CEHE MED122 Week 2 Assignment Latest 2020 June

MED122 Medical Asepsis

Week 2 Assignment

Sterilization, Disinfection, and Handwashing Learning Objectives Covered

LO 01.05 – Identify proper handwashing techniques for medical and surgical situations

LO 02.01 – Differentiate when handwashing, antiseptic handwashing, and use of an alcohol-based hand rub are to be used.

LO 02.04 – Differentiate between sterilization and disinfection

LO 02.05 – Identify and describe techniques for sterilization and disinfection

Career Relevancy

In your everyday professional life, you’ll engage in many cleaning activities to decontaminate surfaces, rooms, and equipment after they’ve been used. But not all cleaning is the same—there are specific methods and tools you must use depending on the circumstances and contexts. In order to properly and appropriately prepare medical devices and settings for patients of all kinds, you need to know how and when sterilization and disinfection, which are both approaches to decontamination, should be used. You’ll also need to know how to decontaminate your hands for different situations. As a healthcare worker, you’ll likely have a variety of asepsis-related tasks, from cleaning up blood and other visibly soiled areas to wiping down surfaces in waiting rooms. No matter where you are in your facility, you’ll come into contact with harmful organisms that you’ll need to eliminate to protect yourself and your patients from infection and disease.

Background

person getting hand sanitizer

With new tools in his toolbox and new skills under his belt, Luca heads back into work. He has expanded his knowledge, and he’s ready to put some of his new skills into practice. Fortunately, he’s given an opportunity almost immediately, when he’s asked to wash his hands for a few different exams and procedures.

Luca recalls what Penny showed him the other day and what she said about handwashing, alcohol-based hand rubs, and antiseptic handwashing. Handwashing, or practicing hand hygiene, is a method of specific and thorough handwashing that is performed when the hands are soiled or contaminated. Alcohol-based rubs, on the other hand, are more for a quick and easy clean. And antiseptic handwashing, or surgical hand scrub, is the most extensive and rigorous of the 3 techniques, requiring that the healthcare worker use antimicrobial cleaning agents, wash and rinse for specific amounts of time, and hold their hands up to let the water drip down their arms rather than over their fingers.

Luca has to decide how and when to use each of these techniques. The first task on his schedule is a simple one—taking the medical history of a healthy 24-year-old male who has come in for a routine check-up. Luca’s hands are clean, but he still wants to protect himself and his patient. He does a quick alcohol-based rub. Next up, he’s got to help out in the delivery room; a woman is giving birth to her first child. Luca performs a thorough antiseptic handwash to make sure his hands are completely germ-free. After that, he moves on to take the vitals of an elderly woman who has a fever and a cough. Because Luca’s touched body fluids in the delivery room, he decides to do a thorough handwash before visiting with his next patient, who is especially vulnerable to disease due to her age and currently compromised health.

After Luca visits with his morning patients, Penny, Luca’s supervisor, asks him to help clean the rooms they used this morning by carrying out techniques of sterilization and disinfection. Luca sets out to complete the tasks but quickly realizes he’s not sure what the differences are between these two methods of decontamination! What constitutes sterilization? And what is disinfection? He hops on a computer and does a quick search.

He finds that sterilization is the more intensive and comprehensive of the two processes. The purpose of sterilization is to destroy all microbes and types of microbial life—not just most of them. In medical facilities, sterilization is used on equipment and instruments that must be completely free of all microorganisms, including bacterial spores. There are several methods of sterilization, and Luca investigates just a few principal sterilizing strategies. They often use a combination of forces and elements, from heat to pressure to chemicals to radiation.

Steam: Steam sterilization—also known as autoclaving because it’s performed in an autoclave—is arguably the most used and most reliable form of sterilization. In this method, the items are exposed to steam at a certain temperature, at a certain pressure, and for a certain amount of time. It is a nontoxic, microbicidal, and sporicidal, or spore-killing, technique.

Dry heat: This is one of the simplest sterilization techniques around—it exposes the materials to air of high temperatures that has zero, or extremely little, moisture. It is nontoxic, but a slightly time-consuming method. Like steam, it destroys microorganisms through a combination of forces, including high heat.

EtO gas: Ethylene Oxide, or ETO, is a flammable and explosive gas that is used to sterilize heat- and moisture-sensitive medical devices. It is more dangerous and costly than steam, but through its chemical reactions prevents normal cellular metabolism and replication in microorganisms.

Hydrogen peroxide gas plasma: In this technique, gas plasmas are produced in a vacuum chamber using radio frequency or microwave energy. It works by inactivating microorganisms through the combined use of hydrogen peroxide gas and the generation of free radicals.

Liquid chemicals: There are several liquid chemical sterilants that are FDA-approved for use on medical devices to destroy microorganisms. But they often take 3 to 12 hours to work, and they may not be as effective when killing spores.

Luca finds numerous other sterilization techniques, including flash sterilization, low-temperature sterilization, peracetic acid sterilization, ionizing radiation, filtration, and performic acid. But then he moves on to disinfection.

Disinfection is a process that eliminates many or all pathogenic microorganisms specifically. However, it doesn’t kill all microbes, such as bacterial spores, and therefore is used in situations in which it’s not critical that the environment or equipment be entirely free of microorganisms. But it still dramatically reduces the likelihood of contamination. Luca finds that there are a few different techniques for disinfection, too. In medical settings, objects usually are disinfected by liquid chemicals.

Chemical substances, which can include active ingredients like formaldehyde, chlorine, or alcohol, can be used to destroy a variety of pathogenic microorganisms. These disinfectants are often classified into high-level, intermediate-level, and low-level disinfection.

High-level substances have high concentrations of chemical germicides and kill or inactivate vegetative microorganisms and viruses. But they can’t be used for extended periods of time, and shouldn’t be used on floors or benches.

Intermediate-level substances, including EPA-Approved Hospital Disinfectants, kill vegetative microorganisms, fungi, and some viruses. They can be used for housekeeping and disinfecting benches.

Low-level disinfectants kill most vegetative bacteria and some fungi and viruses. These are often called “hospital disinfectants” or “sanitizers.”

Luca discovers that both disinfection and sterilization are essential processes for ensuring that medical and surgical instruments and environments do not transmit infectious agents. He watches these videos (5:58 min, 6:25 min) to understand a bit more about sterilization and disinfection.

Resources and References

CDC Principles of Cleaning and Disinfecting Environmental Surfaces. (2014, October 27). Metrex. Retrieved from https://youtu.be/RC0QbwZWiQ0 (Links to an external site.)

Disinfectants and Sterilization Methods. (2008, December 4). University of Colorado Environmental Health and Safety. Retrieved from https://ehs.colorado.edu/resources/disinfectants-and-sterilization-methods/ (Links to an external site.)

Disinfection and Sterilization Dead Bugs Don’t Lie. (2015, November 13). 3M Health Care. Retrieved from https://youtu.be/CH1CMO7SRSE (Links to an external site.)

Introduction, Methods, Definition of Terms. (2016, September 18). Centers for Disease Control and Prevention. Retrieved  from https://www.cdc.gov/infectioncontrol/guidelines/disinfection/introduction.html (Links to an external site.)

Sterilization. (2016, September 18). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/infectioncontrol/guidelines/disinfection/sterilization/index.html (Links to an external site.)

Prompt

Using Kaltura create a minimum 10-slide recording where you demonstrate the appropriate handwashing procedure (medical handwash, alcohol-based scrub, or surgical handwash) for the following situations:

Vaccine administration

Handwash after cleaning a room

Preparing for a suture procedure

Assisting in a skin biopsy

After assisting a vomiting pediatric patient

Meeting a patient and gathering general patient information

Sterilizing equipment

A link for installing Kaltura can be found in your course shell under “Modules”, “General Information”.

Your presentation should have a slide where you describe the difference between glo-germ results with alcohol-based hand sanitizer, medical handwash, and a surgical handwash.