INFECTION PREVENTION & CONTROL, INCLUDING PROCESSING ITEMS FOR REUSE, IN GENERAL PRACTICE

Transcription

1 INFECTION PREVENTION & CONTROL, INCLUDING PROCESSING ITEMS FOR REUSE, IN GENERAL PRACTICE Rose Griffiths May 2016 M Ref: RACGP Infection Prevention and Control Standards for general practices and other office based and community based practices (5 th Edition)

2 LEARNING OBJECTIVES

3 WHY Standards and Guidelines Business Safety

4 WHAT Governance Surveillance Risk Assessment Leadership

5 HOW Written Policies and Procedures Education

6 PARTNERING WITH CONSUMERS A two-way approach that encourages patient participation, is essential to successful infection prevention and control NHMRC (2010) Australian Guidelines for the Prevention and control of Infection in Healthcare. Commonwealth of Australia. (Page 29)

7 OVERVIEW Infection Prevention Basics Washing items for reuse Steps of Sterilisation Validation

8 Preventing cross infection STANDARD PRECAUTIONS Used with all patients regardless known or perceived infection status. TRANSMISSION BASED PRECAUTIONS Only used when known or suspected infection present. (triage) Contact precautions Droplet precautions Airborne precautions

9 Hand Hygiene Occasions for hand hygiene Promote to patients and staff Physical environment Products Liquid soap & water Hand rub

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11 Respiratory hygiene and cough etiquette. Educate patients and staff Posters On hold messages Tissues available Location of bins

12 Aseptic Technique Risk Assessment Manage the environment Decontaminate Aseptic fields Non touch Prevent cross infection

13 Environmental cleaning Designated responsibility Written schedule Risk assessment Trained staff )include contractors) TGA approved products Technique avoid redistribution 2 step clean

14 Waste & Linen General waste Clinical waste Segregate at point of use Bins and sharps containers Linen

15 Sharps safety Education Safe handling and disposal Reduce the risk

16 Blood and body fluid exposure

17 Using Standard Precautions: Blood and body fluid spill Education Spills Kit Instructions

18 Using Standard Precautions: Handling Infectious Items

19 ANY QUESTIONS SO FAR?

20 Washing & Reprocessing Items: 10 Steps

21 Step 1. Staff Support

22 DESIGNATED RESPONSIBILITY KEEP UP WITH CHANGES AND NEW STANDARDS DOCUMENTATION & IMPLEMENTATION STAFF IMMUNISATION WORKPLACE POLICIES EDUCATION & COMPETENCY TESTING NEW STAFF ORIENTATION + COMPETENCY TESTING REFRESHER TRAINING EVERY 3 YEARS

23 Step 2. Environment & workflow

24 Adapted handbasin

25 Purpose built facility

26 Dedicated area, Workflow, Equipment & Consumables

27 Step 3. Wash items

28 Manual Cleaning Ask Is this item suitable to reprocess? Correctly diluted detergent PPE Steps Clean Rinse Dry Cover Tidy up

29 Step 4. Process for intended use

30 Low level disinfection for non-critical items High level disinfection for semi-critical items Sterile for critical items

31 Step 5. Package items for sterilisation

32 Pack contents and barrier system Class 1 indicator on packaging Correct size pouch Fold on the line Label with permanent marker

33 Step 6. Load the steriliser

34 Loading the steriliser-dos & Don ts Don t overload Don t exceed validated load Do try to promote steam flow Do follow operating instructions

35 Step 7. Steriliser parameters & monitoring the cycle

36 Monitoring the cycle Required Class 1 indicator Plus either Printout OR Data logger May also add Class 4, 5 or 6 indicator for additional assurance

37 Check the temperature C Check the sterilisation time Save original (or scan) for your records

38 Data Logger Chemical indicator

39 Step 8. Unloading the steriliser

40 What you need to record for every load Date & Load number Contents Preparation signature Class 1 indicator Monitoring evidence Condition of the packs Release signature Additional comments

41 Documentation & tracking

42 Step 9. Store items for reuse

43 Storage of sterilised items Clean and dry Container with a lid or drawer Minimum handling Stock rotation Check integrity prior to use

44 Step 10. Steriliser maintenance

45 Routine Maintenance & Cleaning (daily/weekly) Servicing- (yearly or as required, validation needed annually or after major service/repair) Failed Cycles Hint: Keep service technicians business card handy

46 Validation of your Sterilisation Process

47 Review policies and procedures and make any changes Document validation cycles in the steriliser log. Select a Challenge pack and determine your Challenge load Service Technician Visits Sterilise your challenge load Challenge pack in the coldest spot 2 biological indicators: Repeat this 3 consecutive times Incubate Biological Indicators 6 sterilised Pass (no growth) 1 control Fail (grew culture) Sign off Educate staff Don t exceed the challenge load DOCUMENT

48 Your Challenge pack & Challenge load Largest pack you sterilise Largest load you are going to want to sterilise Document what you used and how you loaded it so this can be repeated Ensure staff know what went into the load so they do not exceed it in future

49 Service Technician Routine service & calibration Heat distribution studies Penetration time Time at temperature Calculation of total processing time Parameter settings TPT = Penetration time + Holding Time (3 min)

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51 Practice Staff Review written protocols Determine challenge pack & challenge load Diagram showing the placement of packs & Biological indicators in the steriliser Run 3 validation test loads Document in steriliser log Record the Biological indicator results

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53 QUESTIONS?

54 REFERENCES RACGP Standards for General Practices (4th Ed.) (Amended May 2013) NHMRC (2010) Australian Guidelines for the Prevention and control of Infection in Healthcare. Commonwealth of Australia. RACGP Infection prevention and control standards for general practices and other office-based and community-based practices (5 th Edition)