What is wrong with our PracticesDisinfectants used indiscrimately,Used unnecessarilyNot used when needed.Concentration not adequateEconomic consideration,Business promotions.Laboratory testing X Hospital conditions.

Economical loss

Money wasted on unnecessary use.People concentrate on Floors, Inanimate objects,

Basic PrinciplesCleaning more ImportantDisinfection and Sterilization ?Cleaning Removes contaminants, Dust, organic matter,Disinfection Reduces number of microbes

Disinfection x SterilizationSterilization is absolute, removes microbes

and spores too.To achieve Sterilization is Expensive, not

sustainable, many times not needed.

Basic care of Operation Theatres.Reduction of Microbial counts is important.Very rarely the Microbes reach the operation

site,Paying attention to Floors Using unnecessary, too many chemical not

necessaryKeep Clean Dry - Bacteria are reduced,Most Important component of Bacteria is water,

dry areas causes natural death.

Walls and Roof ofOperation TheatreFrequent cleaning has little effect.Do not disturb these areas unnecessarily,Floors get contaminated quickly, depend on Number of persons present in the Theatre / Movements they make,On many people make unnecessary movements

than needed

Care of and FloorsDo remember only 1 % are pathogenic.On many occasion S.aureus.Floor should be decontaminated with Use Vacuum cleaner. Wet cleaning techniques Wet Mop / Keep the mops dry

Care of RoofDo not disturb unnecessarily,Do not use ceiling fans they cause aerosol

spread Clean only when remodeling or

accumulated ,good amount of dust.

How you care for FloorsUse only vacuum cleanersDon't broomUse a Mop keep it dry,

Roof, Artificial ceilings, WallsDo not disturb every dayRoutine disinfection not necessary

Caring for FloorsOnly 1 % are pathogenicThe counts depend on the number of persons,Only people needed for procedures should

enter the theatres.Unnecessary movements disturbs the

bacterial flora

Cleaning the FloorA simple detergent reduces flora by 80 %Addition of disinfectant reduces to 95 %In busy Hospitals counts raise in 2 hours

Environmental Cleaning of Operation TheatresDo not waste chemicals.Only remove the dust with cloth wetted with

clean water,Don't use chemicals/Disinfectants as a habit,Use only when contaminated with blood or

body fluids.

Handling of Air in Operation theatre.Negative Air pressure vented to the

operation theatre.Environmental cleaning should be twice daily

Environmental cleaning of Hospital.Disinfectant Purpose Sodium hypochlorite Contaminated with Blood and body fluidsBleaching powder Toilets, bathrooms 9 grams/lit

Environmental cleaning of OT Contd Disinfectant Purpose Alcohol 70% Metal surfaces trolleys

Safety of Air conditioning andWater cooling systemLegionnaires disease is associated with Air

Condition systemChlorination / Heating of water may prove

better alternatives.

Between procedures in the Operation Theatres.Clean operation tables, theatre equipment with

disinfectant solution with detergent,In case of spillage of blood / body fluids

decontaminate with bleaching powder/chlorine solution ( 1 % available chlorine ).

Always discard wastes in prescribed plastic bags – Don’t accumulate biohazard waste in the operation theatres.

Don’t discard discarded soiled gowns in the operation theatre.

At the End of the Dayin Operation theatre.Clean all the table tops sinks, door handles with

detergent / low level of disinfectant.Clean the floors with detergents mixed with

warm water,Finally mop with disinfectant like Phenol in the

concentration of 1 : 10Low concentration of Phenol serve as perfume

and not as disinfectant.

Infection control programmes1 Monitoring of Hospital associated infections.2 Training of Health care workers.3 Investigations of outbreaks.4 Any technical lapses.5 Monitoring of staff health6 Education on Universal Precautions 7 Advise on isolation of Infectious patients.8 Waste disposal9 Safe use of Antibiotics / Antibiotic policy.

Role of Microbiology DepartmentIdentifies the pathogensMonitoring of Antibiotic therapy,Education on specimen collection and

transportation,Information on common Antibiogram patternsData on Hospital InfectionSurveillance of the Hospital environmentCounseling of the Infected Hospital Staff.

Surveillance of Operation theatreExamination of AirEstimations are done for detection of bacteria

carrying particles in Air.Factors influence Number of persons present. Body movements, Disturbances of clothing.

Bacteriological surveillance testing at regular internals is not warranted,

But warranted when modification of operation theaters are done,

In any unforeseen increase of incidence of infection form any particular operation theatre.