Personal Protective Equipments (PPE) Conti....


Categories of instruments and equipment used in patient care and its reprocessing
1.        Critical: These items confer a high risk for infection if they are contaminated with any microorganism. The items/instruments Entry or penetration into sterile tissue, cavity or blood Stream. High-level disinfection and sterilization is required.
The process as follows;
·         Sterilize after cleaning by steam under pressure
·         If heat or moisture sensitive, sterilize through an automated low temperature chemical sterilant system, other liquid chemical sterilants or ethylene oxide sterilisation
Examples of items/instruments
·         Invasive surgical and dental equipment e.g. surgical oral instruments, arthroscopes, laparoscopes, rigid and flexible bronchoscopes, heat stable scopes.
·         Cardiac and urinary catheters, implants and ultrasound probes used in sterile body cavities
Sterility must be maintained:
·         packaged items must go through a drying cycle and then be checked to ensure drying has taken place before use or storage
·         the integrity of the wrap must be maintained
·         wraps should act as an effective biobarrier during storage
2.        Semi-critical: These items come into contact with mucous membranes or non-intact skin, and should be single use or sterilized after each use.
The process as follows;
·         Clean thoroughly as soon as possible after using
·         Steam sterilization is preferable
·         If the equipment will not tolerate steam use a high level chemical
Examples of items/instruments
·         Respiratory therapy and anaesthesia equipment, some endoscopes, vaginal speculae, laryngoscope blades, cystoscopes,
·         Probes including transoesophagal echocardiogram, transrectal ultrasound and transvaginal probes
Store to prevent environmental contamination
3.        Non critical: These items come into contact with intact skin but not mucous membranes. Thorough cleaning is sufficient for most non-critical items after each individual use, although either intermediate or low-level disinfection may be appropriate in specific circumstances.
The process as follows;
·         Clean as necessary with detergent solution
·         If decontamination necessary, use disinfectant
Examples of items/instruments
·         Stethoscopes, sphygmomanometers, blood pressure cuffs, mercury thermometers, non-invasive ultrasound probes, intravenous pumps and ventilators
·         Store in a clean dry place to prevent environmental contamination

       Methods of cleaning:

a) Automated
Automated cleaners (ultrasonic cleaners and washer-disinfectors) reduce the handling of instruments and are recommended for cleaning basic instruments that can withstand the process.
      Ultrasonic cleaners work by subjecting instruments to high frequency, high-energy sound waves, thereby loosening and dislodging dirt.
      Washer-disinfectors use detergent solutions at high temperatures to wash instruments. When a washer-disinfector is used, care should be taken in loading instruments: hinged instruments should be opened fully to allow adequate contact with the detergent solution; stacking of instruments in washers should be avoided; and instruments should be disassembled as much as possible.
b) 2. Manual
Cleaning is done manually for fragile or difficult-to-clean instruments and in areas without automatic units.
The two essential components of manual cleaning are:
·         Friction: rubbing/scrubbing the soiled area with a soft brush
·         Fluidics - use of fluids to remove soil and debris from internal channels after brushing and when the design does not allow passage of a brush through a channel.

Cleaning agents

The cleaning solution and style must be appropriate for each instrument and equipment. Cleaning solutions are usually neutral pH or mildly alkaline as such solutions generally provide the best material compatibility profile and good soil removal and mildly acidic solutions may damage instruments.

6. Respiratory hygiene and cough etiquette

Respiratory hygiene and cough etiquette should be applied as a standard infection control precaution at all times. Covering sneezes and coughs prevents infected persons from dispersing respiratory secretions into the air. Hands should be washed with soap and water after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions.
Steps in respiratory hygiene and cough etiquette
Anyone with signs and symptoms of a respiratory infection, regardless of the cause, should follow or be instructed to follow respiratory hygiene and cough etiquette as follows:
·         Cover the nose/mouth with disposable single-use tissues when coughing, sneezing, wiping and blowing noses
·         Use tissues to contain respiratory secretions
·         Dispose of tissues in the nearest waste receptacle or bin after use
·         If no tissues are available, cough or sneeze into the inner elbow rather than the hand
·         Practice hand hygiene after contact with respiratory secretions and contaminated objects/materials
Keep contaminated hands away from the mucous membranes of the eyes and nose



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item Personal Protective Equipments (PPE) Conti....
Personal Protective Equipments (PPE) Conti....
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