1 PowerPoint ® to accompany Second Edition Ramutkowski  Booth  Pugh  Thompson  Whicker Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Medical Assisting Chapter 20

2 Objectives 20-1Describe the three levels of infection control. 20-2Compare and contrast the procedures for sanitization, disinfection and sterilization. 20-3Describe measures used in sanitization. 29-4List various methods used in disinfection and the advantages and disadvantages of each. 20-5Explain what an autoclave is and how it operates. 20-6List the steps in the general autoclave procedures. Infection-Control Techniques

3 Objectives (cont.) 20-7Explain how to wrap and label items for sterilization in an autoclave. 20-8Describe how to complete the sterilization procedure using an autoclave. 20-9Describe four other methods for sterilizing instruments List some infectious diseases, and identify their signs and symptoms. Infection-Control Techniques

4 Objectives (cont.) 20-11Describe Centers for Disease Control and Prevention requirements for reporting cases of infectious disease Describe CDC guidelines for patient isolation Explain the purpose of immunization Describe your role in educating patients about immunizations. Infection-Control Techniques

5 Introduction  Patients coming to the office for treatment may be more susceptible to infections.  Importance of immunizations and patient education is stressed as a method of infection control. You will be introduced to identifying infectious diseases, reporting guidelines and how to isolate patients.

6 Medical Assistant’s Role in Infection Control  Follow correct sanitization, disinfection and sterilization procedures  Help patient understand basic disease prevention  Administer immunizations and educate patients about immunizations

7 Three Levels of Infection Control  Sanitization – cleaning and scrubbing instruments and equipment to remove contaminated materials and microorganisms  Disinfection – second level used on instruments and equipments that come in contact with intact mucous membrane Sterilization – complete destruction of all microorganisms- pathogenic, beneficial, and harmless- surface of instrument and equipment

8 Sanitization Methods  Collecting instruments – place in container with water and neutral pH detergent until you can get to them.  Use utility gloves always and mask, eye protection and protective clothing if blood, body fluids or tissue are present

9 Sanitization Methods (cont.)  Drain disinfectant or detergent solution  Rinse each piece under hot running water  Scrub each item using hot, soapy water and small plastic brush  Pay careful attention to hinges, ratchets and nooks

10 Sanitization Methods (cont.)  Rinse instruments individually and place each one on a clean towel.  Roll all instruments in the towel to remove moisture  Place instruments either in trays or bins for storage or wrap for sterilization

11 Apply Your Knowledge What is the difference between sanitization and sterilization?

12 Answer Apply Your Knowledge - Answer Sanitization is the cleaning and scrubbing instruments and equipment to remove contaminated materials and microorganisms. Sterilization is the complete destruction of all microorganisms -pathogenic, beneficial, and harmless - from the surface of instruments and equipment. What is the difference between sanitization and sterilization?

13 Disinfection  Wear gloves when handling instruments.  Disinfection solution must cover every surface.  Used if instrument does not penetrate a patient’s skin or mucous membranes  Enamelware  Endotracheal tubes  Glassware  Laryngoscopes and nasal specula

14 Sterilization  Required for all instruments or supplies that will penetrate a patient’s skin or any other normally sterile area of the body.  First sanitize it and/or disinfect it.  Autoclaving  Chemical (cold) processes  Dry heat processes  Gas processes  Microwave processes

15 Autoclave  Primary method of sterilizing instruments  Steam operate at lower temperature  Moist steam permeates the wrapping  Moisture causes coagulation of proteins causing cells to burst and killing them.

16 Autoclave (cont.) 1.Prepare instruments by wrapping in muslin or special porous paper 2.Preheat according to manufacturer’s guidelines 3.Perform any quality control procedures 4.Load instruments and equipment 5.Set the autoclave for the correct time after temperature and pressure has been reached

17 Autoclave (cont.) 6.Run the autoclave through sterilization cycle and drying cycle 7.Remove the instruments and equipment 8.Store the instruments and equipment properly 9.Clean autoclave and surrounding area

18 Microorganisms Other Methods of Sterilization  Chemical – using chemicals solutions (Chemiclave) when heat can’t be used  Dry heat – used when can’t use heat or chemicals  Gas – used in hospitals takes longer than steam  Microwave – low pressure steam with radiation to produce localized heat that kills microorganisms.

19 Apply Your Knowledge When would you use a chemical process to sterilize instruments?

20 Answer Apply Your Knowledge - Answer You would use chemical process to sterilize instruments when heat and moisture would damage the instruments. When would you use a chemical process to sterilize instruments?

21 Infectious Disease  Pertussis  Poliomyelitis  Roseola  Rubella  Chickenpox (varicella)  Common cold  Croup  Diphtheria  Haemophilus influenzae Type B  Influenza  Measles Identifying signs and symptoms of these diseases can help protect health care workers and patients from exposure to pathogens.

22 Infectious Disease (cont.)  Common cold Signs and symptoms: Coughing and sneezing Incubation lasts 2 to 3 days  Use frequent hand washing

23 Infectious Disease (cont.)  Croup – occurs when an allergy, foreign body, or an infection obstructs the upper airway. Harsh, barking cough, difficulty breathing Use humidified air Encourage rest and clear warm fluids

24 Infectious Disease (cont.)  Measles (rubeola) – viral disease; itchy rash appears 14 days after exposure  Mumps – viral infection; pain and inflammation of the parotid glands, fever  Rubella – viral infection; fever and itchy rash Immunization programs for children will reduce patients risk of contracting these diseases.

25 Infectious Disease (cont.)  Tetanus (lockjaw) – bacterial disease cause by puncture wound by infected fomite  Vaccination can prevent tetanus  Tuberculosis (TB) – bacterial disease of the lungs with night sweats, fever, chills, fatigue, blood sputum.

26 Apply Your Knowledge What are three viral infections that children most commonly receive immunizations against?

27 Answer Apply Your Knowledge - Answer Measles, mumps, and rubella What are three viral infections that children most commonly receive immunizations against?

28 Reporting Guidelines  CDC requires reporting certain diseases to the state or county department of health.  Helps research epidemiologists control the spread of infections.  Certain diseases must be reported to the National Notifiable Disease Surveillance System of the CDC. (See figure )

29 Guidelines for Isolation Precautions Three parts:  Standard Precautions developed  Precautions designed to prevent spread of infection by droplet, airborne, or contact known as Transmission-Based Precautions  Describes specific syndromes you may encounter that are highly infectious

30 Immunizations  Administration of a vaccine or toxoid to protect susceptible individuals from infectious disease  Reduces risk of infection spread

31 Immunization (cont.)  Immunization for Children published jointly by:  Advisory Committee on Immunization Practices  American Academy of Pediatrics  American Academy of Family Physicians  The National Coalition of Adult Immunization (NCAI) publishes a schedule for adults.

32 Patient Education – Immunizations Pediatric Patients  Informed consents  Contraindications  Immunizations recordsPregnant  May need more immunizations  Do not give rubella immunization during pregnancy

33 Patient Education – Immunizations (cont.) Elderly Patients:  Influenza and pneumonia are needed  Describe that side effects are mild Immunocompromised Patients  Can experience minimal to dangerous effects of immunizations  Depends on patient’s disease

34 Patient Education – Immunizations (cont.) Health care Workers:  Risk of contracting infectious disease.  Should pay careful attention to own immunization status.  Employers must offer vaccination against Hepatitis B at no cost to employee.

35 Apply Your Knowledge What organization publishes immunization schedules for adults?

36 Answer Apply Your Knowledge - Answer National Coalition of Adult Immunization (NCAI) What organization publishes an immunization schedule for adults?

37 Summary Medical Assistant Sanitization, disinfection, and sterilization break the pathogen cycle by ridding instruments and equipment of pathogens. You play a vital role in reducing patient vulnerability by encouraging patients to maintain a correct immunization status and by being aware of special immunization concerns of certain patients.

38 End of Chapter