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Health Skills I Unit 101.3 Standard Precautions Sterile Field & Gloving Sterilization Packaging.

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Presentation on theme: "Health Skills I Unit 101.3 Standard Precautions Sterile Field & Gloving Sterilization Packaging."— Presentation transcript:

1 Health Skills I Unit 101.3 Standard Precautions Sterile Field & Gloving Sterilization Packaging

2 Objectives Identify practices of aseptic technique. Demonstrate ability to implement infection control through hand washing, standard precautions, packaging, for sterilization, preparing a sterile field and sterile gloving.

3 Standard Precautions designed to reduce the risks of transmission from both recognized and unrecognized sources of infection Precautions apply to: – *all blood & body fluids – *all body secretions and excretions (except sweat) – *non-intact skin – *mucous membranes

4 Follow Standard Precaution Guidelines when touching body fluids, or there is a potential of body fluid splatters, barriers must be worn this is a standard written by Occupational Safety and Health Administration (OSHA)

5 OSHA mandates that healthcare workers comply with all the safety standards mandates that employers provide and comply with the safety standards

6 OSHA Standards facilities are inspected for compliance & major fines are imposed for violations healthcare workers are mandated to attend yearly bloodborne pathogens training 29CFR Part 1910.1030 is the portion of the code pertaining to safety practices in the healthcare industry

7 Fundamentals of Standard Precautions Handwashing – single most important measure to reduce the risk of transmitting microorganisms from person to person or site to site – OSHA mandates handwashing be done before and after each patient contact, and before applying gloves and after removal of gloves

8 Protective Barriers to reduce the risk of bloodborne pathogen exposure, barriers are to be worn when appropriate: – gloves – gowns – boots – masks – protective eyewear – hats/caps

9 Protective Barriers

10 Gloves worn for three reasons: to provide a protective barrier to reduce transmission of disease from hands to patients to reduce likelihood of transmission of disease from patient to patient – wearing gloves does not replace need for handwashing

11 Gloves 3 Types – sterile worn during sterile procedures to maintain sterility and during invasive procedures to prevent contamination – exam worn as a barrier – utility gloves worn for custodial purposes

12 Protective Barriers Non-latex Latex Exam Gloves

13 Sterile Gloves Sterile Gloves worn during sterile procedures

14 Utility Gloves Utility gloves are worn for custodial activities. Disinfect gloves after each use. Replace when torn.

15 Masks – cover mouth and nose – worn when there is potential splatter of blood or body fluids to mucous membranes of eyes, nose and mouth – reduces risk of transmission of bloodborne pathogens – specific types of masks for airborne diseases (wear the correct one)

16 Masks – if tuberculosis is suspected or diagnosed, NIOSH approved, Hepafilter or N95 mask is required Masks that meet standards

17 Goggles/Eye Shields – worn during procedures that are likely to generate splashes or sprays of blood or body fluids to the eyes

18 Protective Face Barriers

19 Gowns worn to reduce the risk of contamination of clothing and skin from blood and body fluid exposures – the gown must be made with impermeable or fluid resistant material

20 Boots & Shoe Covers Required in specialty areas: – surgery – special procedure rooms – trauma center during specific procedures that will produce splash & splatter of blood and other body fluids

21 Hats/Caps Required in specialty areas of: – surgery – special procedure rooms – trauma center during specific procedures that produces splash & splatter of blood and other body fluids

22 Beware! risk of transmitting nosocomial infections is often highest before a definitive diagnosis is made, therefore: – use standard precaution barriers for all patients – carefully monitor signs & symptoms – familiarize yourself with the isolation standards in your facility and use them appropriately. Work smart

23 Isolation in Hospitals Purpose – to decrease the risk of transmission of microorganisms within the hospital by: protecting infected patient from further infection protecting uninfected patients, visitors & staff minimizing the spread of infection compliance with isolation standards is a must to minimize disease transmission

24 Psychological Effect of Isolating Patients patient may feel dirty or contaminated limits number of visitors may elicit fear from relatives and friends limits ability to move about freely adds to cost of hospital bill adds stress may feel sense of hesitation from caregiver elderly and children feel lonely

25 Waste Disposal specimens of blood, tissue or other potentially infectious (OPI) materials shall be placed in a biohazard, leakproof bag for collecting, storage, handling, transporting and processing

26 Biohazard Wastes – Includes items that: are dripping with blood drip blood when squeezed, unfixed body tissue (know facility policies) – *biohazard wastes placed in red biohazard bags and labeled – *managed by a biological waste firm

27 Biohazard Wastes – *DO NOT pick up broken glass with hands. Wear utility gloves & use dustpan w/broom or forceps Contaminated broken glass

28 Contaminated Sharps Biohazard Waste must be placed in puncture resistance container immediately after use must be clearly labeled in accordance with OSHA standards Sharps Containers

29 Biohazard Waste Disposal all regulated waste shall either be incinerated, treated with chemicals or decontaminated by an autoclave to destroy bloodborne pathogens

30 Linen – contaminated laundry to be handled as little as possible – minimum agitation – bagged in appropriately labeled bags prior to transport to laundry facilities If soaked, must be placed in leakproof laundry container

31 Blood Spills contaminated work surfaces shall be decontaminated immediately or as soon as feasible after any spill of blood or infectious material with appropriate disinfecting solution

32 Blood Spills Must be cleaned with: – *professional disinfecting solution or – *10% bleach solution (made fresh daily)

33 Housekeeping workplace must have appropriate written schedule for housekeeping: – based on activity and soil present – cleaned immediately after blood spill – broken glass must be picked up with mechanical device and placed in sharps container – this is an OSHA regulation

34 Biohazard Signs when this label is present, there is a potential risk of bloodborne pathogen contamination within the container or area designated

35 Biohazard Signs OSHA mandates the following when signs are present: – no eating/drinking in designated area – no smoking in designated area – no application of make up and lip balm in designated area – no handling of contact lenses in designated area – no storage of food/drink in coolers/refrigerators that are preserving biohazard products

36 Sterile Field Definition – a designated area prepared with sterile drape & equipment from which a sterile procedure will be conducted. This area is free of all microorganisms Sterile drape serves as sterile field Sterile gauze Sterile instrument

37 Sterile Field How to determine if an item is sterile: – disposable items have manufacturer’s endorsement, & must be free of holes, wetness or stains

38 Sterile Field How to determine if an item is sterile: indicator (arrows, dots, bars), change color when sterilized wrappers must be free of holes, wetness, stains check expiration dates when appropriate INDICATORS that have changed color DO NOT INSURE STERILITY Indicator arrows

39 Indicators and Biological Monitors

40 Shelf Life Sterile Equipment “Timed Shelf Life” standards are frequently used when packages are sterilized in-house (reusable items) when pharmaceuticals are inside of a sterile package, the Timed Shelf Life standards must be used and consider the expiration date of the pharmaceutical when labeling

41 Shelf Life Sterile Equipment Timed Shelf Life considers: – type & configuration of package – number times package is handled Manufactures recommend only 3 touches: – remove from sterilizer to storage shelf – remove from storage shelf to procedure site – open to use – storage area (open or closed shelves) – environmental conditions (cleanliness, temperature, humidity) – use of dust covers (or not) – date indicated

42 Shelf Life Sterile Equipment “Event-Related Shelf Life”: – recognizes that product remains sterile until some event causes item to be contaminated – commercial manufactures of sterilized items use Event-Related standards – sterile items should be placed on shelf in order to ensure the oldest item is used first when using Event-Related standards

43 Shelf Life Sterile Equipment products such as latex gloves and specialized catheters may degrade over a period of time. It may become hard, dry and crack. This must be taken into account, as quality of the item may no longer be effective don’t stock-pile these types of products

44 Shelf Life Sterile Equipment regardless of standard used to determine sterility, the assessment process is the same: – *check for wetness, tears, stains, soil, cracks! – *check date when appropriate! – *check indicator when appropriate! there must be consistent policies & procedures throughout facility to satisfy the accreditation boards

45 Preparing and Wrapping – purpose of wrapping is to prevent recontamination during storage and handling – material used for wrapping should not tear or puncture easily, or allow for penetration of organisms – materials should open easily to prevent contamination

46 Materials used to Wrap Equipment for Sterilization double thickness disposable paper/or reusable cloth with sealed plastic dust cover rigid containers manufacturer’s wrap paper peel pouches

47 How to Wrap wear exam gloves check items for cleanliness wrap on clean and dry surface wrap according to procedure label package and date according to procedure

48 Examples of Materials


50 What is Sterile? inside 1” border of sterile package contents of package if not contaminated by improper technique Red line indicates 1” border of each package

51 What is NOT Sterile? outside of package outside 1” border of inside of package any part of drape used as field that hangs over edge of surface hosting the sterile field Drape hanging over edge of table is NOT sterile

52 Sterile Field Don’ts Do not walk away or turn your back on a sterile field Do not cough, sneeze, talk or chew gum over the sterile field Do not reach/lean over sterile field Do not spill on a sterile field Do not use fans in areas of sterile fields Do not set up a sterile field on a contaminated surface

53 Sterile Field Don’ts Do not touch anything inside the 1” border of the sterile field or package unless it is sterile Do no put sterile items below your waist. They will be contaminated Do not use anything that you have a doubt about the sterility Do not take it personally if someone identifies a break in sterile field technique

54 Examples of Sterile Procedures Nursing – urinary catheters, wound care, surgery, trach suctioning, etc. Respiratory Therapy – suctioning Medical Asst. – minor surgery Physical Therapist Asst. – wound care Occupational Therapy Asst. – wound care Dental Asst. – tooth extractions Dental Hygiene – certain cleaning procedures Surgical Technology – all surgical procedures

55 Cleaning Procedures For Cleaning Instruments: – wear utility gloves – rinse instruments after procedure – scrub with soap and brush or use ultrasonic cleaner – check grooves and hinges for residual material – rinse thoroughly to remove soap – dry thoroughly before wrapping and sterilization takes place

56 Cleaning Procedures a wet instrument placed into an Ethylene Oxide Sterilizer will cause an explosion when the sterilizer is processing

57 Ultrasonic Cleaner

58 Sterile Gloves Key Factors: sterile gloves should be worn during sterile procedures to: – maintain the sterility of the equipment being used – prevent cross contamination of patient during invasive procedures

59 Applying Sterile Gloves Key Factors : – select the correct size – hands should be washed & dried before & after gloves – open gloves on clean/dry surface – touch only the outer 1” border of inside wrapper – use “dominant” hand to pick-up the opposite glove first

60 Applying Sterile Gloves Key Factors: – gloves must be applied above the waist to maintain sterility – do not apply gloves over any sterile field (including own wrapper) – do not allow a gloved thumb to touch gloves during application – gloves are placed in wrapper with the thumbs up – keep gloved hands above waist

61 Removing Gloves Key Factors: – keep gloves away from face – think “dirty to dirty”! Don’t reach inside 1st glove to remove, pinch outside of glove only – don’t use ungloved thumb on dirty 2nd glove

62 Removing Gloves Key Factors: – “A dirty glove should not touch an uncovered part of your body” – “An uncovered part of your body, should not touch a dirty glove” – Be SAFE

63 Knowledge assessment List all protective barriers. Compare and contrast the different types of gloves. Discuss items to be placed in biohazard waste, waste receptacles, and restrictions where biohazard signs are placed. Define sterile field. Discuss time and event related self-life considerations. Discuss what areas are and are not sterile.

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