Storage Replacement of PN tubing and filters
4.7.1 Introduction
Understanding of infection control in its application to GI endoscopy is important as to prevent the possibility of transmission of infection. Thus compliance with the disinfection guidelines is the key factor in determining endoscopic safety, and posed virtually no risk of patient-borne transmission Hepatitis C, Hepatitis B, HIV, Salmonella, Psuedomonas aeruginosa, Enterobacteriacea or environmental organisms SARS-CoV, Avian influenza A virus [H5N1]. Glutaryldehyde has been most commonly used disinfection in endoscopy previously, but other newer products such as Succine-diadehyde Gigasept 4 and Paracetic Acid Hydrogen Peroxide Perascope has been in the market recently. The ideal choice of disinfection should be based on the following factors:- • Effective against a wide range of organisms including blood-borne viruses • Compatible with endoscopes, accessories and endoscope re-processors • Non-irritant and safe for users • Environmentally friendly for disposal • Stability of the solution for the specified duration of use • Able to be reused for the specified period • Cost-effective include costs of the appropriate automatic endoscopic re-processors AER, storage space, conditions required for use, and staff protection measures It is of utmost important to protect against chemical used during cleaning and disinfection in order to avoid from toxic and allergic reactions. Separate purpose-designed rooms for cleaning and disinfection must be well ventilated and disinfections should be used within a closed system. Diseases may also be transmitted from patient to endoscopic personnel. Therefore, protection from direct contact with the endoscopes and accessories is essential. For the protection of the staff during the disinfection procedure the following apparel or equipment has been recommended:- • Gloves long enough to cover the forearms, preferably sterile gloves to protect arms from splashes • Long sleeves waterproof gowns. Preferably should be changed between patients or when it gets contaminated • Goggles to prevent conjunctiva irritation and protect the splashes • Face masks to reduce inhalation of vapour In local circumstances, training and resources may vary but high standards of disinfection must always be maintained.4.7 Disinfenctions of Endoscopes
Policies and Procedures on Infection Control Ministry of Health Malaysia 564.7.2 Definitions Cleaning
Removal of blood, secretions and debris from endoscopes and accessories Disinfection Reduction of number of viable micro-organisms on a device to a level that is appropriate to be used safely on a patient where sterilisation of the device is not necessary. Disinfection may also be undertaken as a preliminary step to sterilisation, if necessary. Disinfection should be carried out immediately after cleaning and immediately prior to use. Sterilization Validated process used to render a device free from all forms of viable micro-organisms. Endoscopic accessories All devices used in conjunction with an endoscope to perform diagnosis and therapy, excluding peripheral equipment. Single-use accessories Also called “disposable”, these are provided in a sterile state ready for use. The opening of a sterile package implies immediate use, as is routine in surgery. After a single-use device has been used, all materials should be properly disposed of. Under no circumstances should a single-use device be reused. Reusable accessories All reusable accessories should be sterilised. The sterilisation should be carried out after proper cleaning, as detailed below. Manufacturers provide validated standard reprocessing parameters dilution, temperature and time for cleaning, disinfection and sterilisation.4.7.3 Cleaning – Rising – Disinfection – Sterilisation Sequence
Non-compliance with guideline is the chief factor compromising the safety of endoscope reprocessing. The consequence of failure to follow recommendation may not be only transmission of pathogens due to pathological material from one patient being produced into the next patient, but also misdiagnosis instrument malfunction, and a shortened instrument lifespan. Preliminary-cleaning Preliminary-cleaning starts before the endoscope is detached from the light sourcevideo- processor and the reprocessing begins as soon as the endoscope is removed from the patient. 1. Wipe down insertion tube with a detergent-soaked gauze 2. Place the distal end of the endoscope into the enzymatic detergent solution which is diluted according to the manufacturer’s instruction.Parts
» Bacaan Penuh ( bersaiz 5.5 MB)
» Roles of Hospital Infection and Antibiotic Control Committee
» Infection Control Doctor ICD
» Chairman of HIACC Bacaan Penuh ( bersaiz 5.5 MB)
» HOSPITAL INFECTION AND ANTIBIOTIC CONTROL COMMITTEE
» Frequency of meetings Circulation of minutes
» Emergency meetings and outbreak control
» Duties and responsibilities of the infection Control Nurse
» HEALTHCARE ASSOCIATED INFECTION SURVEILLANCE
» Types of Surveillance Bacaan Penuh ( bersaiz 5.5 MB)
» Data Collection Tabulation of Data
» Analysis and interpretation of data
» Preparation and dissemination of reports
» ISOLATION PRECAUTION Standard Precautions
» Respiratory hygienecough etiquette: Instruct symptomatic persons and health
» Signs, BHT, Isolation traytrolley
» Visitor Policy for Infection Control
» Dishes, Glasses, Cups, Eating Utensils and Medications
» Transportation of patients Transmission-based
» Hand Hygiene Bacaan Penuh ( bersaiz 5.5 MB)
» Natural ventilation Personal Protective Equipment PPE
» Use of mechanical ventilation
» Minimizing bacteria at entry points
» Maintaining sterility of instruments disposable items during a procedure
» Catheter change interval Urinary Catheter Care
» General principles of wound care 1.
» Spatial separation of catheterized patients Technique
» Environment Urinary Catheter Care
» Wound Care Bacaan Penuh ( bersaiz 5.5 MB)
» Procedure for insertion of catheter
» A dedicated lumen used for PN line should be identified and not be used for
» Nursing considerations for PN
» Storage Replacement of PN tubing and filters
» General Principles. Replacement of PN tubing and filters
» Specific practices transport, storage, transfusion, dispose
» Blood and Blood Products Transfusion
» Hand hygiene Urinary Tract Infection
» Catheter Insertion Urinary Tract Infection
» Closed Sterile Drainage Urinary Tract Infection
» Irrigation Urinary Tract Infection
» Specimen Collection Urinary Tract Infection
» Urinary Flow Urinary Tract Infection
» Meatal Care Urinary Tract Infection
» Catheter Change Interval Urinary Tract Infection
» Critical items - instruments or objects that enter directly into the vascular
» Semi-critical items - instruments or objects that come into contact with
» Developed a good surveillance system to study the incident of SSI.
» Nosocomial Respiratory Infection Bacaan Penuh ( bersaiz 5.5 MB)
» Introduction INFECTION CONTROL IN SPECIFIC HEALTHCARE SETTING
» Personal Protective Equipment Personnel .1
» Neonatal Intensive Care Unit
» Outer zone: This zone should contain:
» Laminar Flow Ventilation Ultra Clean Ventilation
» Wall Mounted Air Conditioners:
» Protective Clothing for Use in the Operating Theatre
» Surgical Hand Scrubbing Refer to hand hygiene section
» Gowning Free-standing Air Conditioners:
» Gloving Free-standing Air Conditioners:
» Draping Free-standing Air Conditioners:
» Establishing a Sterile Field
» Dispensing of the Sterile Supplies
» Maintaining the Sterile Field
» Waste and Linen Post operative
» Cleaning of the Operation theatre
» Intra operative Initial cleaning at the beginning of the day
» Concurrent cleaning between cases
» Haemodialysis unit water supply and air conditioning
» Staff health Terminal cleaning end of the day
» Hand hygiene Terminal cleaning end of the day
» Nephrology and Hemodialysis Unit
» Instrument processing area in the dental clinic
» Instrument cleaning refer to CSSD chapter
» Cleaning and Disinfection of Treatment Room 1.
» Dental Radiology Asepsis Components permanently attached to dental unit waterlines
» Dental Laboratory Materials and Equipment
» Storage and preparation rooms
» Movement of instruments Safety
» Collection of body from ward
» Routine case autopsy Mortuary
» Specimen handling Procedure for post-mortem examination of known or suspected CJD
» Clinical waste Procedure for post-mortem examination of known or suspected CJD
» Visitors Procedure for post-mortem examination of known or suspected CJD
» Quality control Procedure for post-mortem examination of known or suspected CJD
» Care Givers For Patient In The Burn Unit 1.
» Visitors Full time Care givers
» Culturing and Surveillance Full time Care givers
» Antibiotic Policy Full time Care givers
» Haematology and Oncology Unit
» Laboratory Bacaan Penuh ( bersaiz 5.5 MB)
» Introduction Bacaan Penuh ( bersaiz 5.5 MB)
» Personel protective equipment PPE
» Screening for HCW TUBERCULOSIS
» Infection control in specific area .1
» HOSPITAL OUTBREAK MANAGEMENT Steps in Outbreak Investigation and Management
» Introduction Introduction Bacaan Penuh ( bersaiz 5.5 MB)
» Policy Statement Training Bacaan Penuh ( bersaiz 5.5 MB)
» Arrangements Bacaan Penuh ( bersaiz 5.5 MB)
» Infection Control During Construction and Renovation
» Operation Theatre Commissioning Bacaan Penuh ( bersaiz 5.5 MB)
» Administrative monitoring Mechanical Monitoring
» Distribution of sterile items
» Establish a system Bacaan Penuh ( bersaiz 5.5 MB)
» Monitoring antimicrobial use using aggregated data on Defined Daily
» Each hospital shall send report on DDD every 6 months to National Infection
» However, individual local data shall be reported according to discipline
» It is recommended to have a national benchmark data specifically for Intensive
» It is also beneficial if each state have their own benchmark data from their
» A report of local monitoring data for hospital compared with national
» The aggregate benchmark data included numeric presentation of pooled
» Correlation between antimicrobial use and resistance rate
» Costquantity of empiric antimicrobial administered in a specified period.
» Antimicrobial management programstrategies Antimicrobial policy
» Multi-Resistant Organism 13. Bacaan Penuh ( bersaiz 5.5 MB)
» Methicillin Resistant Staphylococcus Aureus
» Vancomycin Resistant Enterococci Bacaan Penuh ( bersaiz 5.5 MB)
» HIV Bacaan Penuh ( bersaiz 5.5 MB)
» Dengue Bacaan Penuh ( bersaiz 5.5 MB)
Show more