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Infection Prevention
and Control
Chapter 6
Objectives:
As a result of successfully completing this chapter, students will be able to:
 Explain the role of Central Service Technicians in a healthcare facility’s
infection prevention and control efforts.
 Discuss personal hygiene and personal protective equipment
precautions that enable Central Service Technicians to protect patients and
themselves.
 Define the term, “Standard Precautions,” and review its role in preventing
the transmission of infectious organisms.
 List key elements in the Bloodborne Pathogens Standard published by
Occupational Safety and Health Administration (OSHA).
Objectives:
 Describe basic environmental concerns as Central Service work areas
are designed.
 Review environmental aspects of Central Service work procedures that
impact infection control:
 Traffic control
 Work area cleanliness
 Workflow
 Define the terms, “asepsis,” and “aseptic technique,” and review the
five basic principles of asepsis.
Infection Prevention and Control
Goals of Central Service
 Eliminate and/or destroy all potentially
infectious contaminants present on
reusable instruments and equipment.
 Safely distribute reusable and single-use
items required for the delivery of patient
care.
 Establish and enforce standards for
decontamination, disinfection, and
sterilization in various healthcare
settings.
Medical Devices that have not been
properly handled, disinfected or
sterilized…
…can cause infections in
patients and staff
Each Year
 Approximately 10%
of patients
hospitalized
develop a
healthcare facility-
associated infection
 The primary purpose of the
Central Service Department is
to stop the spread of disease-
producing microorganisms in
the healthcare facility
Appropriate Attire for
Central Service
 A facility-issued scrub
uniform
 Hair covering that covers
all head and facial hair
except eyebrows and
eyelashes
 Shoes with non-skid soles
Hand Hygiene
 Remove Watches
and other Jewelry
before entering the
work area.
 Wash hands with
soap and water or
use an alcohol-
based hand rub
Personal Protective Equipment
 Required by OSHA for
Technicians in the
Decontamination area:
 General purpose utility
gloves
 A fluid-resistant
covering with sleeves
 Full face protection.
 Shoe covers
Fluid-Resistant Gowns
(Coverings)
 Regular scrub attire
splashed with liquid
 Fluid-resistant attire
splashed with liquid
Standard Precautions
 Place emphasis on
the use of blood
and body fluid
precautions for all
patients.
OSHA BloodBorne
Pathogen Standard
 Written Exposure Control Plan
 Training upon initial hire and annually thereafter
 Hepatitis B Vaccine offered at no cost to
employees
 Observance of Standard Precautions
 Use of Engineering and Work Practice Controls to
reduce risks
OSHA BloodBorne
Pathogen Standard
 Provision of Personal Protective
Equipment (PPE) at no cost to the
employee
 Provision of a clean and sanitary working
environment
 Use of appropriate Biohazard signs and
labels to identify contaminated items
 Rigid containers for sharps disposal
OSHA BloodBorne
Pathogen Standard
 Covered, puncture-proof containers for
the transport of contaminated items.
 Provision of medical evaluation and
treatment if an employee experiences an
exposure
 Properly maintained medical and training
records.
The Physical Design of the
Central Service Department
 Physical Barriers
(walls) between clean
and dirty areas
 A method to reduce
the likelihood that
airborne bacteria can
be transmitted from
the decontamination
area to the clean
areas
S1
S2
S3
DecontaminationArea
PackagingArea
ProcessingArea
Sterile Goods
Storage Area
t
Sterile Goods
Issuing Point
S1
S2
S3
DecontaminationArea
PackagingArea
ProcessingArea
Sterile Goods
Storage Area
t
Sterile Goods
Issuing Point
The Use of Air Pressure to
Control Airborne Bacteria
Clean Area
Positive Air Pressure
Decontamination Area
Negative Air Pressure
Airflow
Controlling Airflow
Windows and
doors between
areas with positive
and negative air
pressures must be
kept closed
Work Area Requirements
Decontamination
Temperature: 60°F to 65°F (16°C to 18°C)
Humidity: 30% to 60%
Air Exchanges: 10 per hour
Preparation and Packaging
Temperature: 68° F to 73° F (20° C to 23° C)
Humidity: 30% to 60%
Air Exchanges: 10 per hour
Clean/Sterile Storage
Temperature 75° F or lower (24° C or lower)
Humidity: Less than 70%
Air Exchanges: 4 per hour
Work Area Requirements
(cont.)
 Hand washing Sinks
 Fixtures and furniture
that can be washed
Other Requirements:
 Open Rack
storage systems
should have a
solid bottom to
prevent
contamination
during
housekeeping
tasks
Traffic Control
 Traffic control requirements must be
enforced for everyone
 Dress codes for all areas apply to
everyone
Traffic Control Designations
 Biohazard – OSHA-required PPE
 Unrestricted – Normal Traffic areas, cafeteria, waiting rooms,
etc. Street clothes may be worn
 Semi-Restricted – Clean assembly and storage areas,
access corridors to operating rooms, etc. Surgical scrub attire
and hair covering required
 Restricted – Areas where sterile procedures are performed.
Surgical scrub attire, hair covering, and masks required.
*Persons working within the sterile field will have additional
requirements
What to Wear
CS Dress Requirement Review
Decontamination
Area
Clean Assembly
and
Sterile Storage
Operating
Room
Non-restricted
Hallways and
Offices.
Cafeteria, etc.
Surgical Scrubs and OSHA-required PPE
Surgical Scrubs and Hair Covering
Surgical Scrubs, Hair Covering, Masks may be required
Regular Street Attire
Environmental Cleaning
 Floors should be wet-mopped at
least daily
 Work surfaces should be cleaned
at least daily
 Light fixture should be cleaned at
least every 6 months
 Walls cabinets and racks should
be cleaned on a regularly
scheduled basis
Cleaning Sterile Storage Areas
 Remove all sterile items from the
cart, rack, or cabinet
 Thoroughly clean the unit using
the cleaning solution
recommended by the healthcare
facility.
 Allow the storage unit to dry
thoroughly.
 Carefully place items back in their
designated location.
 Record the cleaning date in the
department’s cleaning log.
Control Microorganisms
Entering the Work
Areas
Clean Routinely
No Food or Drink should be
allowed in Central Service work
areas.
Workflow
Practices
Workflow must be...
 …logical
 …one way
 …defined
Contaminated to
Sterile
User
Sterile
Storage
Sterilization
Inspection &
Assembly
Decontamination
User
Principles of Asepsis
 Asepsis – The absence
of microorganisms that
cause disease
 Aseptic Technique –
Any activity or procedure
that prevents infection or
breaks the chain of
infection
Medical Asepsis
 Procedures performed
to reduce the number
of microorganisms or
minimize their spread
Surgical Asepsis
 Procedures performed
to eliminate the
presence of all
microorganisms
and/or to prevent the
introduction of
microorganisms into
an area
Principles of Asepsis
1. Know what is Dirty.
2. Know what is Clean.
3. Know what is Sterile.
4. Keep the 3 conditions separate.
5. Remedy contamination immediately.
“Sterile Conscience”
 A careless attitude
may lead to
increased risk of
infection
Infection Control...
 …manages the growth
and transmission of
bacteria in the
healthcare facility
You Can Manage the
Environment by:
 Following All Infection Control
Protocols
 Recognizing Contamination and
Correcting the Situation
 Paying Close attention to Detail
Controlling the Spread of
Microorganisms…
…is the responsibility of
every Central Service
Technician

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Chapter 6 infection prevention

  • 2. Objectives: As a result of successfully completing this chapter, students will be able to:  Explain the role of Central Service Technicians in a healthcare facility’s infection prevention and control efforts.  Discuss personal hygiene and personal protective equipment precautions that enable Central Service Technicians to protect patients and themselves.  Define the term, “Standard Precautions,” and review its role in preventing the transmission of infectious organisms.  List key elements in the Bloodborne Pathogens Standard published by Occupational Safety and Health Administration (OSHA).
  • 3. Objectives:  Describe basic environmental concerns as Central Service work areas are designed.  Review environmental aspects of Central Service work procedures that impact infection control:  Traffic control  Work area cleanliness  Workflow  Define the terms, “asepsis,” and “aseptic technique,” and review the five basic principles of asepsis.
  • 4. Infection Prevention and Control Goals of Central Service  Eliminate and/or destroy all potentially infectious contaminants present on reusable instruments and equipment.  Safely distribute reusable and single-use items required for the delivery of patient care.  Establish and enforce standards for decontamination, disinfection, and sterilization in various healthcare settings.
  • 5. Medical Devices that have not been properly handled, disinfected or sterilized… …can cause infections in patients and staff
  • 6. Each Year  Approximately 10% of patients hospitalized develop a healthcare facility- associated infection
  • 7.  The primary purpose of the Central Service Department is to stop the spread of disease- producing microorganisms in the healthcare facility
  • 8. Appropriate Attire for Central Service  A facility-issued scrub uniform  Hair covering that covers all head and facial hair except eyebrows and eyelashes  Shoes with non-skid soles
  • 9. Hand Hygiene  Remove Watches and other Jewelry before entering the work area.  Wash hands with soap and water or use an alcohol- based hand rub
  • 10. Personal Protective Equipment  Required by OSHA for Technicians in the Decontamination area:  General purpose utility gloves  A fluid-resistant covering with sleeves  Full face protection.  Shoe covers
  • 11. Fluid-Resistant Gowns (Coverings)  Regular scrub attire splashed with liquid  Fluid-resistant attire splashed with liquid
  • 12. Standard Precautions  Place emphasis on the use of blood and body fluid precautions for all patients.
  • 13. OSHA BloodBorne Pathogen Standard  Written Exposure Control Plan  Training upon initial hire and annually thereafter  Hepatitis B Vaccine offered at no cost to employees  Observance of Standard Precautions  Use of Engineering and Work Practice Controls to reduce risks
  • 14. OSHA BloodBorne Pathogen Standard  Provision of Personal Protective Equipment (PPE) at no cost to the employee  Provision of a clean and sanitary working environment  Use of appropriate Biohazard signs and labels to identify contaminated items  Rigid containers for sharps disposal
  • 15. OSHA BloodBorne Pathogen Standard  Covered, puncture-proof containers for the transport of contaminated items.  Provision of medical evaluation and treatment if an employee experiences an exposure  Properly maintained medical and training records.
  • 16. The Physical Design of the Central Service Department  Physical Barriers (walls) between clean and dirty areas  A method to reduce the likelihood that airborne bacteria can be transmitted from the decontamination area to the clean areas S1 S2 S3 DecontaminationArea PackagingArea ProcessingArea Sterile Goods Storage Area t Sterile Goods Issuing Point S1 S2 S3 DecontaminationArea PackagingArea ProcessingArea Sterile Goods Storage Area t Sterile Goods Issuing Point
  • 17. The Use of Air Pressure to Control Airborne Bacteria Clean Area Positive Air Pressure Decontamination Area Negative Air Pressure Airflow
  • 18. Controlling Airflow Windows and doors between areas with positive and negative air pressures must be kept closed
  • 19. Work Area Requirements Decontamination Temperature: 60°F to 65°F (16°C to 18°C) Humidity: 30% to 60% Air Exchanges: 10 per hour Preparation and Packaging Temperature: 68° F to 73° F (20° C to 23° C) Humidity: 30% to 60% Air Exchanges: 10 per hour Clean/Sterile Storage Temperature 75° F or lower (24° C or lower) Humidity: Less than 70% Air Exchanges: 4 per hour
  • 20. Work Area Requirements (cont.)  Hand washing Sinks  Fixtures and furniture that can be washed
  • 21. Other Requirements:  Open Rack storage systems should have a solid bottom to prevent contamination during housekeeping tasks
  • 22. Traffic Control  Traffic control requirements must be enforced for everyone  Dress codes for all areas apply to everyone
  • 23. Traffic Control Designations  Biohazard – OSHA-required PPE  Unrestricted – Normal Traffic areas, cafeteria, waiting rooms, etc. Street clothes may be worn  Semi-Restricted – Clean assembly and storage areas, access corridors to operating rooms, etc. Surgical scrub attire and hair covering required  Restricted – Areas where sterile procedures are performed. Surgical scrub attire, hair covering, and masks required. *Persons working within the sterile field will have additional requirements
  • 24. What to Wear CS Dress Requirement Review Decontamination Area Clean Assembly and Sterile Storage Operating Room Non-restricted Hallways and Offices. Cafeteria, etc. Surgical Scrubs and OSHA-required PPE Surgical Scrubs and Hair Covering Surgical Scrubs, Hair Covering, Masks may be required Regular Street Attire
  • 25. Environmental Cleaning  Floors should be wet-mopped at least daily  Work surfaces should be cleaned at least daily  Light fixture should be cleaned at least every 6 months  Walls cabinets and racks should be cleaned on a regularly scheduled basis
  • 26. Cleaning Sterile Storage Areas  Remove all sterile items from the cart, rack, or cabinet  Thoroughly clean the unit using the cleaning solution recommended by the healthcare facility.  Allow the storage unit to dry thoroughly.  Carefully place items back in their designated location.  Record the cleaning date in the department’s cleaning log.
  • 27. Control Microorganisms Entering the Work Areas Clean Routinely
  • 28. No Food or Drink should be allowed in Central Service work areas.
  • 30. Workflow must be...  …logical  …one way  …defined
  • 32. Principles of Asepsis  Asepsis – The absence of microorganisms that cause disease  Aseptic Technique – Any activity or procedure that prevents infection or breaks the chain of infection
  • 33. Medical Asepsis  Procedures performed to reduce the number of microorganisms or minimize their spread
  • 34. Surgical Asepsis  Procedures performed to eliminate the presence of all microorganisms and/or to prevent the introduction of microorganisms into an area
  • 35. Principles of Asepsis 1. Know what is Dirty. 2. Know what is Clean. 3. Know what is Sterile. 4. Keep the 3 conditions separate. 5. Remedy contamination immediately.
  • 36. “Sterile Conscience”  A careless attitude may lead to increased risk of infection
  • 37. Infection Control...  …manages the growth and transmission of bacteria in the healthcare facility
  • 38. You Can Manage the Environment by:  Following All Infection Control Protocols  Recognizing Contamination and Correcting the Situation  Paying Close attention to Detail
  • 39. Controlling the Spread of Microorganisms… …is the responsibility of every Central Service Technician