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Dis-infection and sterilization
Principle of Dis-infection and Sterilization
Dis-infection and sterilization is important for Prevention and Infection in Hospital. Re-usable Medical Device used for treatment must be obtained effectively Dis-infection and Sterilization.According to the standard for patient safety.
Spaulding Classification
|
Classification |
Dis - infection Level |
Effectiveness |
Example |
|---|---|---|---|
|
Critical Item; |
• Sterilization level |
• Kills all micro - organism life |
• Surgical instrument |
|
Se-mi critical; |
• Sterilization |
• Kills all micro - organism but not necessarily all bacterial spores |
• Flexible endoscope |
|
Non-Critical ; |
• Intermediate - level dis - infection |
• Kills virus ,bacterial, Fungi |
• EKG |
Classification Medical device
Dis-infection
Dis-infection is Kill all micro-organism on medical device surface but can not kill prion or mycobacteria by heat, chemical and Dis-infectant
There are 3 level of Dis-infection
- 1. Low-level dis-infection
- Destruction can destroy bacterial, some virus and fungi
- but cannot destroy durable bacteria such as tuberculosis
- 2. Inter-mediated dis-infection
- Do not destroy bacteria spores
- 3. High-level dis-infection
- Can destroy bacterial. All type of virus, fungi and mycobacteria
Temperature and duration Dis-infection
|
High level Dis-infectant |
Temperature & Duration |
Temperature & Duration |
|---|---|---|
|
7.5% Hydrogen peroxide |
Temperature 20 c Duration 30 min | Temperature 20 c Duration 6 hours |
|
0.2% Peracetic acid |
- |
Temperature 50-56 c Duration 12 min |
|
>= 2% Glutaraldehyde |
Temperature 20-25 c Duration 20-90 min |
Temperature 20-25 c Duration 10 hours |
| 0.55% Otho phthalaldehyde (OPA) | Temperature 20-25 c Duration 5 min |
- |
|
7.35% Hydrogen peroxide / 0.23% peracetic acid |
Temperature 20 c Duration 15 min |
Temperature 20 c Duration 3 hours |
Micro-organism resistant
|
Resistance |
Micro-organism |
Dis-infection level |
|---|---|---|
| The most | Prion (Creutzfeldt – jakob disease) | Prion reprocessing |
| Bacterial spores (C.difficile) | Sterilization | |
|
Mycobacterial |
High level dis-infection | |
| Small , non-envelope viruses (HP, polio, EV-D68) |
Intermediate-level dis-infection |
|
|
Fungal spores (Aspergillus , Canada) |
Intermediate-level dis-infection | |
| Gram negative bacilli (Acenetobacter) |
Intermediate-level dis-infection |
|
|
Vegetative fungi and algae |
Low-level dis-infection | |
| Large , non-envelope viruses |
Low-level dis-infection |
|
|
Gram positive bacteria (MRSA ,VRE) |
Low-level dis-infection | |
| Least | Envelope viruses (Ebola .MERS- CoV) |
Low-level dis-infection |
What is Sterilization ???
- Sterilization is the process used to render a medical device free from all forms of viable micro-organisms (Bacteria, Spore, Fungi and Viruses)
- Sterilization is required not all micro-organisms have been completely destroyed during the contamination process
- Within the Sterile processing department, the sterilization are is where sterilizer (steam, low temperature), are located including the space for loading, unloading, and cooling. This can be accommodated by separated three zone system.
Sterile processing Zoning
Variables that Sterilization
- The dryness of medical device to be processed
- The temperature and humidity of the process area
- Medical device were properly prepared and loaded in to sterilizer
- The sterilant is properly in process
- Sterilizer Maintenance protocoz
- The correct sterilization method and cycle were used
- Knowledge and skill of operation staff
Sterilization Process
Sterilization Method
Monitoring of sterilization
| Sterilizer | Mechanical Monitoring |
Chemical monitoring | Biological test | ||
|---|---|---|---|---|---|
| External | Internal | Bowie Dick test | |||
| Steam | |||||
| Sterrad | - | ||||
| Hot Air Oven | - | - | - | ||
Sterilization of Quality Assurance
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