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SELF-STUDY SERIES March 2014


The self-study lesson on this central service topic was developed by STERIS. The lessons are administered by KSR Publishing, Inc.


Earn CEUs


The series can assist readers in maintaining their CS certifi cation. After careful study of the lesson, com- plete the examination at the end of this section. Mail the complete examination and scoring fee to Health- care Purchasing News for grading. We will notify you if you have a passing score of 70 percent or higher, and you will receive a certifi cate of completion within 30 days. Previous lessons are available on the Internet at www.hpnonline.com.


Certifi cation


The CBSPD (Certifi cation Board for Sterile Processing and Distribution) has pre-approved this in-service for one (1) contact hour for a period of fi ve (5) years from the date of original publication. Successful completion of the lesson and post test must be documented by facility management and those records maintained by the individual until re-certifi cation is required. DO NOT SEND LESSON OR TEST TO CBSPD.


For additional information regarding certifi cation con- tact CBSPD - 148 Main Street, Suite C-1, Lebanon, NJ 08833 • www.sterileprocessing.org. For more infor- mation direct any questions to Healthcare Purchasing News (941) 927-9345, ext 202.


Learning


Objectives 1. Defi ne chemical disinfection and sterilization


2. Describe various standards and guidelines for chemical disinfection/ sterilization of devices


3. Explain the key factors in the safe handling and use of chemical disinfectants and sterilants


Sponsored by: by Dr. Gerald McDonnell, BSc PhD


Reusable medical devices are widely used in healthcare facilities for a variety of surgical, therapeutic and diagnostic purposes. It is important that these devices are safely handled to reduce the risk of adverse events such as device malfunction or damage, the transmission of pathogenic (harmful) microorganisms, or a toxic event in a patient. Reusable devices can become soiled with a variety of patient materials (including blood and tissues) during their use, and these soils may harbor pathogenic microorganisms, posing an infection risk to staff who handle used devices or to patients on which such devices are subsequently reused. Effective device processing (or reprocessing) is required to render these devices safe for subsequent staff handling or patient use. This generally includes cleaning, to physically remove soil from the device, followed by an antimicrobial process appropriate to the intended use of the device. The antimicrobial processes include disinfection and sterilization. Disinfection may be defi ned as a reduction in the number of viable microorganisms on a surface to a level previously specifi ed as appropriate for its intended handling or use. There are various levels of disinfection: low-, intermediate- and high-level,1,2


R defi ned by their ability to kill particular types of microorganisms. The purpose


of disinfection is to reduce the level and types of microorganisms. The result achieved will depend on the label claims of the disinfectant (to include activity against different types of microorganisms under stated conditions) as well as its correct and effective use as part of a standardized process. Sterilization is also an antimicrobial process, but is expected to render the device free from, and inactivates, all types of microorganisms. Disinfection and sterilization can be achieved using a variety of methods. The most com- mon methodologies currently used in healthcare facilities are heat (such as hot water or steam), other physical methods (such as UV light) and a variety of chemicals and related processes, or a combination of these methods. This self-study guide considers the use of chemical disinfectants and sterilization processes.


Guidelines and standards


An important consideration for device processing is the risk that each device could pose to patients when it is used. For this reason, reusable devices can be categorized under the Spaulding Classifi cation system1, 3, 4


. This classifi cation system is based on three different


levels of risk and defi nes devices as being non-critical, semi-critical and critical (Figure 1). Non-critical surfaces only contact intact skin and are considered to have the lowest infection transmission risk. Labeled low- or intermediate-level chemical disinfectants are typically used in these situations. Specifi c product claims can vary, but in general low-level dis- infectants are expected to be effective against many types of bacte- ria, some fungi and some viruses in accor- dance with their stated claims. Intermediate- level disinfectants are also effective against other more resistant forms of viruses (non- enveloped, such as po- lio and noroviruses) and bacteria (myco- bacteria, such as Myco- bacterium tuberculosis).


Figure 1. A summary of the Spaulding Classifi cation system. 50 March 2014 • HEALTHCARE PURCHASING NEWS • www.hpnonline.com


Sponsored by


Chemical disinfection and sterilization


eusable devices and processing


SELF-STUDY SERIES


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