www.carolina.com

Here are web sites you may want to use as resources for OSHA and infectious diseases: www.osha.gov www.cdc.gov

Teaching/Learning Indicators: The following symbols are used to indicate specific skills/areas required in the instructional activity.

 Reading  Social Studies  Writing  Science  Math  The Arts  Health professional/parent/community involvement

Objective 2H06.01 Analyze principles of infection control.

A. Basic principles (disease transmission) 1. Microorganism

Summer 2000 F.3 2. Pathogen/non-pathogen 3. Bacteria 4. Protozoa 5. Fungi 6. Rickettsiae 7. Viruses 8. Aerobic/anaerobic 9. Endogenous/exogenous/nosocomial/opportunistic 10. Chain of infection 11. Asepsis B. Handwashing * C. Standard precautions 1. HBV/HIV 2. OSHA regulations

Teaching/Learning Activities

 Basic Skills  Have students complete the first two columns of the modified K-W-L Activity on the “Principles of Infection Control.” (Appendix 2H06.01A) Then, have students read Unit 12 in Diversified Health Occupations, pgs. 216-220, to complete the third column.

 Employability Skills  Invite a health professional to talk to the class about Standard Precautions, OSHA regulations, and HBV/HIV. Suggestions include an Infection Control Nurse, representative from the American Red Cross or an environmental health professional.

Have students take notes during the speaker’s presentation.

 Teamwork  Have students work in pairs. Provide sealed slides of microorganisms for students to view under a microscope or a MicroSlide©.

Note: This may be a good activity to integrate with a science teacher.

Invite a medical technologist to assist with the activity and discuss their career.

 Critical Thinking  Have students role-play situations related to standard precautions. (Appendix 2H06.01B)

 Cognitive  Have students complete the worksheet, “Infection Control Review" as a review of principles for infection control. (Appendix 2H06.01C)

Summer 2000 F.4 Objective 2H06.01 Analyze principles of infection control.

Teaching/Learning Activities (Continued)

 Employability Skills  After learning the proper technique for handwashing and successfully demonstrating the skill (Appendix 2H06.01D) have students teach younger students about handwashing using the GloGerm kit.

 Special Needs Each student will reach the highest level of mastery in the least restrictive environment as recommended in the student’s IEP.

Summer 2000 F.5 Objective 2H06.02 Maintain sterile technique and isolation.

A. Sterilization 1. Use of autoclave 2. Wrapping instruments for autoclave * B. Disinfection 1. Chemical disinfection 2. Boiling water 3. Ultrasonic unit C. Using sterile technique 1. Principles 2. Opening sterile packages 3. Sterile gloving * 4. Sterile dressing change D. Isolation 1. Types of isolation 2. Donning and removing isolation garments *

Teaching/Learning Activities

 Cognitive  Have students listen to a teacher-led presentation on sterilization, disinfection, and using sterile technique.

 Basic Skills  Have students read pages 252-259 on isolation practices, and complete the "Isolation Matching" worksheet. (Appendix 2H06.02C)

 Employability Skills  Invite a guest speaker to discuss isolation. Appropriate guest speakers may include a medical assistant or physician/nurse who specializes in infection control, communicable diseases, or burn treatment.

 Teamwork  Following instruction and demonstration on wrapping instruments for autoclave (Appendix 2H06.02A), sterile gloving (Appendix 2H06.02B), and donning and removing isolation gowns (Appendix 2H06.02D), have students practice the skills in pairs with their partner evaluating each procedure.

 HOSA  Following the guidelines for Extemporaneous Health Poster, have students create a poster following a topic provided by the teacher.

 Special Needs Each student will reach the highest level of mastery in the least restrictive environment as recommended in the student’s IEP.

Summer 2000 F.6 Daily Lesson Plans

Unit F: Infection Control Lessons: 6 Hours: 10 clock hours

Steps Lesson #1 Lesson #2 Lesson #3 Focus and Have students write a short answer Have students take a sheet of Have students exchange papers Review to the question, “What do you paper and tear it into 6 pieces and grade “Infection Control know about microoganisms?” labeled B (Bacteria), F (Fungi), P Review” in class. (Protozoa), R (Rickettsiae) and V (Virus). Then, call out infectious diseases. Students should select and hold up the correct paper. Statement of 2H06.01 Analyze principles of 2H06.01 Analyze principles of 2H06.01 Analyze principles of Objectives infection control. infection control. infection control.

Teacher Discuss students’ answers to the Review correct answers to K-W-L Demonstrate handwashing. Input focus and review question. activity. After students have a chance to practice, complete skill check-off. After the guided practice activity, Lecture on Standard Precautions provide slides of microorganisms (overheads in appendix) Have students listen to a teacher- (using microscopes or Microslide led presentation on use of an viewer) and have students identify In groups, have students role-play autoclave and disinfection. different kinds and shapes of “Standard Precaution Scenarios” microorganisms.

Guided Have students complete the first Have students review concepts of Practice handwashing. Practice two columns of the K-W-L Infection Control in pairs, then try activity “Principles of Infection to answer as many questions on Control.” the “Infection Control Review” as possible. Once they complete the first two columns, they should read the chapter on Infection Control and then complete the third column.

Independent Complete the K-W-L assignment Complete the “Infection Control Have students read the DHO Practice for homework. Review” as homework. sections on using an autoclave, and disinfection.

Closure Ask students to name one thing Have all students stand. Start Ask students to answer the they learned about around the room with one student question – considering what microorganisms that they found naming an infectious disease and you’ve learned about surprising, or that they had never the next the causative organism. handwashing, how will you react heard before. Keep going around the room until in clinical areas when you see there is one student standing. health professionals NOT Provide a reward. following handwashing rules? Materials DHO Overheads/projector DHO K-W-L worksheet Worksheet – Infection Control Overheads/projector Microscopes with slides and/or Review Handwashing skill sheets MicroSlide viewer. Rewards Sink, soap, towels & hand brushes

Unit F: Infection Control (Continued)

Summer 2000 F.7 Steps Lesson #4 Lesson #5 Lesson #6 Focus and Ask students to evaluate Call on students to share answers Students will share their poster Review "handwashing opportunities" in to the homework assignment. with the class in review for the our school. test.

Statement of 2H06.02 Maintain sterile 2H06.02 Maintain sterile 2H06.02 Maintain sterile Objectives technique and isolation. technique and isolation. technique and isolation.

Teacher Have students listen to a teacher- Invite a guest speaker to talk about Test on “Infection Control.” Input led presentation on sterile isolation in a health care setting, technique and changing sterile and demonstrate donning and If time permits, grade the test in dressings. removing isolation garments. class.

Demonstrate wrapping instruments Using Extemp Health Poster for autoclave, sterile gloving, and guidelines, have students create a opening a sterile package. poster depicting one aspect of Infection Control.

Guided Practice wrapping instruments for Practice donning and removing After test, complete any check-offs Practice autoclave and sterile gloving. isolation garments. (skills) that have not been completed. Teacher will do check-offs on Teacher will complete check-offs handwashing, wrapping for skills remaining in this unit. instruments, and sterile gloving as students have mastered the skills. Students will work on their posters when not performing skills for Note: Teacher will demonstrate evaluation. opening a sterile package and sterile dressing change. Students do not need to be checked off on those two skills.

Independent As a homework assignment, have Finish Extemporaneous Health Practice students complete the worksheet Poster. on "Isolation: Fact or Fiction." Study for the test.

Closure Ask students to go home and teach Review important aspects of Tell students you will be a young child the proper way to isolation technique. beginning the Emergency skills use a bandaid – keeping the pad unit - and to look over the section sterile. in DHO.

Tell students to bring one sheet of poster board to class the next day.

Materials DHO Isolation supplies Tests Overheads/projector Skill check-lists Answer Keys Materials for wrapping instruments Materials for sterile gloving Unit F: Infection Control Terminology List

Summer 2000 F.8 1. Aerobic 2. Anaerobic 3. Antisepsis 4. Asepsis 5. Autoclave 6. Bacteria 7. Boiling water 8. Cavitation 9. Chain of infection 10. Chemical disinfection 11. Clean 12. Communicable disease 13. Contaminated 14. Disinfection 15. Endogenous 16. Exogenous 17. Fungi 18. Isolation 19. Microorganism 20. Nonpathogens 21. Nosocomial 22. Opportunistic 23. Pathogens 24. Protective (reverse) isolation 25. Protozoa 26. Rickettsiae 27. Standard precautions 28. Sterile 29. Sterile field 30. Sterilization 31. Ultrasonic 32. Viruses

Summer 2000 F.9 Name ______Date ______

Principles of Infection Control

Terms What I Know What I Want to Know What I Learned

. Pathogens

. Bacteria

. Protozoa

. Fungi

. Rickettsiae

. Viruses

. Aerobic/ Anaerobic

. Endogenous

. Exogenous

. Nosocomial

. Opportunistic

. Asepsis

Appendix 2H06.01A

Standard Precaution Scenarios

What should be used to protect health care workers? You should act out the following scenarios in small groups.

1. Stephanie is a new CNAI at Byrd General Hospital. As she walks into Room 541, she observes Mrs. Branch sitting in bed, holding her catheter in one hand and the side rail with the other. Blood is on the bed linens, siderails and floor. She yells “I couldn’t take another minute of pain with this thing sticking in me. I want to see Dr. Stubbs, now!”

2. Michael is attending phlebotomy school at night. He has been informed that gloves are a must when performing venipuncture.

Michael is mentoring with Mrs. Hill, a MLT for 24 years. Upon entering the room of a gravely ill patient with a very productive cough, Mrs. Hill gets out a syringe, blood tubes, tourniquet, alcohol swabs, gauze and a bandaid. As Mrs. Hill applies the tourniquet, Michael asks “What about your gloves?” Mrs. Hill states, “I’ve been doing it like this for 24 years without any problems, and I can feel the vein better this way.”

3. Louisa is cleaning the room of a recently discharged tuberculosis patient. As she cleans the overbed table, she notices soiled wet tissues in the drawer, dried blood on the tray, and a suction liner still in the canister on the wall. Shen she moves the trashcan, she also finds a syringe with a needle intact lying on the floor.

4. Larry has decided to register for ASHII next year. Before he enters the hospital, several requirements must be met. He is not very happy because it means getting “shots” – and Larry has always been terrified of needles.

5. Stan needs to collect a sputum specimen from the patient in room 118 who is HIV positive. After collecting the specimen, he takes the cup and places it on the counter by the phone in order to complete the lab slip before taking the specimen to the lab.

6. Samantha and Carlita are Allied Health Sciences II students. They are helping a patient ambulate. The patient is recovering from a mild left-sided CVA. The patient states “I feel like I’m going to pass out” and suddenly stops breathing and falls to the floor. Samantha starts CPR while Carlita screams for help.

Appendix 2H06.01B

Infection Control Review

1. Why does the body temperature increase when a person has an infection?

2. Should a health care worker who refuses the vaccine for Hepatitus B because of religious reasons be allowed to work as a hospital lab technician?

3. Efforts are made to get patients home from hospitals as soon as possible. What type of infection would be reduced by early discharge?

4. Fill in the blank with the most appropriate type of aseptic control?

a. Surgical instruments ______b. Human hands ______c. Hypodermic needles ______d. A hospital bed ______e. Bedpan ______f. An abrasion on the knee ______

5. What type of equipment would a medical office buy in order to sterilize instruments?

6. Give four examples of portals of entry, and an example of an infection that could result?

7. Sometimes, severe infections are treated by placing a person in a hyperbaric chamber. What type of infection would that be?

8. Fill in the blank with the most appropriate classification of infection or disease?

a. Hypothermia ______b. Pneumocystis carnii ______c. One transmitted by a health care worker ______d. Kaposi’s sarcoma ______e. Diabetes ______f. Sun poisoning ______g. Pseudomonas ______

Appendix 2H06.01C

Summer 2000 F.12 ANSWER KEY: INFECTION CONTROL REVIEW

1. Why does the body temperature increase when a person has an infection? Higher body temperatures kill bacteria

2. Should a health care worker who refuses the vaccine for Hepatitis B because of religious reasons be allowed to work as a hospital lab technician? Yes. Risk is to the health care worker, not the patient

3. Efforts are made to get patients home from hospitals as soon as possible. What type of infection would be reduced by early discharge? Nosocomial

4. Fill in the blank with the most appropriate type of aseptic control?

a. Surgical instruments sterilization b. Human hands antisepsis c. Hypodermic needles sterilization d. A hospital bed disinfection e. Bedpan disinfection f. An abrasion on the knee antisepsis

5. What type of equipment would a medical office buy in order to sterilize instruments? Autoclave

6. Give four examples of portals of entry, and an example of an infection that could result? Break in the skin = infected cut Respiratory tract = pneumonia Digestive tract = food poisoning Genitourinary tract = cystitis

7. Sometimes, severe infections are treated by placing a person in a hyperbaric chamber. What type of infection would that be? Anaerobic

8. Fill in the blank with the most appropriate classification of infection or disease?

a. Hypothermia Exogenous b. Pneumocystis carnii Opportunistic d. One transmitted by a health care worker Nosocomial d. Kaposi’s sarcoma Opportunistic e. Diabetes Endogenous f. Sun poisoning Exogenous g. Pseudomonas Nosocomial and exogenous

Name ______Date ______

Summer 2000 F.13 2H06.01D HANDWASHING

MASTERY YES NO

1. Removed jewelry ______

2. Turned faucet on with paper towel and adjusted temperature ______

3. Wet hands and wrists thoroughly with fingertips pointing down ______

4. Applied soap to get lather on hands ______

5. Rubbed all surfaces of hands together several times ______

6. Interlaced fingers on both hands and rubbed them back and forth ______

7. Cleaned nails with an orange/cuticle stick and/or hand brush ______

8. Rinsed hands with fingertips pointed downward ______

9. Dried hands thoroughly, from tips of fingers to wrist ______

10. Turned faucet off with dry paper towel ______

11. Discarded towel(s) in wastebasket without contaminating hands ______

12. Did not lean against sink or touch inside of sink ______

------TOTAL ______

Mastery = 100% Yes Non-Mastery = Below 100%

Date ______Evaluator ______

Comments:

2H06.02A WRAPPING INSTRUMENTS FOR AUTOCLAVE

MASTERY YES NO

1. Gathered equipment ______

2. Washed hands ______

3. Thoroughly cleaned items in soapy water and rinsed in cool water ______

4. Selected appropriate size wrap ______

5. Positioned wrap at a diagonal ______

6. Placed the item(s) in the center of the wrap, hinged instruments open ______

7. Added internal autoclave indicator (if used) ______

8. Folded the bottom corner to center, folded back tab ______

9. Folded right corner to center, folded back tab ______

10. Folded left corner to center, folded back tab ______

11. Assured that edges were sealed, no air pockets ______

12. Brought the final corner up and over the package ______

13. Tucked this into pocket created by previous folds, leaving a small corner exposed ______

14. Checked edges to be sure they are sealed and tight ______

15. Secured with autoclave tape ______

16. Labeled tape with date and contents ______

------TOTAL ______

Comments:

2H06.02B STERILE GLOVING MASTERY YES NO

1. Assembled equipment ______

3. Opened outer wrapper handling only the outside ______

4. Opened inner wrap: a. Handled only outside of wrap ______b. Maintained sterility of wrap and gloves ______c. Positioned with cuff end toward self ______

5. Donned first glove correctly: a. Grasped inside of glove with thumb and forefinger ______b. Lifted glove out and inserted other hand ______c. Donned glove while maintaining sterility ______

6. Donned second glove correctly: a. Puts sterile gloved hand under cuff ______b. Lifted glove out and inserted other hand ______c. Donned glove while maintaining sterility ______

7. Straightened cuff: a. Put gloved hand under cuff, pulling up and out ______b. Maintained sterility of glove ______

8. Removed gloves correctly: a. Removed first glove by grasping outside with the other gloved hand ______b. Pulled glove down over hand ______c. Removed second glove by placing ungloved hand inside the cuff ______d. Pulled glove down over hand ______e. Pulled glove inside out while removing ______f. Put contaminated gloves in proper waste container ______

------TOTAL ______Mastery = 100% Yes Non-Mastery = Below 100%

Comments:

Isolation: Fact or Fiction?

Fill in the blank with "Fact" if the statement is true about isolation practices, or "Fiction" if the statement is NOT true. Be prepared to share the "true story" for the statements you mark as fiction.

______1. Isolation precautions always require the use of a gown, gloves and a mask. ______2. Isolation techniques are used for all hospitalized patients. ______3. Before gloving, remove rings and put them in your pocket or pin them to your uniform. ______4. Two people are required to take equipment out of an isolation unit. ______5. Many agencies use special isolation linen bags that dissolve in the washing machine. ______6. Protective isolation is the same thing as reverse isolation. ______7. A special two-room unit is necessary for isolation. ______8. Isolation is a method of caring for patients with a communicable disease. ______9. A patient with tuberculosis would be placed on Contact Precautions. ______10. Gloves should be removed after leaving an isolation room. ______11. A severely burned patient would be placed on Contact Precautions. ______12. It is best to leave patient care equipment (stethoscope, sphygmomanometer, etc.) in the room of an isolation patient. ______13. If you are wearing a mask in an isolation room and you sneeze, the first thing you should do is wash your hands. ______14. Gloves should be tucked under the sleeve of the isolation gown. ______15. The inside of a contaminated gown is considered clean. ______16. Metal utensils used for meals should be washed and remain in the isolation room for the next meal. ______17. After you've been in an isolation unit, the neck and waist ties of the gown are considered contaminated. ______18. Special filters are used in all isolation rooms to filter the air. ______19. A young, female health care worker who is susceptible to measles should NOT enter the isolation room of a patient with measles. ______20. A patient with severe viral influenza would not be placed on isolation. Appendix 2H06.02C

Summer 2000 F.17 ANSWER KEY: Isolation: Fact or Fiction?

Fill in the blank with "Fact" if the statement is true about isolation practices, or "Fiction" if the statement is NOT true. Be prepared to share the "true story" for the statements you mark as fiction.

Fiction 1. Isolation precautions always require the use of a gown, gloves and a mask. Fiction 2. Isolation techniques are used for all hospitalized patients. Fact 3. Before gloving, remove rings and put them in your pocket or pin them to your uniform. Fact 4. Two people are required to take equipment out of an isolation unit. Fact 5. Many agencies use special isolation linen bags that dissolve in the washing machine. Fact 6. Protective isolation is the same thing as reverse isolation. Fiction 7. A special two-room unit is necessary for isolation. Fact 8. Isolation is a method of caring for patients with a communicable disease. Fiction 9. A patient with tuberculosis would be placed on Contact Precautions. Fiction 10. Gloves should be removed after leaving an isolation room. Fiction 11. A severely burned patient would be placed on Contact Precautions. Fact 12. It is best to leave patient care equipment (stethoscope, sphygmomanometer, etc.) in the room of an isolation patient. Fact 13. If you are wearing a mask in an isolation room and you sneeze, the first thing you should do is wash your hands. Fiction 14. Gloves should be tucked under the sleeve of the isolation gown. Fact 15. The inside of a contaminated gown is considered clean. Fact 16. Metal utensils used for meals should be washed and remain in the isolation room for the next meal. Fiction 17. After you've been in an isolation unit, the neck and waist ties of the gown are considered contaminated. Fiction 18. Special filters are used in all isolation rooms to filter the air. Fact 19. A young, female health care worker who is susceptible to measles should NOT enter the isolation room of a patient with measles. Fiction 20. A patient with severe viral influenza would not be placed on isolation.

2H06.02D Donning and Removing Isolation Garments

MASTERY YES NO

1. Assembled equipment ______

3. Removed rings ______

4. Placed watch in a plastic bag or on a paper towel ______

5. Put on mask correctly ______

6. Rolled up uniform sleeves (If needed) ______

7. Put on gown correctly: a. Kept hands inside shoulder ______b. Worked arms into sleeves ______c. Adjusted neck with hands inside neck band ______d. Tied at neck first ______e. Tied at waist ______f. Handled only inside of gown ______

8. Put on gloves correctly ______

REMOVAL OF GARMENTS

9. Untied waist ties of gown first ______

10. Removed gloves: a. Used gloved hand to grasp outside of opposite glove ______b. Pulled glove off inside out ______c. Placed hand under cuff to removed second glove ______d. Pulled glove off inside out ______e. Placed gloves in proper waist container ______

11. Washed hands thoroughly, operated faucet with towel ______

12. Removed mask, handling ties only, disposed of properly ______

13. Removed gown last: a. Untied neck ties ______b. Placed hand inside cuff and pulled sleeve over hand ______c. Placed covered hand on outside of gown, pulled gown sleeve over ______d. Eased out of gown gently ______e. Folded gown inside out and rolled it up ______f. Disposed of gown appropriately ______g. Touched only inside of gown ______2H06.02D Donning and Removing Isolation Garments (continued)

Summer 2000 F.19 14. Washed hands thoroughly ______

15. Removed watch from towel or plastic bag without contamination ______

16. Opened door with towel, discarded towel in waste can ______

17. Washed hands immediately ______

------TOTAL ______

Comments:

Summer 2000 F.20 Standard Precautions

. Sometimes called “Universal” precautions . Used to break the chain of infection . Pathogens spread by blood and body fluids - Hepatitis B (HBV) - Human immunodeficiency virus (HIV)

. OSHA passed regulations in 1991 requiring all health care facility employers to:

- Determine which employees will have exposure to blood and body fluids - Provide Hepatitis B vaccine free to employees with exposure risk (or signed refusal) - Provide personal protective equipment (PPE) such as gloves, gowns, lab coats, masks, and face shields - Provide adequate handwashing facilities and supplies - Ensure clean & safe work environment - Follow decontamination protocol for contaminated surfaces - Dispose of infectious wastes correctly - No eating, drinking, smoking, handling contact lenses, applying lip balm, etc. in risk area

Summer 2000 F.21 Bioh azard

Biohazard

- Provide color-coded containers labeled for sharps and other infectious wastes - Post signs in work areas where this is exposure risk - Provide medical evaluation & follow-up for employees who’ve had an exposure incident - Provide training about the regulations to all employees at no cost during working hours

Summer 2000 F.22 Standard precautions rules are developed by the CDC and FDA.

1. All body fluids should be considered potentially infectious 2. All patients should be considered potential sources of infection 3. Wash hands before and after any patient 4. If any surface comes in contact with blood or body fluids, wash immediately and thoroughly 5. Wash hands after removal of gloves 6. Wear gloves whenever contact with blood or body fluids is possible 7. Change gloves after contact with each patient 8. Gloves should not be reused 9. Gowns should be worn during any procedure with risk of splashing blood or body fluids 10. Masks and protective eyewear to be worn during procedures that may produce blood or body fluids 11. Extreme care should be taken while handling sharp objects. (Do not bend, break or recap needles. Dispose of them in puncture-resistant containers.)

Summer 2000 F.23 12. Spills or splashes of blood or body fluids should be wiped up immediately. Wear gloves, and use a disinfectant solution.

13. Mouthpieces or resuscitation devices should be used to avoid the need for mouth-to-mouth resuscitation. 14. Know the requirements for disposal of waste materials and dispose of wastes in the proper container. 15. Report any cut, injury, needle stick, or splashing of blood or body fluids immediately.

Summer 2000 F.24 Sterilizing with an Autoclave

 Uses steam under pressure or gas  Destroys ALL microbes, pathogenic and nonpathogenic – including spores & viruses  Before wrapping, instruments must be clean  Wraps must allow for penetration of steam - Muslin - Autoclave paper - Special plastic or paper bags - Autoclave containers  Indicators are used to ensure articles have been sterilized - Autoclave tape, sensitivity marks on bags or wraps, indicator capsules - Indicator will change appearance when sterile  Autoclave must be loaded correctly  Amount of time depends on the article to be sterilized – usually 15 – 30 minutes  If wrap becomes torn or wet, it is contaminated  Expires in 30 days

Summer 2000 F.25 Disinfection

 Chemicals frequently used for aseptic control  They do not kill spores & viruses so it’s not sterilization  Used to disinfect instruments that don’t penetrate body tissue: - dental instruments - percussion hammers - thermometers  Examples: - 90% isopropyl alcohol - formaldehyde-alcohol - 10% bleach solution - Lysol - Zephiran  Boiling water disinfects but does not sterilize  Satisfactory for home care where instruments/supplies used for one person only  Usually 15-30 minutes  Ultrasonic unit – used in dental & medical offices to disinfect  Uses sound waves to produce millions of microscopic bubbles  Cavitation – bubbles hit instrument and explode, driving cleaning solution into article

Summer 2000 F.26 Sterile Technique - Principles

 Surgical Asepsis – procedures that keep an object or area free from living organisms  Sterile – free from all organisms, including spores and viruses  Contaminated – organisms/pathogens are present  A clean, uncluttered work area necessary when working with sterile supplies  Sterile field – sterile area – never reach across a sterile field – reach in from the side  Never turn your back on a sterile field  2-inch border of sterile field is considered contaminated  Common techniques: - Drop technique - Mitten technique - Transfer forceps  Keep sterile field dry (pathogens travel through wet) and be careful when pouring fluids  Be sure sterile field is open and ready before putting on sterile gloves  Sterile gloves are contaminated on the inside – once on, keep hands away from body and above waist  When in doubt, consider it contaminated

Summer 2000 F.27 Opening Sterile Packages

 Check to be sure the sterile package has not expired  Open the distal end and pull it away from you, reaching around the package, not across  Open the sides without touching the inside wrapper  Pull the bottom down toward you  Drop technique  Mitten technique  Transfer forceps

Summer 2000 F.28