Chapter 6 infection prevention

1. Infection Prevention
and Control
Chapter 6

2. Objectives:
As a result of successfully completing this chapter, students will be able to:
 Explain the role of Central Service Technicians in a healthcare facility’s
infection prevention and control efforts.
 Discuss personal hygiene and personal protective equipment
precautions that enable Central Service Technicians to protect patients and
themselves.
 Define the term, “Standard Precautions,” and review its role in preventing
the transmission of infectious organisms.
 List key elements in the Bloodborne Pathogens Standard published by
Occupational Safety and Health Administration (OSHA).

3. Objectives:
Describe basic environmental concerns as Central Service work areas
are designed.
Review environmental aspects of Central Service work procedures that
impact infection control:
Traffic control
Work area cleanliness
Workflow
 Define the terms, “asepsis,” and “aseptic technique,” and review the
five basic principles of asepsis.

4. Infection Prevention and Control
Goals of Central Service
Eliminate and/or destroy all potentially
infectious contaminants present on
reusable instruments and equipment.
Safely distribute reusable and single-use
items required for the delivery of patient
care.
Establish and enforce standards for
decontamination, disinfection, and
sterilization in various healthcare
settings.

5. Medical Devices that have not been
properly handled, disinfected or
sterilized…
…can cause infections in
patients and staff

6. Each Year
Approximately 10%
of patients
hospitalized
develop a
healthcare facility-
associated infection

7. The primary purpose of the
Central Service Department is
to stop the spread of disease-
producing microorganisms in
the healthcare facility

8. Appropriate Attire for
Central Service
A facility-issued scrub
uniform
Hair covering that covers
all head and facial hair
except eyebrows and
eyelashes
Shoes with non-skid soles

9. Hand Hygiene
Remove Watches
and other Jewelry
before entering the
work area.
Wash hands with
soap and water or
use an alcohol-
based hand rub

10. Personal Protective Equipment
Required by OSHA for
Technicians in the
Decontamination area:
General purpose utility
gloves
A fluid-resistant
covering with sleeves
Full face protection.
Shoe covers

11. Fluid-Resistant Gowns
(Coverings)
Regular scrub attire
splashed with liquid
Fluid-resistant attire
splashed with liquid

12. Standard Precautions
Place emphasis on
the use of blood
and body fluid
precautions for all
patients.

13. OSHA BloodBorne
Pathogen Standard
Written Exposure Control Plan
Training upon initial hire and annually thereafter
Hepatitis B Vaccine offered at no cost to
employees
Observance of Standard Precautions
Use of Engineering and Work Practice Controls to
reduce risks

14. OSHA BloodBorne
Pathogen Standard
Provision of Personal Protective
Equipment (PPE) at no cost to the
employee
Provision of a clean and sanitary working
environment
Use of appropriate Biohazard signs and
labels to identify contaminated items
Rigid containers for sharps disposal

15. OSHA BloodBorne
Pathogen Standard
Covered, puncture-proof containers for
the transport of contaminated items.
Provision of medical evaluation and
treatment if an employee experiences an
exposure
Properly maintained medical and training
records.

16. The Physical Design of the
Central Service Department
Physical Barriers
(walls) between clean
and dirty areas
A method to reduce
the likelihood that
airborne bacteria can
be transmitted from
the decontamination
area to the clean
areas
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17. The Use of Air Pressure to
Control Airborne Bacteria
Clean Area
Positive Air Pressure
Decontamination Area
Negative Air Pressure
Airflow

18. Controlling Airflow
Windows and
doors between
areas with positive
and negative air
pressures must be
kept closed

19. Work Area Requirements
Decontamination
Temperature: 60°F to 65°F (16°C to 18°C)
Humidity: 30% to 60%
Air Exchanges: 10 per hour
Preparation and Packaging
Temperature: 68° F to 73° F (20° C to 23° C)
Humidity: 30% to 60%
Air Exchanges: 10 per hour
Clean/Sterile Storage
Temperature 75° F or lower (24° C or lower)
Humidity: Less than 70%
Air Exchanges: 4 per hour

20. Work Area Requirements
(cont.)
Hand washing Sinks
Fixtures and furniture
that can be washed

21. Other Requirements:
Open Rack
storage systems
should have a
solid bottom to
prevent
contamination
during
housekeeping
tasks

22. Traffic Control
Traffic control requirements must be
enforced for everyone
Dress codes for all areas apply to
everyone

23. Traffic Control Designations
Biohazard – OSHA-required PPE
Unrestricted – Normal Traffic areas, cafeteria, waiting rooms,
etc. Street clothes may be worn
Semi-Restricted – Clean assembly and storage areas,
access corridors to operating rooms, etc. Surgical scrub attire
and hair covering required
Restricted – Areas where sterile procedures are performed.
Surgical scrub attire, hair covering, and masks required.
*Persons working within the sterile field will have additional
requirements

24. What to Wear
CS Dress Requirement Review
Decontamination
Area
Clean Assembly
and
Sterile Storage
Operating
Room
Non-restricted
Hallways and
Offices.
Cafeteria, etc.
Surgical Scrubs and OSHA-required PPE
Surgical Scrubs and Hair Covering
Surgical Scrubs, Hair Covering, Masks may be required
Regular Street Attire

25. Environmental Cleaning
Floors should be wet-mopped at
least daily
Work surfaces should be cleaned
at least daily
Light fixture should be cleaned at
least every 6 months
Walls cabinets and racks should
be cleaned on a regularly
scheduled basis

26. Cleaning Sterile Storage Areas
Remove all sterile items from the
cart, rack, or cabinet
Thoroughly clean the unit using
the cleaning solution
recommended by the healthcare
facility.
Allow the storage unit to dry
thoroughly.
Carefully place items back in their
designated location.
Record the cleaning date in the
department’s cleaning log.

27. Control Microorganisms
Entering the Work
Areas
Clean Routinely

28. No Food or Drink should be
allowed in Central Service work
areas.

29. Workflow
Practices

30. Workflow must be...
…logical
…one way
…defined

31. Progression from
Contaminated to
Sterile
User
Sterile
Storage
Sterilization
Inspection &
Assembly
Decontamination
User

32. Principles of Asepsis
Asepsis – The absence
of microorganisms that
cause disease
Aseptic Technique –
Any activity or procedure
that prevents infection or
breaks the chain of
infection

33. Medical Asepsis
Procedures performed
to reduce the number
of microorganisms or
minimize their spread

34. Surgical Asepsis
Procedures performed
to eliminate the
presence of all
microorganisms
and/or to prevent the
introduction of
microorganisms into
an area

35. Principles of Asepsis
1.Know what is Dirty.
2.Know what is Clean.
3.Know what is Sterile.
4.Keep the 3 conditions separate.
5.Remedy contamination immediately.

36. “Sterile Conscience”
A careless attitude
may lead to
increased risk of
infection

37. Infection Control...
…manages the growth
and transmission of
bacteria in the
healthcare facility

38. You Can Manage the
Environment by:
Following All Infection Control
Protocols
Recognizing Contamination and
Correcting the Situation
Paying Close attention to Detail

39. Controlling the Spread of
Microorganisms…
…is the responsibility of
every Central Service
Technician