Download Infection Control Techniques

Introduction

Patients coming to the
office for treatment
may be more
susceptible to
infections

Immunizations and
patient education are
important methods of
infection control
You will be introduced to OSHA guidelines, the
Blood-Borne Pathogen Standard, reporting
guidelines, and isolation procedures.
MA’s Role in Infection Control

To control infectious
diseases, the cycle of
infection must be
broken

Apply principles of
infection control in
office setting
MA’s Role in Infection Control (cont.)



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Follow correct sanitization,
disinfection, and sterilization
procedures
Help patients understand basic
disease prevention
Educate patients about
immunizations
Administer immunizations
Apply Your Knowledge
What is your role as a medical assistant in control of
infection in the medical office?
ANSWER: To apply principles of infection control
by following correct sanitization, disinfection, and
sterilization procedures.
Correct!
Infection Control Measures


Eliminate elements needed for disease
to occur
Knowledge of
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Medical asepsis
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Based on cleanliness
As few microorganisms as possible
Surgical asepsis
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Sterile environment
No microorganisms
Medical Asepsis
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Keep office clean:
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Reception area: sick vs. well patients
Reception room clean, well lit, and
ventilated
Keep furniture in good repair
Strict “no food or drink” policy
Empty trash as necessary
Medical Asepsis (cont.)
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During medical assistant procedures
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Prevent cross-contamination
Hand washing
 Beginning of day
 After breaks
 Before and after each patient
 Before and after handling equipment or specimens
 After blowing your nose or coughing
Medical Asepsis (cont.)

Other precautions
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Avoid leaning against sinks, supplies, equipment
Avoid touching your face and mouth
Use tissues when you cough or sneeze, and
always wash your hands afterward
Avoid working directly with patients when you
have a cold; wear gloves and mask if you must
Stay home if you have a fever
Sanitization

Scrubbing with a brush and detergent to remove
blood, mucus, and other contaminants or media
where pathogens can grow

For cleaning items that touch only
healthy, intact skin
OR
First step in disinfection and
sterilization for other equipment

Sanitization (cont.)
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Collect items for sanitization
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Place in water and special
detergent solution
Use utility gloves
Separate sharps from other
equipment
Scrub items

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Follow manufacturers’ guidelines
Dry thoroughly
Examine carefully
Sanitization (cont.)
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Rubber and plastic items
Syringes and needles


Use disposable whenever possible
Ultrasonic cleaning


For delicate instruments and those with
moving parts
Sound waves generated through a cleaning
solution to loosen contaminants
Disinfection



Adequate for instruments that do not
penetrate skin or mucus membranes and
surfaces not considered sterile
OR
Second step in infection control prior to
sterilization
Will not kill spores, certain viruses
Disinfection (cont.)

Using disinfectants

Cleaning products applied to
inanimate materials to reduce or
eliminate infectious organisms


Antiseptics are anti-infective
cleaning agents used on human tissue
Follow manufacturers’ guidelines
Disinfection (cont.)

Factors impacting effectiveness
of disinfectants

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Number of times solution is used
Wet items – surface moisture may
dilute solution
Traces of soap left from sanitization
– alters chemical composition
Evaporation
Disinfection (cont.)
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Choose the correct disinfectant
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Germicidal soap products
Alcohol
Acid products
Formaldehyde
Glutaraldehyde – “cold disinfection”
Bleach
Iodine and iodine compounds
Disinfection (cont.)

Handling disinfected supplies

Prevent contamination with other
surfaces

Use sterile transfer forceps

Wear gloves

Store in clean, moisture-free
environment
Surgical Asepsis
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
Goal is to keep the surgical
environment completely free of
all microorganisms
Used for even minor operations
and injections
The more extensive the
procedure, the greater the risk of
infection
Sterilization

Required for all instruments or supplies that
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
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Object is either sterile or not sterile

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Penetrate the skin
Contact normally sterile areas of the body
If unsure of sterility, consider it not sterile
Prior to sterilization
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Sanitize
Disinfect
Sterilization: The Autoclave
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Primary method of sterilization
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Pressurized steam

Operates at lower
temperatures than dry heat
sterilization

Moisture causes coagulation
of proteins in microorganisms at lower temperatures

Cell walls burst when cell cools, killing the
microorganism
Sterilization: The Autoclave (cont.)
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Wrap sanitized and disinfected
items
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Special porous fabric, paper, or
plastic
Items should not touch
Label
Check water level – distilled
water only
Preheat, but do not overheat
Sterilization: The Autoclave (cont.)
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Load, choose correct setting, run cycle

Temperature 250° to 270° F
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Pressure 15 to 30 pounds
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Unload

Store items properly
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Clean, dry location

Shelf life based on packaging, but generally 30 days
Sterilization: The Autoclave (cont.)
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Clean autoclave and area
Quality control checks
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Sterilization indicators –
confirm that items have been
exposed to correct volume
of steam at the correct
temperature for the correct
length of time
Biological indicators – contain bacterial spores and
confirm that sterilization occurs
Sterilization: The Autoclave (cont.)
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Prevent incomplete
sterilization
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Correct timing
Adequate temperature
Properly wrapped packs
Adequate steam levels
Timing
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Preset for load types
Use sterilization indicators
Sterilization: The Autoclave (cont.)
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Temperature
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Too high – steam too little moisture
Too low – steam too much moisture
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Do not overcrowd autoclave
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Steam level
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If incorrect, items will not be sterile at end of
cycle
Sterilization: Sterile Technique
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Surgical scrub
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During surgical procedures
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Do not touch sterile items without
sterile gloves or transfer forceps
Aseptic technique
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Throughout surgical procedures
Caring for surgical wounds
Sterilization: Surgical Asepsis
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After procedures
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Sanitize, disinfect, and sterilize reusable items
Disinfect surfaces
Waste disposal
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Biohazard waste containers
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Leak-proof containers either color-coded
red or labeled with biohazard symbol
Biohazardous waste
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Biological agents that can spread disease
to living things
OSHA Guidelines
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Blood-Borne Pathogen Standards
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Protect health-care workers from health hazards
on the job
Also protect patients and others who come to
medical facilities
Dictate how to handle infectious or potentially
infectious wastes
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Discarded
Held for processing
OSHA Guidelines (cont.)
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Blood-Borne Pathogen Standards
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Measures to prevent the spread of
infection
Provide a margin of safety by
ensuring that medical facilities
meet minimal standards for
asepsis
Requirements for training,
keeping records, housekeeping,
and personal protective gear
OSHA Guidelines (cont.)
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Universal Precautions
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Prevent health-care workers from exposure to
infections
Assume that all blood and blood and body
fluids are infected with blood-borne pathogens
Standard Precautions
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Combination of Universal Precautions and Body
Substance Isolation guidelines
Used in hospitals to prevent transmission of disease
OSHA Guidelines (cont.)
Categories of tasks
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I.
Tasks that expose a worker to blood, body
fluids, or tissues and require specific protective
measures
II.
Tasks that usually do not involve risk of
exposure but require precautions in certain
situations
III. Tasks that have no risk of exposure, so no
special protection is required
OSHA Guidelines (cont.)
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Personal Protective Equipment
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Protective gear worn to protect
against physical hazards
Employers must provide PPE at no
charge to the employee
Disposable, sterile exam and utility
gloves
Masks and protective eyewear or face
shields
Protective clothing
OSHA Guidelines (cont.)
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Postprocedure Cleanup
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Decontaminate all
exposed surfaces
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Replace protective
coverings on
surfaces or
equipment

Decontaminate
receptacles

Pick up any broken
glass with tongs

Discard all potentially
infectious waste
materials
OSHA Guidelines (cont.)
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Apply guidelines daily on the job
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Exposure incidents
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Contact with infectious substance
Rules apply to all serious infections – HIV, HBV
HBV vaccine
Transmission to patients
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Nosocomial infection – an infection acquired by a
patient in a health-care facility
Apply Your Knowledge
OSHA divides medical tasks by level of risk. What
are these risk categories?
20-35
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ANSWER: There are three categories of risk:
Category 1: Expose a worker to blood, body fluids, or tissues
and require specific protective measures
Category 2: Usually do not involve risk of exposure, but
precautions are required in certain situations
Category 3: No risk of exposure, so no special protection is
required
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Reporting Guidelines

Certain diseases must be
reported to state or county
health department

Information is forwarded to
the CDC – control of the
spread of infection
Reporting Guidelines (cont.)

National Notifiable Disease Surveillance
System (Table 20-2)

Examples
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HIV/AIDS
Rubella
Legionellosis
Mumps
Tetanus

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Cholera
Hepatitis
Lyme disease
Smallpox
Tuberculosis
Apply Your Knowledge
How is the information on reportable diseases used by the CDC?
ANSWER: The CDC uses the information reported to them
to help control the spread of infection.
Isolation Guidelines
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CDC guidelines
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Types of precautions needed
Patients requiring precautions
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Create an environment that protects against
pathogens
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Standard Precautions
Isolation Guidelines (cont.)
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PPE

Select appropriate PPE for mode of
transmission
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Gloves
Masks, face shields,
respirators
Gowns
Table 20-3
Apply Your Knowledge
Mrs. Findley brings her child with chickenpox into the
medical office. What type of personal protective
equipment should you use when caring for this child?
ANSWER: Chickenpox requires airborne and contact
precautions, so you should use gloves and a mask and goggles
or a respirator.
Nice!
Immunizations

Immunization


Administration of a vaccine or
toxoid to protect susceptible
individuals from infectious
diseases
Reduces risk of infection
spread

Decreases the susceptibility of
the host
Immunizations: Recommendations

Immunization schedules for children
Advisory Committee on Immunization Practices
 American Academy of Pediatrics
 American Academy of Family Physicians
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Immunization schedules for adults

The National Coalition of Adult Immunization
(NCAI)
Immunizations (cont.)
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When administering. you must explain
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The need for immunization
Side effects
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Soreness at site
Low-grade fever
General malaise
Immunizations (cont.)
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Concerns
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Pediatric patients
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Informed consent
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Do not give if child has fever
Explain benefits and risks
Contraindications

Symptoms that render the use of a remedy or
procedure inadvisable because of the risk
Immunizations (cont.)
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Immunization records
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Pregnant patients
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National Childhood Vaccine Injury Act of 1988
Instruct parents keep record as proof of
immunization
Avoid live virus vaccines
FDA categories A, B, C, D, and X
Elderly

More likely to develop side effects
Immunizations (cont.)
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Immunocompromised patients
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May experience minimal to dangerous effects
Adjust dosage or delay administration
Must also consider immunization status of family
and caregivers
Health-care workers

Hepatitis B vaccination
offered by employer at no
cost to employee
Preventing Disease Transmission

Patient education
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Health promotion
Disease prevention
Disease treatment
Medical Assistant role in patient education
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Share responsibility
Reinforce and explain instructions
Preventing Disease Transmission (cont.)
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Educate patient on
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Nutrition and diet
Exercise and weight control
Prevention of STDs
Smoking cessation
Alcohol and drug abuse prevention and
treatment
Proper use of medications and prescribed
treatments
Stress-reduction techniques
Preventing Disease Transmission (cont.)

Goal of patient education

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Help patients take care of
themselves
Encourage patients to
participate actively in
their own health care
In Summary
Medical Assistant
Sanitization, disinfection, and sterilization break the cycle of
infection by ridding instruments and equipment of pathogens.
The medical assistant plays a vital role in reducing patient
vulnerability by encouraging patients to maintain a correct
immunization status and by being aware of special immunization
concerns of certain patients.