Sterilization and disinfection of operation theatres.pptx

Sterilization and Disinfection of Operation Theatres

1. STERILIZATION AND DISINFECTION OF OPERATION THEATRES   (GENERAL ASPECTS AND PROTOCOLS )   HEAD PROF. Dr. NAEEM AKHTAR    Prepared by Dr. USMAN QURESHI Dr. KIRAN AHMAD Dr. RABIA ANJUM Dr. MOBEEN KAUSAR  

2. PURPOSE AND INTENT To provide evidence based guidelines for thorough , consistent and safe cleaning and disinfection practices in the Operati on Theatre s. To provide a clean environment and minimize exposure risks to Operation theatre personnel and patients. To foster an environment of teamwork and collaboration.

3. GOAL High-quality care for patients and a safe working environment for healthcare workers

4. PROBLEMS IN OUR PRACTICES Indiscriminate/unnecessary use of disinfectants. High traffic flow and increased activity in theatres. Poor communication. Bad operative techniques. Malfunctioning or improper use of equipment. Cognitive errors due to stress or inattention Resource and organizational problems

5. ZONES OF OPERATION THEATRE ZONE 1 PROTECTIVE : reception, waiting, trolley bay, Changing rooms for all staff, Transfer bay for patient, material and record rooms for administrative staff ZONE 2 CLEAN AREA : preoperative, recovery, plaster room, staff lounges, stores, pantry, maintenance workshop, close circuit T.V. control area, emergency exit ZONE 3 STERILE AREA: operating room, scrub room, anesthesia room, setup room. ZONE 4 DISPOSAL AREA: dirty utility, disposal corridor 

6. ITEMS Critical: Require high level of disinfection or sterilization Semi critical: Require high level of disinfection or sterilization Non critical: Require low level of disinfection

7. STANDARD PRECAUTIONS These precautions are applied to prevent  transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. Hand hygiene. Personal protective equipment. Needle stick or sharp injury prevention. Cleaning and disinfection. Respiratory hygiene (cough etiquette). Waste disposal. Safe injection practices.

8. STERILIZATON AND DIINFECTION OF OPERATION THEATRES Washing & Cleaning Disinfection of surfaces and equipment Disinfection of environment  

9. HIGH: Kills all the organisms except Spores, Prions E.g.. Glutaraldehyde INTERMEDIATE: Kills Mycobacteria, most viruses and bacteria LOW: Kills some viruses and bacteria LEVELS OF DISINFECTION

10. C lean environment for each patient is a shared responsibility. Use Appropriate Personal Protective Equipment (PPE) Use approved cleaning products as per manufactures instructions. Ensure availability of Safety Data Sheets Use Reusable/single use low-lint cleaning materials Change mop heads after each use and do not reintroduce into the bucket. Keep minimum storage of equipment in theatre GENERAL PRINCIPLES

11. GENERAL PRINCIPLES Minimize the theatre traffic and k eep O T doors closed . V isually inspec t the OTs for cleanliness before the Commencement of list. Simple detergent reduces flora to >80%, addition of disinfectant results in 95% reduction.

12. PRELIMINARY CLEANING Damp dust horizontal surfaces prior to first case . Clean and disinfect portable patient-care equipment which is not stored within the operating room, Inspect OR Theatre lights for cleanliness before the first case of the day .

13. INTRAOPERATIVE CLEANING If a team member is aware of contamination occurring during a procedure it is his/her responsibility to ensure the contaminated surface/item is cleaned . Equipment leaving the OR Theatre is cleaned and disinfected. Chemical spills occurring intra-operatively are to be managed as per site/regional policy/procedure and according to the SDS

14. BETWEEN PROCEDURES CLEANING Remove all trash, linen, and recycling from the room including soiled anesthesia equipment and supplies. All surfaces that have been in direct or indirect contact with the patient or body fluids are considered to be contaminated . Ensure OR Theatres are cleaned/disinfected as required after each patient. Wipe touched objects and areas after each procedure . Clean and disinfect from least contaminated to most contaminated and top to bottom.

15. BETWEEN PROCEDURES CLEANING Remove all used linen and surgical drapes, waste for reprocessing or disposal. Clean and disinfect: H igh-touch surfaces outside of the surgical field A ny visible blood or body fluids outside of the surgical field. All surfaces (high- and low-touch) and the floor inside the surgical field, including: Tops of surgical lights Reflective portion of surgical lights Suction canisters Tourniquet cuffs and leads, patient monitors. Anesthesia trolley, anesthesia machines Operating table from top to bottom and floor area under the bed

16. TERMINAL CLEANING Additional PPE may be required. Occurs at the end of the day or at minimum once every 24 hours during a regular work week. All floors should be cleaned using a wet vacuum or single-use mop and a Disinfectant . Cleaning and disinfecting of all exposed surfaces. Fixed and mobile equipment Horizontal & Vertical surfaces Hand washing sinks and scrubs Base boards and area under operating table

17. Visual inspection Short-term evaluation of the impact of infection-control measures or changes in infection control protocols. Swabs collected from various locations in the OT include Operation table at the head end Over head lamp Four Walls Floor below the head end of the table Instrument trolley AC duct Microscope handles. SURVEILLANCE OF OPERATION THEATRES

18. Unit /Area Level of restriction Post anesthesia care unit Unrestricted or semi-restricted Endoscopy suite Unrestricted Pain clinic/procedure room Unrestricted Locker room/administrative office/waiting room Unrestricted Sterile processing area Semi-restricted Equipment and sterile supply storage Semi-restricted Sterile processing decontamination area Semi-restricted Operating room /invasive procedure room Restricted Preoperative/postoperative patient-care area U nrestricted LEVELS OF TRAFFIC RESTRICTION

19. OPERATION TEATRE SAFETY IS…..