Chapter 5: Decontamination (2) Questions and Correct Solutions Rated A+

Cleaning - defined as the removal of contamination from an item to the extent necessary for further processing or for the intended use Decontamination - the use of physical or chemical means to remove, inactivate, or destroy blood-borne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface is rendered safe to handle Decontamination involves two steps - First step is manual and/or automated, mechanical cleaning Second step Application of a thermal or chemical disinfection process Disinfection process is used - When cleaning alone may not be enough to make them safe to handle without transmitting disease Items processed in Decontamination - Surgical instrumentation Patient care equipment Medical devices Staff working in decontamination are constantly exposed to contaminants - Blood Body fluids Tissue Pathogenic and non-pathogenic organisms Decontamination Environment - Wet, contains Contaminated Sharps Hazardous chemicals such as Detergents and Disinfectants Knowledge of steps and process in the decontamination area - is require to understand and perform the activities necessary to achieve decontamination in a safe, effective and efficient manner. The Decontamination Area - Should be set up to provide for efficient and effective cleaning and also to minimize and contain potential environmental contamination Items received in Decontamination area - are contaminated with blood, body fluids, tissue, and unknown microorganisms that could be pathogenic (disease producing) bioburden - Microorganisms on a contaminated item are referred to as Standard Precautions - The type and level of contamination is unknown, all items must be handled as if they represent the worst-case scenario. The process of decontaminating medical devices - •Should be centralized in one location to accomplish consistent, effective, and efficient processing and containment of bioburden. •physically separated from all other areas of the department and access should be from an outside corridor The decontamination area should - •Provide space to accommodate type and quantity of supplies, equipment, and instrumentation to be processed. •Contain equipment needed for manual and automated, mechanical cleaning and disinfection •Allow traffic control and efficient work flow •Provide space to store, apply and remove PPE •Provide hand-washing facilities that are separate from the sinks used for cleaning Including conveniently located alcohol-based waterless hand hygiene solutions •Allow unobstructed access to eyewash facilities •Accommodate disposal of hazardous substances •Accommodate collection of sharps •Provide space for supply storage •Control and maintain the temperature in the range of 60°F to 65°F (16°C to 18°C) and the humidity at 30% to 60% (ANSI/AAMI ST79) •The temperature and humidity should be monitored and documented daily If physical barriers are not available "procedural barriers" should be used - •Soiled activities performed first •Clean and disinfect the work areas •Remove PPE and wash hands •Then perform, Preparation, Packaging, Sterilization Decontamination activities should not - Take place while clean activities (preparation,packaging, and sterilization) are being performed Temp and humidity - Should be monitored and documented daily. If the temperature or humidity levels are above or below the recommended levels, the discrepancies should be reported to the SPD manager or supervisor. The ventilation system should - be designed to maintain negative pressure. •Air should be directly exhausted to the outside. •Requires 10 air exchanges per hour. •Because of the potentially high levels of contaminants in the area from potentially hazardous vapors generated by cleaning agent, disinfectants, or chemical sterilants used to be removed. Clean floors and work surfaces - •Daily, Routinely clean vents and walls, Work should flow from clean to dirty. Floor drains should - be treated to inhibit the growth of microorganisms in the traps and to prevent the emission of noxious odors To minimize the potential cross-contamination - •Traffic in the decontamination area must be restricted to individuals with job responsibility in the area. And individuals entering the area must wear PPE to protect themselves from airborne contaminants and from the microorganism found on the surfaces of items being processed. OSHA's regulation on occupational exposure to blood borne pathogen - •Requires employers to identify tasks that might put employees at risk for exposure to blood or other body fluids and to take appropriate measures to protect them from exposure. Regulation in the decontamination area - •All personnel entering must wear Personnel Protective Equipment (PPE). •PPE may vary according to the task and must not "permit blood or other potentially infectious materials to pass through or reach the employees work clothes, street clothes, under garments, skin, eyes, mouth or other mucous membranes under normal conditions of use." PPE - •Is not optional and must fit •Provided by the employer and must be available in sizes appropriate for the employees, ensure that it is used and document any failure to comply •Staff should be trained in appropriate protective attire and experience disciplinary consequences if they fail to comply and adhere to the policies •Training should be documented and competencies verified Surgical scrub attire - •Changed daily or when soiled or wet •is to be laundered by the facility •long sleeved, impervious (fluid proof ) or fluid resistant gown or jumpsuit •Eye and face protection (face shield, goggles) that prevents splashed fluids from entering from above, below or the sides •Fluid resistant mask and eye and face protection when risk of splash or splatter may occur (ANSI/AAMI ST79) •Head coving that covers all head and facial hairs (except eye brows and lashes) •Fluid protective shoe covers with slip proof bottoms (remove when leaving decontam) •Heavy duty protective gloves with a long cuff that prevents fluid from going between the gown and the glove during use; should be fitted at cuff to prevent fluids from entering