CSAO Theta Chapter Education Day May 30, 2009

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Flare-ups in the News. Lawful Issues in Patient Safety . 2003: CDN Hospitals told >900 patients that uncalled for disinfection of gear may have presented them to HIV, Hepatitis and different maladies. $150M legal claim documented charging carelessness in neglecting to meet satisfactory disinfection standards.Government requested a region wide review of healing facility contamination control practicesHealthcare Qua

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Contamination Control Facts: How to Select an Ideal Disinfectant CSAO – Theta Chapter Education Day May 30, 2009 Lee Nesbitt, BMSc Manager, Professional & Technical Services Virox Technologies Inc Phone: 1-800-387-7578 x115 Email: lnesbitt@virox.com

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Outbreaks in the News

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Legal Issues in Patient Safety 2003: CDN Hospitals advised >900 patients that shameful sanitization of gear may have presented them to HIV, Hepatitis and different sicknesses. $150M legal claim documented asserting carelessness in neglecting to meet satisfactory cleansing measures. Government requested an area wide review of doctor's facility contamination control rehearses Healthcare Quarterly Vol. 8, Special Issue October 2005

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Patient Disclosure Canadian law unmistakably sets up a positive obligation on care suppliers to advise patients of mistakes that happen amid their care When mind suppliers understand that patients may have been presented to disease from hardware, different patients or human services laborers, a legitimate commitment may emerge to contact patients to caution them of the hazard and give counsel with respect to suitable follow-up testing and care.

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On the Same Page Terminology, Definitions, Common Words

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Cleaning The evacuation of follower obvious soil, blood, protein substances (tissue) and different flotsam and jetsam from surfaces by mechanical or manual process Generally expert with water and cleansers Removes or disposes of the stores of potential pathogenic creatures

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Major Groups Of Microbes Most Susceptible Viruses (concealed) Bacteria ( Gram +ve & Gram - ve ) Fungi Viruses (non-encompassed) Mycobacteria Protozoa Bacterial Spores Least Susceptible

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Process for Choosing a Disinfectant Consider the Device Classification (According to Spaulding) Once the gadget has been characterized decide the Disinfection Process Choose the CORRECT Product

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Process for Choosing a Disinfectant Sterilization Critical Devices* High Level Disinfection Semi-Critical Devices Intermediate Level Disinfection Non-Critical Devices Low Level Disinfection *Foot Care Instruments characterized as basic as indicated by CCDR Vol. 23S8 (Dec 1997) Infection Control Guidelines: Foot Care by Health Care Providers

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Definition: Low Level Disinfectant alludes to the level of purification required when handling noncritical things or some natural surfaces and murders most vegetative microorganisms and a few parasites and in addition encompassed infections however not mycobacteria or bacterial spores.

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Definition: Intermediate Level Disinfectant alludes to disinfectant that executes vegetative microorganisms, most infections and most organisms yet not safe bacterial spores.

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Definition: High Level Disinfectant alludes to a procedure which devastates vegetative microscopic organisms, mycobacteria, parasites, encompassed and non-wrapped infections, however not really bacterial spores

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Definition: Chemosterilization alludes to the synthetic cleansing procedure that decimates all types of microbial life including microorganisms, infections, spores and growths.

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Microbial Kill Summary

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What's in your jug? Disinfectants: Desired Traits & Limiting Factors

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Basic Facts Disinfectants are the foundation of Environmental Infection Control >8000 Products enrolled in the U.S. & Canada half of which are utilized for Healthcare Infection Control There are 300 distinctive dynamic sciences 14 are in 95% of the disinfectant items 6 are the most widely recognized

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Microbiological Detergency properties for cleaning Not Readily Neutralized in Organic or Inorganic Matter Microorganism Resistance won't create Broad-Spectrum & Fast Acting Germicidal Activity

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Chemistry Comparisons - Surfaces

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Chemistry Comparisons - Surfaces

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Chemistry Comparisons - Instruments

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Chemical Safe to Transport & Easy to Store Improper capacity of disinfectants may prompt to blasts or flames Long Shelf Life Improper or delayed capacity of disinfectants may prompt to development of microscopic organisms in them Non-Corrosive & Material Compatible Using the wrong sort or level of disinfectant may bring about consumption or other harm to costly things, for example, adaptable endoscopes

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Chemical Profile - Surfaces

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Chemical Profile - Instruments

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Toxicity Non-Toxic to people & creatures Non-Allergenic & non-sharpening Non-Hormone disturbance Certain microbicidal chemicals or their breakdown items can upset hormone work in people & creatures Safe for the User and Patient Exposure to cleaner & disinfectant vapors may bring about respiratory refinement Improperly flushed endoscopes or different gadgets may discharge buildups of disinfectants into body cavity

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Health & Safety - Surfaces

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Health & Safety - Instruments

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Environmental Environmentally stable (Biodegradable) Environmentally-stable sanitizers & disinfectants can defile sustenance or water (groundwater & surface water) No Active Residual Chemistry Good Air Quality Free of any impactful odor No Volatile Organic Compounds (VOCs) Use of vaporous or unpredictable items may contrarily influence indoor air quality Fragrance Free

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Environmental Sustainability - Surfaces

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Environmental Sustainability - Instruments

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Understanding the Label

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TPD: Disinfectant Drugs Clearly diagrams the prerequisites of what must be incorporated on a mark Name of Product & Manufacturer DIN must be on the principle board Active Ingredients Intended Use Net substance Lot Number & Expiry Date Precautionary images and preventative articulations

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TPD: Disinfectant Drugs Label necessities proceeded with: Claims Area or Site of Use Directions for Use Specific bearings for get ready being used weakening including proportions or metric units Reference to level of hardness of item diluent at time of testing Pre-cleaning or cleaning prerequisites Contact Times Temperature Stability of weakened or being used item

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TPD: Disinfectant Drugs Label prerequisites proceeded with: Rinse techniques Directions for Use for proposed use against bloodborne pathogens Reference to PPE Directions for transfer of irresistible waste

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Disinfectant Selection Remember: Match Product with Protocol Surfaces versus Instruments Cleaning = 1 st step Disinfection = 2 nd step Contact Time is MANDATORY!

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Virox Technologies Inc. Building Revolutionary Disinfectants for the War Against Microbes

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References Infection Control Guidelines: Hand Washing, Cleaning, Disinfection and Sterilization in Health Care, Health Canada. Dec 1998, Vol 24S8 Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Health Care, Health Canada. July 1999, Vol 25S4 Guidelines for Environmental Infection Control in Healthcare Facilities, CDC. MMWR June 2003, Vol 52, No RR-10 Best Practices for Cleaning, Disinfection and Sterilization in All Health Care Settings, PIDAC, May 2006

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References Block S. Sterilization. Cleansing, and Preservation, 5 th Ed. 2001 Mayhall CG. Doctor's facility Epidemiology and Infection Control, 3 rd Ed. Philadelphia. Lippincott Williams & Wilkins, 2004:1473-1522 Cokendolpher JC & Haukos JF. The Practical Applications of Disinfection and Sterilization in Health Care Facilities, Chicago. American Hospital Association, 1996: 47-59 Rutala WA. APIC Guideline for Selection and Use of Disinfectants AJIC 1990:17(2) 99-117

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References Bessems E. The impact of viable conditions on the adequacy of disinfectants. Int Biodeter & Biodeg 1998:177-183 Crawford L et al. A Comparison of Commonly Used Surface Disinfectants: Alcohol-, Phenol-, Chlorine-and Quat Disinfectants. www.infectioncontroltoday.com/articles/0b1feat2.html Russel AD. Glutaraldehyde: Current Status and Uses. Inf Con & Hosp Epi 1994;15 (11) 724-733 Rutala WA. Sporicidal Activity of Chemical Sterilants Used in Hospitals. Inf Con & Hosp Epi 1993; 14(12) 713-718

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References Rutala WA & Weber DJ. The advantages of surface sanitization. AJIC 2004;32(4) 226-229 Woldkoff P et al. Hazard in cleaning: synthetic and physical introduction. Sci of Total Env 1995:215:135-156 Sattar SA. Current issues in testing, choice and utilization of microbicides in contamination control: a basic survey. AICJ 2004;9(3):84-100 Health Canada. Restorative Products Program Guidelines: Disinfectant Drugs. Fall 1999

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References Degussa, Hydrogen Peroxide: Properties, Handling and Application Hugo, Inhibition and devastation of the microbial cell Ascenzi, Handbook of disinfectants and cleaning agents CCDR Supplement, Vol 23S8 (Dec 1997), Infection Control Guidelines: Foot Care by Health Care Providers. http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/97vol23/23s8/fcindexe.html