Disinfection and sterilization

Importance of sterilization,
In health care setting it is important;

• To render articles and environment safe from the risk of transmitting infections.
•  Pathogens on hands & environment are removed or destroyed by ,

–        high standard of cleanliness

–        drying, washing, good ventilation and sun light.

 

o   Wards should be well ventilated and sunny.

● High risk procedures

o       Require absolute sterility

–        Surgery

–        preparation

•         of culture media

•         Iv fluids and other injectable drugs

–        Types of research work

Sharp tools

●   Sharp tools in use in hospital setting:

• Syringes and needles
• Scalpel blades
• Razors
• Infusion sets
• Lancets
• Broken glass

● Why proper handling and disposal of sharps is important?

• Improper handling and disposal of sharps leads to acquisition of infections by Healthcare Workers during their work ( occupational health hazards).
• This leads to transmission of blood borne infections namely HBV, HCV AND HIV  infections among patients as well as Healthcare workers.
• Proper handling and disposal of sharps leads to the minimization of the risk of getting infected by above blood borne infections. 

 

Hand hygiene

• On average, 8.7% of hospital patients suffer nosocomial infections.
• Hospital infections are a leading cause of death in some parts of the world.
• Most patient deaths and suffering attributable to health care-associated infections can be prevented.
• The costs of health care-associated infections vary by country and institution. 
• The single most important measure to prevent and control health care -associated.

Benefits of hand washing are,

• Reduces nosocomial infections
• Preventing cross transmission of multi-resistant organisms
• Preventing and control epidemics
• Cost saving
• Reduces morbidity and mortality

A guide to performing a bone marrow aspiration

1. Decide on the most appropriate site for aspiration;

• The usual site for puncture in adults is the posterior superior iliac spine (PSIS).
• This may be technically difficult in obese or immobile subjects.
• The main advantage of this site is that a trephine biopsy can also be performed. Alternatively the sternum ( manubrium or 1^st or 2^nd parts of the body) can be used with care as there is a danger of  perforating the inner cortical layer and damaging the underlying large blood vessels and right atrium with serious consequences.

2. Obtain informed written consent;

• The procedure (in brief) and its main adverse effects (although rare) should be explained to the patient prior to obtaining consent.
• Pain, bleeding/haematoma formation and infection at aspiration site are the most commonly seen adverse effects, however, very rarely cause major concern.

3. Positioning the patient;

• Either left or right lateral decubitous on a bed/couch, with the dorsal surface of the patient facing the operator.
• Hold the hips and knees flexed to a comfortable maximum – knees drawn up and tucked into chest.

Venepuncture

Introduction Venepuncture is the term used for the procedure of entering a vein with a needle.

Indications

1. Withdrawal of blood for investigations
2. As a route for venous access

Procedure

1. Confirm patient identity   
2. Communicate with the patient
• Explain the procedure to the patient and get his/her verbal consent
• Try to minimize the patient distress
• Ask if blood has been withdrawn previously
• Sometimes the patient is able to point out sites where blood can be withdrawn successfully.
• Answer any questions the patient has  
3. Gather the equipment needed
• Non sterile pair of gloves
• Kidney tray
• Tourniquet
• Sterile alcohol swabs
• Sterile needle and syringe of an appropriate size
• Plaster / hypoallergenic tape
• Blood collecting tubes or bottles
• Ensure there is adequate light