2. CHAPTER 6 Microbiology-Related Procedures
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3. Introduction Medical waste Requires special handling
Infectious
Non-infectious
Requires special handling
Proper procedures necessary for obtaining culture from appropriate body site without contamination
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4. Infectious Waste Disposal
Solid or liquid wastes may cause disease if improperly handled, treated, transported, stored, or disposed
Examples of waste: body fluid, items coming in contact with body fluids/blood
Handle with gloves
Place in biohazard container for disposal in sanitary landfill per local/state rules and regulations
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5. Types of Infectious Waste
Non-sharp
Biological liquid wastes
Pathological wastes
Patient care items
Sharp
Needles or IV tubing with needle attached
Scalpel blades
Glassware
(Continues)
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6. Types of Infectious Waste
Disposal of non-sharp items
Wearing gloves, place waste in red infectious waste biohazard bags
If bag ¾ full, seal, place in disposal container
Discard liquids per local/state Department of Health regulations
Place liquids in leakproof container in red infectious biohazard bags
Remove gloves/wash hands
(Continues)
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7. Types of Infectious Waste
Disposal of sharp items
Wearing gloves, place sharps in disposable sharps container located at point of use
Never recap needles
Seal container when ¾ full
Never force instruments into sharps container
Never place sharps container in normal waste disposal
Wash hands after completing task
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8. Applying Non-Sterile Disposable Gloves
Gloves are not always needed; do not waste/misuse PPE
Donning non-sterile gloves
Wash and dry hands
Remove one glove from box; slide glove onto other hand; with gloved hand, remove another glove and slide onto bare hand
Interlace fingers, push down between fingers to ensure proper fit
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9. Removing Non-Sterile Disposable Gloves
Remove immediately after use
Grip one glove at base of palm; pull off inside out, place in palm of other glove
Slip bare fingers under other glove at wrist
Push glove down and off holding first glove inside
Place gloves in appropriate receptacle
Wash and dry hands
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10. Applying Sterile Gloves
Two methods
Open
Closed
Open (see text for complete instructions)
Wash and dry hands before and after gloving
Dispose of gloves in appropriate container
(Continues)
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11. Applying Sterile Gloves
Closed
Allows donning of gloves without possibility of sterile outside of glove touching skin of health care worker
Used by personnel who are scrubbed for operating room, or wearing sterile gown for performing of procedure
See text for complete instructions of procedure
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12. Asepsis Absence of microorganisms Two types
Medical: reduces number, growth, and spread of microbes
Surgical: eliminates microbes/spores from object/area
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13. Medical Asepsis Includes Hand washing Gloving
Changing bed linens daily
Cleaning furniture daily
Cleaning floor daily
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14. Surgical Asepsis Surgical hand scrub Sterilization of instruments
Surgical attire
Proper handling of sterile equipment/ instruments
Establishing/maintaining sterile field
Used for: OR, delivery room, diagnostic/therapeutic interventions
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15. Hand Hygiene for Surgical Asepsis
Requires careful scrubbing of hands, nails, wrists, forearms before donning sterile gloves
Requires 3- to 6-minute scrub
Since skin is not sterile, donning of sterile gloves is required to obtain/maintain sterility of field
Refer to text for specific instructions
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16. Sterile Principles
Guidelines designed to determine areas and items of sterility and actions that might cause contamination
Sterile field may be created by using sterile drapes, gloves, and gowns if procedure is performed in area where sterility is not possible (e.g., insertion of IV at jugular site at bedside)
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17. Maintenance of Sterile Field
Sterile objects must be dry and should not touch non-sterile objects
Maintain visual contact with sterile field
Items below waist level are considered contaminated
See text/tables for specific instructions
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18. Specimen Collection Use aseptic technique
Note date, time, site, antibiotics (if applicable), collection method, possibility of infectious organisms
Transport immediately or refrigerate
Blood and CSF should be kept at room temperature
(Continues)
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19. Specimen Collection
Refer to text for specific information for each type of culture
Blood culture
Use aseptic phlebotomy procedures
Transport to lab immediately or store at room temperature or place in incubator at 35˚C; never refrigerate
(Continues)
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20. Specimen Collection CSF culture Sputum culture
Obtained by physician or specially trained personnel only; 8–15 mL of fluid withdrawn; transport immediately
Sputum culture
Obtain prior to antibiotic regimen; specimen should be expelled after deep cough; transport immediately or refrigerate
(Continues)
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21. Specimen Collection Wound culture Urine specimen
Needle aspiration or deep tissue culture is preferred over swab; transport immediately or refrigerate
Urine specimen
Avoid bacterial contamination from distal urethra; clean-catch specimen, catheterization or suprapubic aspiration; transport immediately or refrigerate
(Continues)
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22. Specimen Collection Stool specimen Throat culture
Best performed on fresh specimen
May use transport medium
Transport immediately or refrigerate
Throat culture
Use sterile swab
Do not touch tongue, sides of mouth, or uvula
Transport immediately
(Continues)
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23. Specimen Collection Nasal specimen Reminder Use nasal swab
Insert at depth of 2–3 cm
Transport immediately
Reminder
Refer to text for specific instructions for each specimen collection
Proper specimen collection assists with determination of diagnosis
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24. Summary Disposal of medical waste, sharps
Donning and removal of non-sterile gloves
Donning and removal of sterile gloves
Gloving does not replace hand washing
Obtaining culture specimens using aseptic technique (blood, CSF, sputum, wound, urine, stool, throat, nasal)
(Continues)
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25. Summary Proper transportation/storage of specimens
Asepsis (medical/surgical)
Maintaining sterile field
Specimen collection
Refer to textbook for specific instructions concerning obtaining specimens for each type of culture
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