Exam - Cleaning Techniques Flashcards
Describe the different ways of maintaining hand hygiene and when each may be used
- Handwashing using an appropriate antiseptic e.g. Hibiscrub and WHO handwashing technique
- Alcohol Rubs - for use when hands aren’t visibly soiled.
Some viruses e.g. parvovirus aren’t killed by alcohol rubs so would use hand wash
What are the 9 steps of barrier nursing?
- Isolate patient from other animals
- Minimal number of staff in contact with animal
- Animal remains in kennel for entire stay
- Separate equipment, bowls, blankets etc.
- Wear PPE
- Use footbath
- Separate waste facilities
- Use of appropriate disinfectant
- No visitors
What can increase the effectiveness of infection control procedures?
Biosecurity policies e.g. O’Dwyer system used to classify susceptibility of patient to infection and what order you should treat them in
What constitutes an ideal scrub solution?
- Broad spectrum of antimicrobial activity
- Quick and easy application
- Long residual effect
- Effective in the presence of organic matter
- safe and non-irritating
- Economical/ cost-effective
- Practical/ easy to make up
Give examples of scrub solutions and pros and cons of each
- Hibiscrub has long residual effect effective against bacteria, viruses, fungi and spores effective in presence of organic matter not irritating to normal skin
-povidone iodine
can be impaired by organic matter
very sensitive - can be used for eyes, MMs etc.
can cause reactions in staff skin
Describe the sterilisation method of instruments
- Put on PPE
- Soak all instruments in cold water and ensure everything is open
- Prepare instrument cleaner according to manufacturers guidelines
- Scrub instruments with a brush specifically for this purpose
- Rinse instruments with cool running water, preferable distilled
- Put in ultrasonic cleaner
- Dry thoroughly with paper towel or soft cloth
- Check for damage (misalignment, rust etc)
- Lubricate hinges
- Protect sharp ends with rubber tips
- Insert instrument into packaging the correct way
I2. Insert indicator strip - Remove excess air
- seal tight
- Double wrap items
- Label package with name, contents and date (and potentially 3months from now date) using a permanent marker
- Load autoclave - heavy items at bottom, don’t overpack
- Check distilled water level
- Set cycle at 134 degrees
Describe the autoclave process
- Exposes pathogens to heat at high pressure which increases the temperature and reduces the time required. The increase in pressure and therefore temperature kills resistant pathogens. Commonly 134 degrees.
- Use distilled water to increase sterility
- don’t overpack
- heavy items at bottom
Describe the safety implications of Cold Sterilisation
Use of Ethylene Oxide
- it chemically modifies what its trying to kill
- EO sterilises at 20 degrees so keep it at room temp
- The limit according to health and safety policies is 5ppm but most operates at 1ppm so very safe
- Monitoring is best done using badge worn for 25 mins when unloading
- some materials absorb the EO so require an aeration period.
Describe the process of cold sterilisation
Very small amount of EO in glass ampule
Dosimeter (indicator) and Ampule put in gas release bag and snapped
This causes the liquid to turn into gas
The whole thing is contained in a EO chamber system
(this increases safety)
Gas exits through an exhaust pipe and the machine cycles fresh air through for 2 hours after finished before It allows the door to be opened.
The cycle lasts 12 hours for normal items followed by an aeration time of 24hours. For excessively large or absorbent materials, the cycle is 24hrs and aeration time is 24hrs.
What are the benefits/ downsides of using EO sterilisation?
Doesn’t blunt equipment/ instruments as no steam or water - great for orthopaedics
Can sterilise anything except food drugs and water
- great for scopes
- Takes a long time
Describe the process of disinfecting a kennel that has housed a dog with an infectious disease
PPE
Use detergent first to remove organic matter
Use correct disinfectant at correct dilution rate for that infection
Ensure left for correct contact time
Rinse kennel
Describe methods to reduce MRSA transmission in patients with wounds, Urinary catheters and IV cannulas
PPE - gloves! Hand hygiene Antiseptic wipes Sterile equipment Effective cleansing of wound area Cleaning of areas before placement of catheter and IV
What are the 2 draping methods?
Fenestrated sterile drape
Four corner plain drape
Give the steps involved in a surgical hand scrub
Need to Know all steps for exam!
- Remove all jewellery
- Wash hands and arms using an antimicrobial solution
- Clean under nails using a pick
- Use either the anatomic timed method or the counted brush stroke method.
Either
(a) Start timing:
- Brush sides of each finger & back to front of hands for 2 minutes.
- Scrub arm to just below elbow for 1 minute (keeping hands raised above arms to allow used soap to drip away from clean area)
-Rinse the brush (not the hand) and repeat for next hand and arm.
- Process should take about 6 minutes
OR
b) Start Counting:
- apply 30 strokes to fingertips
- Divide fingers into 4 planes and 20 strokes to each surface working from the tip of the finger to the wrist
- Divide the forearm into 4 planes and stroke each 20 times.
- Repeat for other hand and arm, keeping hands raised.
- Rinse hands and arms by passing through the water in one direction only from fingertips to elbow.
* Note: hands are now clean, not sterile*
