Marcia Patrick, MSN, RN, CIC [email protected] Patrick, MSN, RN, CIC [email protected] Understand the basic elements of infection prevention and control to ensure

1

Marcia Patrick MSN RN CICmarciapatrickipgmailcom

Understand the basic elements of infection prevention and control to ensure patient and worker safety

Identify gaps in the practice setting that put patients and health care workers at risk

2

Hand Hygiene

MedicationInjection Safety

Standard amp Transmission-Based Precautions

Role of the Environment

Linen Laundry Trash and Sharps Disposal

Refrigerator Monitoring

Cleaning Disinfection Sterilization3

4

CDC Guideline for Hand Hygiene in Healthcare Settings 2002

httpwwwcdcgovhandhygiene

5

Antiseptic ndash antimicrobial substances (eg alcohol CHG triclosan) applied to the skin to reduce microbial flora

Alcohol-based hand rub ndash alcohol-containing preparation applied to the hands to reduce the number of viable microorganisms

Antimicrobial soap ndash detergent containing antiseptic agent

Waterless antiseptic agent ndash an antiseptic agent that does not require use of exogenous water

Before and after each contact with patient or their environment

Before and after using the restroom

Before handling clean supplies linen medications

Before invasive procedures

After contact with soiled or contaminated surfaces supplies equipment linen the floor

After contact with blood or body fluids

When hands visibly soiled

6

Why We Use Hand Sanitizers

7

Hands after abdominal exam onPatient with nasal swab + MRSA

Hands after use of ABHR

Surgical Hand Antisepsis

8

State of the science waterless surgical scrub solutions LABELED AS SURGICAL HAND PREP

1 Alcohol-based surgical hand-scrub Prewash hands and forearms with non-antimicrobial

soap dry then apply per manufacturers instructions

2 Antiseptic surgical hand-scrubChlorhexidine amp PVI are most common

Can be done by IP or use secret shopper

Many forms and guidelines available

bull SHEA- Strategies to Prevent Healthcare-Associated Infections Through Hand Hygiene httpwwwsheaonlineorgPortals0PDFsStrategies-to-Prevent-HAIs-through-HHpdf (draft as of 114)

bull Joint Commission Measuring Hand Hygiene Adherence Overcoming the Challengesrdquo wwwjointcommissionorg

bull App for handhelds iScrub

httpvincicsuiowaeduindexphpResearchIScrub

9

10

HCWs more likely to harbor gram negative pathogens on their fingertips

Outbreak of Pseudomonas aeruginosa in NICU attributed to artificial fingernails

Artificial fingernails epidemiologically implicated in several other outbreaks

Do not wear artificial fingernails or extenders when having direct contact with patients at high risk (eg those in intensive-care units or operating rooms) (IA)

Skin underneath rings is more heavily colonized than comparable areas of skin on fingers without rings

Study 40 of nurses harbored gram-negative bacilli (eg E cloacae Klebsiella and Acinetobacter) on skin under rings amp certain nurses carried the same organism under their rings for several months

In a more recent study involving gt60 intensive care unit nurses multivariable analysis revealed that rings were the only substantial risk factor for carriage of gram-negative bacilli and S aureus and that the concentration of organisms recovered correlated with the number of rings worn

Rings are not appropriate in the OR

Earringsnecklaces must be covered in OR11

(CDC Guideline for Hand Hygiene in Healthcare Settings 2002)

AORN Standards and Recommended Practices and CDC- facilitycontract laundering of OR attire

SHEA Healthcare Personnel Attire in Non-Operating-Room Settings

httpwwwshea-onlineorgViewArticleId249Health-care-Personnel-Attire-in-Non-Operating-Room-Settings-SHEA-Expert-Guidanceaspx

12

Perform hand hygiene appropriately amp at key times

Soap and water (friction all surfaces turn off with paper towel)

Hand sanitizer (friction all surfaces with adequate amount)

13

Investigations were resource-intensive and disruptive Notification testing and counseling of hundreds of patients

Delayed recognition and missed opportunities Prolonged transmission

Growing reservoirs of infected patients

IC programs lacking or responsibilities unclear Clinic space rented from a hospital (NE)

Contractors (NYC and OK)

Entirely preventable Standard precautions + aseptic technique

15

MMWR 2003 52901-6 CID 2004 381592ndash8

Perform hand hygiene before accessing preparing meds

Disinfect (scrub) all vial tops amp IV portshubs locks with alcohol for 15 seconds before accessing (includes needleless systems)

Let dry 15 seconds

Never leave a needle or other device inserted into a medication vial septum for multiple uses

This provides a direct route for microorganisms to enter the vial and contaminate the fluid

Use 5 micron filter needle for ampules

16

A new sterile needle amp syringe used for each injection ampeach entry into vial

Do not use bags or bottles of intravenous solution as a

common source of supply for more than one patient

Leftover parenteral medications should never be pooled for later administration

Single-use medication vials (eg propofol) should never

be used for more than one patient

Assign multi-dose vials to a single patient whenever

possible17

Use only in holder

Do not withdraw med from cartridge into syringe

Risk of contamination

Risk of med errors

Unacceptable practice to use as single or MDV

18

August 9 2012

Discard medications upon expiration date or any time there are concerns regarding sterility

Date multidose vials on first entry amp discard at 28 days or the mfrrsquos expiration date whichever is first

Discard unopened vials at mfrrsquos expiration date

Discard single dose vialampule immediately after use

Discard prepared syringes at end of procedure-do not save for next case (includes anesthesia)

19

httpwwwcdcgovinjectionsafetyprovidersprovider_faqs_multivialshtml

USP 797

SINGLE PATIENT USE

Sanitize hands before any contact with IV tubing or bag handling or change

Keep IV bags in plastic overwrap until ready for use (if out date amp discard in 30 days or per manufacturer)

Begin administration within one hour of spiking IV bagbottle (USP 797) or a soon as possible (APIC)-otherwise discard bag

Follow IV manufacturer guidance on discarding IV solutions kept in a warmer

NEVER set an unlabeled syringe down or leave it unattended

NEVER administer a medication from an unlabeled syringe that you did not draw up amp have control of from time drawn up to time given

NEVER draw up an oral or topical liquid into an injection syringe

WWWTP

22

Discard irrigation solutions after each patient

Most now labeled ldquosingle patient userdquo

Warming irrigation solutions

T max lt113degF lower (104deg) if IV fluids included (record temp daily)

NEVER warm in microwave

Medication-containing irrigations obtain from Pharmacy - single patient use

MANY issues in anesthesia infection control risks

Both ASA and AANA have written Infection Control Documents that support CDC and APIC positions

Search on web to find

If providers not cooperative ask them to provide you with documentation supporting their practice and absent that they must follow their professional guidelines

Yoursquoll need admin support

24

Intubation

Whatrsquos wrong with this picture25

Changed

Cleaned

Single use roll

26

27

2007 Guideline for Isolation Precautions Preventing

Transmission of Infectious Agents in Healthcare Settings

httpwwwcdcgovncidoddhqppdfisolation2007pdf

Reduces the risk of transmission of

microorganisms from both recognized and

unrecognized sources

28

You protect

the patientYou protect

yourself

Supplies

Environment

Procedures

29

Airborne Transmission Can hang in air up to 2 hours

Droplet Transmission Heavier drops quickly 3-6 feet range

Contact Transmission Direct body-surface-to-body surface physical transfer of

microorganisms Indirect transfer of microorganisms by a contaminated

intermediate object

30

Standard Precautions apply to all patient care regardless of diagnosis or presumed infectious status

Blood and all other body fluids including stool

Non-intact skin and mucous membranes

OPIM semen vaginal secretions amniotic cerebrospinal pericardial pleural peritoneal synovial fluids

DOES NOT apply to tears sweat urine or feces BUThellip

If itrsquos wet and not yours wear gloves

If itrsquos likely to spray or splash on your clothes wear a gown (single use)

If itrsquos likely to spray or splash your face wear eye and face protection

This is a federal law under OSHA not a guideline applies to all care givers

31

Also includes Safe Injection Practices Respiratory Hygiene- cover coughs offer

masks tissues hand sanitizer during coldflu season

Use of masks for spinal injectionsCover in orientation annual updates

32

Airborne- TB measles chickenpox disseminated shingles (defer surgery)

Droplet- URI flu pertussis mumps etc

Contact- large draining wounds large rashes MDROs etc

33

Not ldquorequiredrdquo especially in outpatient settings base policy on risk assessment risk of transmission between patients and to staff Standard and Airborne (TB) Precautions must be followed

Consider for draining wounds multidrug-resistant organism colonizationinfection non intact skin (extensive skin rashes) diarrheal illness (C difficile)

34

If itrsquos wet and not yours and itrsquos likely to get on your clothing wear a gown

Should be appropriate to the level of exposure expected (I amp D requires gown)

Single patient use NEVER hang to reuse

35

Hair Covers

Hair and jewelry (if worn) to be completely covered when in semirestricted and restricted areas of the surgical suite (AORN)

Chest beard amp sideburns must be covered

Shoe CoversBoots

Wear when blood or body fluid exposure anticipated

36

Protects you and the patient

During invasive procedures wear a mask to protect the patient from your respiratory droplets - This includes lumbar punctures

All personnel entering restricted areas of the OR suite must wear a mask when open sterile items and equipment are present

Masks are single patient use

37

Contain the route(s) of transmission Respiratory Mask patient for respiratory pathogens

coughing

Contact Cover wounds clean patient gown clean sheet

Donrsquot put chart in bed with the patient Place under gurney

Can use plastic bag and turn out onto counter

Transporter- good hand hygiene others as needed

38

Basic infection preventioncontrol principles

Require a bundle of strategies

Consistently performed at appropriate times

To prevent direct or indirect transmission of pathogens and contamination

39

Objectives

Identify environmental modes of transmission

Describe preventive measures to reduce the risk of microbial transmission

Describe environmental monitoring and environmental cleaning needs

40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41

bull Office occupancy- no special ventilation airflow air exchanges etcbull Soiled Utility Rooms- negative gt 10 ACH (old standard gt 6 ACH)bull ASC usually no capacity for Airborne Infection Isolation Rooms (AIIR) for TB varicella measlesbull Class A ORprocedure room = + pressure min ACH of 15 (min outdoor air exchange of 3)bull Class B and C ORs = + pressure min total ACHof 20 (min outdoor air exchange of 4)2014 Guidelines for Design amp Construction of Health Care Facilities (The American Institute of Architects)

42

2014 Guidelines for Design amp Construction of Health Care Facilities (The American Institute of Architects)

Class A OR Class B OR Class C OR

Minor surgical

procedures performed

under topical local or

regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures

which are Class B or

Class C surgeries)

Minor or major surgical


in conjunction with oral

parenteral or IV

sedation or performed

with patient under

analgesic or

dissociative drugs

Major surgical

procedures that require

general or regional

block anesthesia and

or support of vital

bodily functions

Enemy 1 MOLD

ATTIC MOLD CEILING MOLD BLACK MOLD IN DUCT

MOLD CINDER BLOCK MOLD ON AIR DUCT MOLD IN BATHROOM

Vents should be clean-no dust present on the grill

How often are the grills cleaned inside and out

Is the ventilation on 24 hours a day or is it off during the night Weekends

How often is preventive maintenance done on the ventilation system and how often are the ventilation filters changed

Water leaks can lead to mold

Any material not dry 48-72 hours remove

Use moisture meters

Vinyl wallpaper can hide mold

Adequate volume pressure temperature quality

Back flow air break (prevents back flow of water)

No aerators

Donrsquot use handwashing sink to dump biofluids use clinical sink

Adequate number of sinks located to facilitate handwashing

Water features can be a reservoir of water bugs contaminate environment hands

Totally enclosed fish tanks and water walls OK professionally maintained not by staff

Furnishings should be cleanable including waiting room furniture Vinyl preferred for chair coverings

Wood furniture amp cabinet finishes deteriorate with cleaning- porous

Infection Prevention amp Environmental Services should have input into decisions about furniture purchases

Carpet does not belong in health care It cannot be disinfected looks poorly after a short time difficult to clean

Carpet Cloth sofa

Must be washablewipeable with germicide

Covers must be intact- no cuts tears holes

Includes positioners

MattressesTears cracks holes

not cleanable

All toys must be washable or given to child

Crayons in 4-pack amp coloring sheets

Bin for clean toys child picks one

Bin for used toys child places on leaving

Toys washed with dish soap amp water dried

Used for receipt cleaning disinfection sterilization of surgical instruments and scopes

Area for soiled receiving

Unidirectional flow of instruments without crossovers

Clear delineation of functional areas

Specimen refrigerators may be stored in soiled utility room

Used for clean and sterile storage

Separate clean from sterile

No soiled items trash etc

Positive air pressure

ABHR

55

Separate machines for food reagents specimens and medications donrsquot mix

Record temps of both compartments daily at the same time twice if there are vaccines

Refrigerator ranges Food 34degF - 41degF (1-5degC)

Meds 36degF - 46degF (2-8degC)

Specimens amp Reagents 36degF - 46degF (2-8degC)

If the temp is out of range reset the temp and wait 15-30 minutes If itrsquos STILL out of range move items to a working refrigerator and call for service

Donrsquot record an out-of-range temp and do nothing

Penny in a cup in the freezer is no longer an acceptable monitor need a min-max thermometer or central monitoring

Clean monthly and as needed

Separate refrigerators and ice machines from sterile and clean supplies due to potential water contamination if flooding occurs in medical facilities that fall under DOH jurisdiction Other accrediting agencies look for this also

Not OK to put food or medication refrigerators in clean supply or linen storage

What do you do if facility has limited or no space

Used for ice bags beverages for patients and staff etc

Two types bin and chute

Chutes have less chance of contamination less cleaning needed

For bins store scoop dry in container near machine and a box of non-sterile gloves Sanitize hands first

ALWAYS glove and use scoop

Sanitize scoop every 12-24 hours

Document preventive maintenance and cleaning

Never store

scoop in bin

Who does it Contract or staff Both

What are HCW responsibilities vs housekeeping staff OR PACU change areas halls waiting areas bathrooms equipment

When is cleaning expected to take place OR turnover PACU discharge between patients end of day Every item accounted for who cleans it

Where are cleaning supplies kept Are they the correct supplies needed Environmental disinfectant gloves glass cleaner stainless steel

polisher etc

How is cleaning performed Are there written procedures and are they followed

How is compliance monitored

Monitoring cleaning usinga fluorescent marker canmake a big impact

www Breviscom- Glo-germ Glitterbug Clue Spray

Antiseptic chemical that inhibits the growth of or destroys organisms on living tissue (skin) Not suitable for environmental cleaning

Disinfectant chemical that kills or destroys organisms (ex spores) on inanimate objects and NEVER used on skin

Use EPA registered product

Manufacturerrsquos instructions

How is it dispensed

Wipes are efficient

Sprays donrsquot cover surface amp can aerosolize chemical

Squirt bottles

Manufacturerrsquos label

PPE required-gloves minimum

Expiration dates

Disinfectants are labeled tuberculocidal notbecause TB is a risk on contaminated floors amp surfaces but because TB is a tough bug to kill If the product is effective against TB it is effective against a wide range of organisms including Hepatitis B Virus

However any EPA registered germicide that has a HBVHIV claim is adequate for use when blood is present

ldquoTuberculocidalrdquo Germicides

httpwwwepagovoppad001list_d_hepatitisbhivpdf

bull Prions

bull Bacterial Spores

- Geobacillus stearothermophilus

bull Mycobacteria

- M tuberculosis

bull Viruses (HBV HIV HCV)

bull Fungi

bull Vegetative Bacteria

- Pseudomonas MRSA Staph aureus etc

HARDEST

EASIEST

Concentration of disinfectant

Amount amp type of contamination

How is surface cleaned manual steam

Cleanliness of the surface

Contact time

Physical amp chemical factors in environment (water hardness type of surface etc)

Factors Affecting Disinfection

Alcohols (ethyl isopropyl)

Halogens (chlorine iodophors)

Phenols- Phenolics can be toxic

Quaternary ammonium compounds (quats) a four-chain ammonia often with detergent fragrance most frequently used

Combination products (alcoholquat)

EPA approves germicides

Liquid Chemical Germicides

Bleach has no cleaning properties two-step process is necessary

May harm stainless steel furnishings

Employee exposure mixing

Will kill C difficile spores

Mix 110 to 1100 solution

Mix fresh daily or use wipes

Good detergent properties

Fast acting broad spectrum

Non-toxic surface compatible

Unaffected by type of soil water

Residual action long shelf life

Easy to use stable mild odor

Cheap

Ideal Disinfectant

Read labels carefully

Must be approved by EPA to kill Hep B HIV

Look under sinks (store nothing that can be harmed by water- paper patient care items etc)

Check expiration dates- shelf and mixed

Disinfectants

Donrsquot cut corners-take time Use right product or process Use appropriate PPE for task Follow manufacturerrsquos instructions for usedilution Clean thoroughly before disinfection Prevent contamination

Donrsquot re-dip cloth in disinfectant Pop-up wipes- one wipe for one surface Change mop heads each OR suite Separate dirty from clean including in janitorial closet Donrsquot top off disinfectant solution

It is the physical removal of visible dust soil other foreign material amp visible organic material from a surface

Cleaning removes most organisms-up to 99 but does not kill them-friction required

Prepares surface for disinfection

Most healthcare disinfectants have cleaning agents in them which makes them a one-step cleaning process (alcohol and bleach are not cleaners bleach WIPES have detergent)

If the surface does not have visible soil or organic matter then a thorough wipe using friction will clean and disinfect the surface

If body substance present clean discard wipe then clean again with another wipe and let air dry- this will disinfect the area

To meet federal regulations follow the manufacturerrsquos instructions often 10 minutes

Some of the pop-up wipes have shorter wet contact times

Those with high-alcohol content may need repeated applications to keep surface wet for the indicated length of time

EPA kill HBV HIV or a tuberculocidal

110 to 1100 bleach solution freshly mixed (never mix with anything but water)

PPE (gloves at a minimum) must be worn

Training- initial and annual required

Bloodborne Pathogens Standard


Bucket and cloth application have lots of cleaning cloths available-never redip and never top off disinfectant solution

Pop-up wipes fine ONE wipe ONE surface wear gloves

Pop-ups may be too small for large surfaces beds

Keep bucket and containers clean

Keep lids on wipes closed

Is enough time allowed (TAT goal)

How many staff clean a suite

Who is responsible for what surfaces and equipment

Is there a pause to make sure room properly cleaned before admitting next case

Have staff been trained

What monitoring is done and by whom whom and with what frequency

General purpose cleaner vs disinfectant

Floors are always considered dirty

Anything that falls on the floor goes in trash or soiled linen hamper as appropriate

Disinfect if blood body fluids stool spilled

Keep mop bucket clean-donrsquot re-dip mop

Microfiber much better at cleaning

Anything that comes in contact with a patient must be able to be disinfected

Anything that comes in contact with a patient must be disinfected before it touches another patient

This includes stethoscopes BP cuffs pulse ox probes EKG leads gurneys wheelchairs etc

Critical to clean whatever has been touched during the procedure by the patient or healthcare worker

Evaluate equipment prior to purchase What chemicals can be used to cleandisinfect Are there areas that are not cleanable Does it come in contact with sterile tissue mucous

membranes or non-intact skin Donrsquot take vendorrsquos word-get it in writing from the

company If instructions are not adequate donrsquot purchase If no other choice require manufacturer to provide

you with adequate disinfection guidelines in writing

Transport and store to protect from contamination

Wrapped or sealed carts from laundry

Clean linen carts may or may not be covered-riskier to have staff duck under flap that touches headshoulders than to leave flap up

Write this in your policy

Check stateother regulations

Soiled laundry placed in leak-proof bags

All can go in same bag unless contractor requires otherwise

Standard Precautions (gloves for soiled laundry)

No sorting rinsing prewashing in facility

Laundry accredited or meets HLAC standards

Non-commercial machines cannot meet standards

Water temp wash formula etc

Visit contract laundry to ensure safe processing

httpwwwhlacnetorgstandardsphp

Sharps pose a risk of exposure to bloodborne pathogens

OSHA requires if there is a safer device you must use it

Frontline workers must have input into selection

Donrsquot base only on cost

OSHA can fine facility- up to $70000 for a ldquowillful and serious violationrdquo

Bad publicity

bull Sharps disposed of in puncture-resistant sharps containers placed at point of use

bull Containers are replaced when fill line is reached

bull NIOSHOSHA Mounted 52-56rdquo from floor to slot for standing use

bull Biohazard labeledbull Located at point of usebull Store filled containers in secure location

httpwwwcdcgovnioshdocs97-111

The environment poses risks and challenges

Reduce risks as much as possible

Cleaning amp disinfection is critical

Control dust during construction

Remediate leaks and floods immediately

The level of disinfectionsterilization depends on the use of the instrument

Critical devices enter sterile body sites or the blood stream Must be STERILE

Semi-critical devices touch mucus membranes non-intact skin Minimum HIGH-LEVEL DISINFECTION

Non-critical devices touch normal intact skin LOW LEVEL DISINFECTION

87

Cleaning removal of all soil from objectssurfaces

Decontamination removal of all pathogenic microorganisms from objects to ensure they are safe to handle

Disinfection elimination of many or all pathogenic organisms with the exception of bacterial spores

Sterilization complete elimination destruction of all microbial life

CDC Guideline for Disinfection and Sterilization in Healthcare Settings 2008

Cleaning of the object

Organic and inorganic load present

Type and level of microbial contamination

Concentration of and exposure time to disinfectant sterilant

Nature of the object

Temperature and relative humidity

Improper packaging or overloading the sterilizer chamber can form air pockets that prohibit items from being sterilized

Instruments scopes surfaces must be physically clean before they can be disinfected or sterilized

Presoak- enzymatic detergent helps remove proteins and soil keeps item moist

Manual cleaning- elbow Wear PPE scrub under surface of solution use a brush

Ultrasonic- difficult to clean fragile items

Based upon intended use

Degree of disinfection required

Spauldingrsquos classification

Capability to meet all requirements to use the disinfection agent safely appropriately

Turn-around-time (TAT)AAMI ST79 2010 7261 p 60

A process (usually liquid chemicals or wet pasteurization) that eliminates

Many or all pathogenic microorganisms on inanimate objects

Except large numbers of bacterial spores

Short exposure times (lt30 minutes)

CDC Guideline for Disinfection amp Sterilization in Healthcare Settings 2008

Any instrument that will touch mucous membranes or non-intact skin Flexible endoscopes

Ultrasound probes vaginal and anal used with sheath

Brushes used to clean instruments for HLD

Laryngoscope blades

Vaginal specula amp related equipment

Diaphragm fitting rings

Follow label directions for soak time temperature use life shelf life product restrictions

No OPA for urology scopes per label on OPA

Some solutions require activation if not activated not soaking in HLD

Many HLD products are similar Compare

Different brands of same chemical may have different soak time and temp requirements

NEVER use HLD for environmental cleaning

Use for temperature-sensitive devices

Glutaraldehyde (gt 20) Many brands

Ortho-phthalaldehyde ndash OPA (055) Many brands

2 Activated Hydrogen Peroxide (Resert XL)

Peracetic acid-PA (02) Steris 1e (sterilant)

Brand names used for illustration only no endorsement is implied

Glutaraldehyde and Ortho-phthalaldehyde ndashOPA Various formulations and brands Ready to use or requires activation (mixing) 14 28 and 72 day formulations (maximum use days)

Must use test strips to assess concentration prior to each use Minimum Effective Concentration (MEC) specific to each

product

Product must be rinsed thoroughly x 3 Sterile or potable water (dependent upon intended

use of instrument)

Maintain log Must be neutralized for disposal - EPA (Glycine)

bull Perform some or all of the functions leak testing cleaning

disinfection alcohol rinse and air drying of scopes

bull MUST ensure all lumens are properly connected

bull MEC check before each use

bull Temperature set for HLD being used

bull Preventive maintenance service documented

Chemical dilution occurs during routine use

Test strips for monitoring the MEC specific to each product test prior to each use log

Do not use test strips beyond expiration date

QC test amp document when opening a new bottle refer to manufacturerrsquos protocol

Test strips are brand amp product-specific

AORN Perioperative Standards amp Recommended Practices 2014

Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass

IMPORTANTSolution must be discarded by expiration date even when MEC test passes

Training of ALL staff responsible for cleaning instruments scopes equipment (vacationsillness)

Post the cleaning procedure in work area

Ensure proper equipment PPE supplies available

Competency evaluation initially and at least annually for each scope

Maintain training records

Periodic visual monitoring of practice

Consider microbiological monitoring if indicatedAAMI ST79 2010 42 p 37httpwwwuncedudeptsspicedisEndoscopehtml

101

Leak testing and scope inspection

Processing per manufacturer

Chemical

Automated endoscope washer-disinfector

Use alcohol for final rinse blow air

Hang to dry per manufacturer (vented cabinet designed for hanging and storage of scopes)

Do not store in the case

Thermal (Heat)

Moist (Tabletop or large Gravity amp High Speed Vacuum)

Dry

Chemical

ETO (ethylene oxide ldquogasrdquo)

Other chemicals- H2O2 gas plasma (Sterrad) Steris

Ozone- commercial use

Radiation- commercial use

Example of a tabletop steam autoclave

CDC Guideline for Disinfection amp Sterilization in Healthcare Settings 2008 p 59

Low cost quick turnover no toxic chemicals accommodates large loads

Steam enters the chamber by gravity amp displaces air (so steam can penetrate load)

Takes longer for steam to reach required temperature

May not penetrate complex instruments

CDC Guideline for Disinfection amp Sterilization in Healthcare Settings 2008 p 59-60


Air is removed (so steam can penetrate load) by a pump before steam at an elevated temperature is rapidly introduced then rapidly removed at end to facilitate drying

Will penetrate complex instruments


105

Ethylene oxide (EtOEO)

Used for heat amp moisture sensitive devices

Lengthy aeration time must follow each cycle to allow removal of harmful residuals before opening chamber doors

EtOEO is associated with human tumors

Alarms ventilation and training of staff promote safe use of this agent



106

FDA Approved

107

Use the correct wrappercasket for the type of sterilization to be performed items to be packaged

Wrapperscaskets must have a 510k that specifies what it can be used for (ETO steam etc)

Same for peel packs

Donrsquot put peel packs inside trays

AORN Standards amp Recommended Practices 2014

109

Definition

AAMI ldquoprocess designed for the steam sterilization of patient care items for immediate userdquo

AORN ldquoshould be used only when there is insufficient time to sterilize the item by the preferred wrapped or container methodrdquo

Not recommended outside of the hospital or ambulatory surgical center where it can be used in a controlled manner

Should never be used as a substitute for sufficient inventory

AAMI ST79 2010 88 p 86

Considerations

Risk of burns from hot instruments

Recontamination of instruments during transport

Keep logs of all immediate using (process surveillance)

Monitor number of times used what procedures and why ndash use as dept PI

Monitor staff training and performance

AORN Standards and Recommended Practices 2014

Acceptable

AAMI amp AORN guidelines for implants

Single instruments only (not trays)

Urgently needed

Cleaned well

Used close to point of sterilization

Adequately covered or protected from contamination

Use mechanical chemical and biological indicators


Please indicate which best describes your practice

1 Only use IUSS for dropped items for which there was no replacement

2 Routinely use IUSS to process trays

3 Do not use IUSS at all

Cycle time temperature amp pressure is displayed on the sterilizer gauges with each instrument load

Printout or graph documents these

Tabletop units should have printout

If these fail load is no good

The CI is a process indicator that signals the item has been exposed to sterilization process (temperature time etc)

A CI is affixed to outside of package amp used with every load

An indicator is also placed inside the pack to verify steam penetration

Peel-packs have a single indicator


Closest to being the ideal monitor amp measure of effectiveness by challenging the sterilization process against a resistant spore (Bacillus sp)

Run BI at least weekly daily if sterilizer is used infrequently

Also use a BI for every implant amp EtO run

Rapid indicator for implants must be negative before using item

Policy for positive tests- who to notify identify instruments used recall

Manufacturers cite ldquosingle use onlyrdquo on many of their products (eg cardiac caths orthopedic bitsblades DVT sleeves etc)

Re-use of these products can result in significant financial savings

Concern with the risk of infection and injury when the devices are re-used

Must consider regulatory medical ethical legal amp economic issues before proceeding forward

3rd party reprocessing acceptable when premarket requirements are met (FDA 510(k)

httpwwwfdagovMedicalDevicesDeviceRegulationandGuidanceReprocessingofSingle-UseDevicesdefaulthtm

Store at least

8-10rdquo from the floor

18rdquo from the ceiling

2rdquo from outside walls

Solid bottom shelf

Closed cabinets

Controlled temp humidity

Avoid overfilled drawers

NO RUBBER BANDS


Written policy

bullMust be delivered to the CS decon for cleaning and sterilization (with instructions or check Internet)

bullAllow adequate time for processing

bullKeep a log use for QAPI

bullRecord loaner equipment contents vendorlender name patient or case number surgeon date and time

Proper disinfection and sterilization practices support patient and staff safety in the use of invasive and non-invasive medical devices

The method of disinfection and sterilization used depends on the intended use of the medical device and of what itrsquos made

Meticulous cleaning should precede high-level disinfection and sterilization

Staff should know the current recommended guidelines and utilize them when developingreviewingrevising related policies

Self-assessment of cleaning disinfection and sterilization as presented

1 My facility is in substantial compliance

2 My facility is in partial compliance

3 My facility has a way to go to reach compliance

4 OMG

AORN - Association of periOperative Registered Nurses

httpwwwaornorg

(AAMI) Association for the Advancement of Medical Instrumentation

- httpwwwaamiorgpublicationsstandardsst79html

CDC Guidelines for Environmental Infection Control in Health-Care Facilities

httpwwwcdcgovmmwrpreviewmmwrhtmlrr5210a1htm

CDC Guideline for Sterilization amp Disinfection in Healthcare Settings 2008

httpwwwcdcgovhicpacpdfguidelinesDisinfection_Nov_2008pdf

APIC web site Practice Guidance section

httpwwwapicorg

INFORMATION FOR SPECIFIC AMBULATORY AREAS

Both need to have germs from previous patients removed but usually donrsquot require sterility

High-level disinfect or sterilize Bag in zip lock bag if sterilized wrapped Laryngoscope handles ideally will be HLD or sterilized

between patients remove batteries Rutala Blade sterilized in Sterrad handle steam

sterilized then both placed in zip lock after batteries amp bulb replaced and device tested before return to unit

Decontamination and care of equipment Insertion of central catheters- central line ldquobundlerdquo

Single use vs reusable patient care items

Disposable cover for probes (vaginal rectal etc)

Cleaning and high level disinfection of probes ndashManufacturerrsquos instructions

Use of closed flush and waste containment systems for angiography

Environmental cleaning especially in procedure areas

Cleanable positioners- clean between patients

Instruments that penetrate soft tissue or bone (eg extraction forceps scalpel blades bone chisels periodontal scalers and surgical burs) should besterilized after each use or discarded (Critical items)

After each use sterilize dental instruments that are not intended to penetrate oral soft tissue or bone (eg amalgam condensers hand pieces air-water syringes) but that might contact oral tissues and are heat-tolerant although classified as semicritical

Clean and at a minimum high-level disinfect heat-sensitive semicritical items


Noncritical clinical contact surfaces such as uncovered operatory surfaces (eg countertops switches light handles) should be barrier-protected or disinfected between patients with an intermediate disinfectant (ie EPA-registered hospital disinfectant with a tuberculocidal claim) or low-level disinfectant (ie EPA-registered hospital disinfectant with HIV and HBV claim)

So called ldquoBead Sterilizersrdquo are not approved by the FDA for sterilization and should not be used

Barrier protective coverings can be used for noncritical clinical contact surfaces that are touched frequently with gloved hands during the delivery of patient care that are likely to become contaminated with blood or body substances or that are difficult to clean

Change these coverings when they are visibly soiled when they become damaged and on a routine basis (eg between patients)

Disinfect protected surfaces at the end of the day or if visibly soiled

Tonometer tips can spread

Herpes simplex virus

Adenovirus (keratoconjunctivitis)


CDCAOA Wipe tips clean then disinfect by soaking for 5-10 minutes in either 5000 ppm chlorine or 70 ethyl alcohol

CDC 3 H2O2 and 70 IPA are not effective against adeno and other viruses causing EKC and should not be used

Soaking is the key wiping alone is not sufficient

Schiotz devices damaged by chlorine

Rinse thoroughly with tap water and air dry 1 part household bleach to 9 parts water freshly mixed

American Academy of Ophthalmology Infection Prevention in Eye Care Services amp Operating

Areas 2009

TASS- Toxic Anterior Segment Syndrome Severe inflammation of eye- blindness Poor cleaning and disinfection of eye instruments Introduction of foreign matter into the eye Detergent residues preservatives Contaminated salt solution Endotoxins from overgrowth of GNB in ultrasonic cleaners Impurities in steam Degradation of brass in gas plasma sterilizers

Follow device manufacturerrsquos instructions

Single use cleaning brushes

Pour rinse solution over instruments

Sterile deionized or distilled water for final rinse

Avoid use of immediate use sterilization (flashing)-not an acceptable substitute for adequate instrumentation

Perform a variety of services

Tools that penetrate tissues should be sterilized or high-level disinfected per Spaulding criteria

Follow monitoring requirements for each

Water environments risky for water-borne pathogens such as P aeruginosa and others

Disinfect surfaces between patients

Wear gloves for procedures sanitize hands before and after monitor

Wash linens in hot water with bleach hot dryer

Not exempt from safe patient care practices

Not exempt from Bloodborne Pathogens for staff

Written policies and procedures

Document employee orientation and at least annual education on infection prevention




Staff should know the current recommended guidelines and utilize them when developing reviewingrevising related policies

Guidelines

AORN - Association of periOperative Registered Nurses wwwaornorg

(AAMI) Association for the Advancement of Medical Instrumentation- httpwwwaamiorgpublicationsstandardsst79html





APIC web site Practice Guidance section wwwapicorg





4 OMG

wwwdisinfectionandsterilizationorgEstablished by William A Rutala PhD

MPH

1 Are used when the hands are visibly soiled

False

2 Damage skin

- False

3 Kills 999 of transient pathogens on the hands within 15 seconds of application

- True

4 Not recommended as a surgical scrub

False

1 After using the bathroom

2 Before accessing clean supplies

3 Prior to preparing medication

4 Before and after intubation

5 All of the above

All True

1 Patients or HCWs with colonization can transmit the organism

bull True

2 Donrsquot need to use contact precautions in the ASC

False

1 The top of the vial is sterile when the cap is removed so it doesnrsquot need to be wiped with alcohol False

2 IV tubing ports do not need to be wipe with alcohol prior to accessingbull False

Organisms from the environment can cause infections

True

142

Patients with untreated pulmonary TB can have surgery in an ASC

False

a It must be thoroughly cleaned to be chemically disinfected

b The wet contact time on the label must be observed

c It may be necessary to reapply disinfectant to achieve wet contact time

d All of the above

Understand the basic elements of infection prevention and control to ensure patient and worker safety

Identify gaps in the practice setting that put patients and health care workers at risk

2

Hand Hygiene







4



5












6


7




8











9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Hand Hygiene







4



5












6


7




8











9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

4



5












6


7




8











9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

5












6


7




8











9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above








6


7




8











9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above


7




8











9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above


8











9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above







9

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

10














12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above










12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above




12




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above




13







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above







15

MMWR 2003 52901-6 CID 2004 381592ndash8



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above



Let dry 15 seconds




16








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above








possible17

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Use only in holder



Risk of med errors


18

August 9 2012






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above






19


USP 797

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

SINGLE PATIENT USE








WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above




WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

WWWTP

22












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above












24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above






24

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Intubation


Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Changed

Cleaned

Single use roll

26

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

27







28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

28

You protect


yourself

Supplies

Environment

Procedures

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

29





intermediate object

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

30










31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above





31




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above




32




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above




33



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above



34




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above




35

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Hair Covers



Shoe CoversBoots


36





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above





37


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above


coughing





38





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above





39

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Objectives




40

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Air

Water

Space

Furnishings

Equipment

Supplies

Maintenancecleaning

41


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above


42



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above



Minor surgical



regional anesthesia

without pre-op

sedation (Excluded

are IV spinal and

epidural procedures


Class C surgeries)




parenteral or IV


with patient under

analgesic or

dissociative drugs

Major surgical


general or regional


or support of vital

bodily functions

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above

Enemy 1 MOLD









Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above







Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above



Use moisture meters




No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above



No aerators









Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above







Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above





Carpet Cloth sofa





not cleanable















ABHR

55




















Never store

scoop in bin





polisher etc









How is it dispensed

Wipes are efficient


Squirt bottles



Expiration dates





bull Prions



bull Mycobacteria

- M tuberculosis


bull Fungi



HARDEST

EASIEST





Contact time






















Cheap

Ideal Disinfectant





Disinfectants






























































Bad publicity















87






























Laryngoscope blades

















product


use of instrument)














Tray

Equipment

Date

Processed

Solution

Expiration

Date

Test Strip

Expiration

Date

MEC Test

Result

(+ Pass or

- Fail)

Solution

Temperature

Solution

Soak Time

Initials

Test Strip Example

-Fail

+ Pass









101



Chemical





Thermal (Heat)


Dry

Chemical
















105








106

FDA Approved

107



Same for peel packs



109

Definition





AAMI ST79 2010 88 p 86

Considerations







Acceptable



Urgently needed

Cleaned well





























Store at least




Solid bottom shelf

Closed cabinets



NO RUBBER BANDS


Written policy













4 OMG


httpwwwaornorg








httpwwwapicorg
































Areas 2009






















Guidelines












4 OMG


MPH


False

2 Damage skin

- False


- True


False





5 All of the above

All True


bull True


False




True

142


False




d All of the above