For the best experience on our site, be sure to turn on Javascript in your browser. Workplace health and safety is the cornerstone of employment within medical settings. Employers and employees within healthcare facilities know that there are certain precautions set in place for their protection. These common precautions are implemented to best control infection exposure and the spread of diseases. This concept of general precautions is a basic level safety measure that is used in the care of all patients within a facility at all times.
However, within the healthcare industry, there are two different terms for these precautions that can be easily misunderstood. Complete guidance on safe injection practices can be found in the Guideline for Isolation Precautions pdf icon [PDF — 1. Additional materials, including a list of frequently asked questions from providers and a patient notification toolkit , are also available.
If multidose vials will be used for more than one patient, they should be restricted to a centralized medication area and should not enter the immediate patient treatment area e. If a multidose vial enters the immediate patient treatment area, it should be dedicated for single-patient use and discarded immediately after use. Date multidose vials when first opened and discard within 28 days, unless the manufacturer specifies a shorter or longer date for that opened vial.
Ensure that the dental cartridge syringe is appropriately cleaned and heat sterilized before use on another patient. Instrument processing requires multiple steps using specialized equipment. Each dental practice should have policies and procedures in place for containing, transporting, and handling instruments and equipment that may be contaminated with blood or body fluids. Most single-use devices are labeled by the manufacturer for only a single use and do not have reprocessing instructions.
Use single-use devices for one patient only and dispose of appropriately. Cleaning, disinfection and sterilization of dental equipment should be assigned to DHCP with training in the required reprocessing steps to ensure reprocessing results in a device that can be safely used for patient care.
Training should also include the appropriate use of PPE necessary for safe handling of contaminated equipment. Patient-care items e. Note: Dental handpieces and associated attachments, including low-speed motors and reusable prophylaxis angles, should always be heat sterilized between patients and not high-level or surface disinfected.
Although these devices are considered semicritical, studies have shown that their internal surfaces can become contaminated with patient materials during use. If these devices are not properly cleaned and heat sterilized, the next patient may be exposed to potentially infectious materials.
Digital radiography sensors are also considered semicritical and should be protected with a Food and Drug Administration FDA -cleared barrier to reduce contamination during use, followed by cleaning and heat-sterilization or high-level disinfection between patients. If the item cannot tolerate these procedures then, at a minimum, protect with an FDA-cleared barrier. In addition, clean and disinfect with an Environmental Protection Agency EPA -registered hospital disinfectant with intermediate-level i.
Because these items vary by manufacturer and their ability to be sterilized or high-level disinfected also vary, refer to manufacturer instructions for reprocessing. Cleaning to remove debris and organic contamination from instruments should always occur before disinfection or sterilization. If blood, saliva, and other contamination are not removed, these materials can shield microorganisms and potentially compromise the disinfection or sterilization process.
Automated cleaning equipment e. After cleaning, dried instruments should be inspected, wrapped, packaged, or placed into container systems before heat sterilization. Packages should be labeled to show the sterilizer used, the cycle or load number, the date of sterilization, and, if applicable, the expiration date.
The ability of a sterilizer to reach conditions necessary to achieve sterilization should be monitored using a combination of biological, mechanical, and chemical indicators. Biological indicators, or spore tests, are the most accepted method for monitoring the sterilization process because they assess the sterilization process directly by killing known highly resistant microorganisms e.
A spore test should be used at least weekly to monitor sterilizers. However, because spore tests are only performed periodically e. Mechanical and chemical indicators do not guarantee sterilization; however, they help detect procedural errors and equipment malfunctions. Mechanical monitoring involves checking the sterilizer gauges, computer displays, or printouts; and documenting the sterilization pressure, temperature, and exposure time in your sterilization records.
Since these parameters can be observed during the sterilization cycle, this might be the first indication of a problem. Chemical monitoring uses sensitive chemicals that change color when exposed to high temperatures or combinations of time and temperature.
Examples include chemical indicator tapes, strips or tabs, and special markings on packaging materials. Chemical monitoring results are obtained immediately following the sterilization cycle and therefore can provide more timely information about the sterilization cycle than a spore test. A chemical indicator should be used inside every package to verify that the sterilizing agent e.
If the internal chemical indicator is not visible from the outside of the package, an external indicator should also be used. External indicators can be inspected immediately when removing packages from the sterilizer. If the appropriate color change did not occur, do not use the instruments.
Chemical indicators also help to differentiate between processed and unprocessed items, eliminating the possibility of using instruments that have not been sterilized. Note: A single-parameter internal chemical indicator provides information regarding only one sterilization parameter e.
Sterilization monitoring e. Maintaining accurate records ensures cycle parameters have been met and establishes accountability. In addition, if there is a problem with a sterilizer e. Ideally, sterile instruments and supplies should be stored in covered or closed cabinets. Wrapped packages of sterilized instruments should be inspected before opening and use to ensure the packaging material has not been compromised e.
The contents of any compromised packs should be reprocessed i. Recommendations for the cleaning, disinfection, and sterilization of dental equipment can be found in the Guidelines for Infection Control in Dental Health-Care Settings— pdf icon [PDF — 1. The extension of precautions to all patients was referred to as Universal Precautions. Under these guidelines, blood and body fluids of all patients were considered potentially infectious. Universal Precautions specified the use of gloves and face shields and avoiding exposure with needles and other instruments after use when the potential for contact with blood and bodily fluids was anticipated.
The importance of frequent handwashing was at the core of these recommendations. It expanded the concept of personal protective equipment to include plastic aprons and covers for hair and shoes to keep all moist body substances off hair, skin, clothes, and mucous membranes.
BSI went beyond simply discarding needles in puncture-resistant containers to placing them in puncture-proof containers. Hands were to be thoroughly washed before as well as after patient care and wearing gloves.
Body Substance Isolation utilized hospital gowns, medical gloves, shoe covers, safety goggles, and surgical masks or N95 respirators. However, there was not a consistent interpretation or use in either BSI or universal precautions.
Times have changed since Universal Precautions were first set in place. The 21st century has seen devastating illness from Ebola virus, avian flu, West Nile virus, SARS, Zika virus and biological warfare as well as the pandemic flu from previous generations. Gloves alone do not completely protect a health professional or patient. Even diseases usually transmitted by contact can be aerosolized by saliva and respiratory secretions.
Am J Infect Con-trol. Back to basics: hand hygiene and isolation. Curr Opin Infect Dis. September 9, Accessed Feb. Standard precautions--a new approach to reducing infection transmission in the hospital setting. J Intraven Nurs. April 11, By Elizabeth Srejic Healthcare-associated infections HAIs are a major health concern, despite being largely preventable.
0コメント