1. What is the autoclave thing again

2. Sanitization: fancy word for Cleaning Removing of foreign material Dirt, body fluids, lubricants Using detergents, soap & H2O, scrubbing, ultrasonic 1 st step in the disinfection and/or sterilization process Temperature of the water is important.

3. Sanitization: First level Equipment and instruments and surfaces Scrubbing Cleaning Using detergents and H20 Scrubbing to remove contamination on hard to reach surfaces Open hinges and ratchets

4. Ultrasonic Bath of special solution through which sound waves pass loosing debris from instruments Used for sanitization of Sharp objects: scalpels, or those with sharp edges Be aware that instruments made of different metals should be separated Always place instruments in open position

6. Note For instruments contaminated with blood or protein these need to be rinsed in cool water to remove contamination before sanitization This step is not necessary if using Specialized detergents that are neutral ph, low sudsing, formulated to dissolve blood and blood products

7. After Cleaning Rinse individually Place on clean towel Dry thoroughly Inspect for damage and smooth operation If instruments do not require further disinfection or sterilization they can be stored

8. Note Be aware of manufactures guidelines Think soft metals Rubber tubing Electronics

9. Disinfection: Second Level Process that eliminates many or all microorganisms except spores Either with liquid chemicals or boiling (instruments placed into room temperature water that is raised to boiling for a period of time and then allowed to cool)

10. Disinfection: Key point Proper contact Proper time Proper dilution

11. Disinfection Three Levels High-level Destroy all microorganisms except bacterial spores Intermediate disinfection Inactivates M. tuberculosia vegetative bacteria such as Staphlycococcus aureus, most fungus and viruses Not bacterial spores

12. Disinfection Low-level disinfection Most bacteria Some viruses Some fungi Not resistant microorganisms (super bugs) Not bacterial spores

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

15. Sterilization: Third Stage Required for all instruments or supplies that will penetrate a client’s skin or come in contact in areas below the integumentary level. Any instrument that will come in contact with a sterile field

16. 16 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

17. 17 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.

18. 18 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

19. 19 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

20. 20 Microorganisms Other Methods of Sterilization  Chemical – using chemicals solutions (Chemiclave) when heat can’t be used  Dry heat – used when can’t use moist heat or chemicals  Gas – used in hospitals takes longer than steam  Microwave – low pressure steam with radiation to produce localized heat that kills microorganisms.

21. 21 Apply Your Knowledge How would you know the autoclave is working?.

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

23. Storage of Autoclaved instruments What is the most important detail about where you would store sterilized instruments?

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

25. 25 Apply Your Knowledge What is the difference between sanitization and sterilization? 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.