Fundamentals of Infections Control

Aman UllahB.Sc. MLT

M. Phil MicrobiologyMaster in Health Research

Certificate in Health and Physical Education

Objectives

Describe basic principles of cleaning, disinfection, sterilization

Identify when to use cleaning, disinfection, or sterilization

How to perform cleaning and disinfection of healthcare settings

Cleaning, Disinfection and Sterilization

Cleaning General removal of debris (dirt, food, feces, blood,

saliva and other body secretions) Reduces amount of organic matter that contributes to

proliferation of bacteria and virusesDisinfection Reducing the number of microbes on a surface to very

low levelsSterilization killing or removal of all microorganisms

Cleaning, Disinfection and Sterilization in Healthcare Settings

Practice standards are based on Spaulding's Classification system

Spaulding’s levels are based on the potential for infectious disease spread via equipment, instruments, furniture and others

Spaulding’s levels: •Critical •Semi-critical •Non-critical

Critical Items

Require sterilizationIncludes items that enter sterile tissue or the

vascular systemExamples include surgical instruments and

accessories, biopsy forceps, cardiac and urinary catheters, implants, needles

Semi-Critical ItemsRequire minimum high level disinfection (or

sterilization)Includes items in contact with non-intact skin or

mucous membranesExamples include respiratory therapy equipment,

anesthesia equipment, flexible and laryngoscopes, bronchoscopes, GI endoscopes, cystoscopes, vaginal ultrasonic probes

Cleaning process must precede high-level disinfection

Non-Critical ItemsRequire intermediate-level or low-level

disinfection Includes items in contact only with intact skinExamples include BP cuffs, stethoscopes,

durable mobile patient equipmentHowever, these items could potentially

contribute to secondary transmission, by contaminating the hands of health care workers or by contact with medical equipment that will subsequently come in contact with patients

CleaningThe principal aim of cleaning is to remove visible dirtMechanical process: the dirt is dissolved by water,

diluted until it is no longer visible, and rinsed offSoaps and detergents act a solubility promoting

agentsTwo main functions: nonmicrobiological (improve or

restore appearance, maintain function and prevent deterioration), microbiological (reduce the numbers of microbes present, together with any substances that support their growth or interfere with disinfection/sterilization

Disinfection

Activity of a disinfectant process can vary widelyAccording to CDC following can be made:• High-level disinfection: can be expected to destroy all

microorganisms, with the exception of large numbers of bacterial spores.

• Intermediate disinfection: inactivates Mycobacterium tuberculosis, vegetative bacteria, most viruses, and most fungi; does not necessarily kill bacterial spores.

• Low-level disinfection: can kill most bacteria, some viruses, and some fungi; cannot be relied on to kill resistant microorganisms such as tubercle bacilli or bacterial spores

Standard procedure for cleaning and disinfection

Standard procedure for cleaning and disinfection

Standard procedure for cleaning and disinfection

Standard procedure for cleaning and disinfection

Standard procedure for cleaning and disinfection

Thanks