Infection Control
Practicum in HS II
– Medical Assisting
Standard Precautions
• Sometimes called “Universal Precautions”
• Used to break the chain of infection
• Pathogens spread by blood and body fluids
– Hepatitis B (HBV)
– Human Immunodeficiency Virus (HIV)
OSHA
• Passed regulations in 1991 requiring all
healthcare facility employers to
– Determine which employees will have exposure
to blood and body fluids
– Provide HBV vaccine free to employees with
exposure risk (or signed refusal)
– Provide personal protective equipment (PPE)
such as gloves, gowns, lab coats, masks, and face
shields
OSHA
– Provide adequate handwashing facilities and
supplies
– Ensure clean and safe work environment
– Follow decontamination protocol for
contaminated surfaces
– Dispose of infectious wastes correctly
– No eating, drinking, smoking, handling contact
lenses, applying lip balm, etc. in risk area
OSHA
– Provide color-coded containers labeled for
sharps and other infectious wastes
– Post signs in work areas where there is exposure
risk
– Provide medical evaluation and follow-up for
employees who’ve had an exposure incident
– Provided training about the regulations to all
employees at no cost during working hours
Standard Precautions
• Rules developed by the CDC and FDA
1. All body fluids should be considered
potentially infectious
2. All patients should be considered potential
sources of infection
3. Wash hands before AND after any patient
4. If any surface comes in contact with blood
or body fluids, wash immediately and
thoroughly.
Standard Precautions
5. Wash hands after removing gloves
6. Wear gloves whenever contact with blood
or body fluids is possible
7. Change gloves after contact with each
patient
8. Gloves should not be reused
9. Gowns should be worn during any
procedure with risk of splashing blood or
body fluids
Standard Precautions
10. Masks and protective eyewear to be worn
during procedures that may produce blood or
body fluids
11. Extreme care should be taken while
handling sharp objects. (Do not bend, break,
or recap needles. Dispose of them in a
puncture-resistant container.)
12. Spills or splashes of blood or body fluids
should be wiped up immediately. Wear
gloves, and use a disinfectant solution.
Standard Precautions
13. Mouthpieces or resuscitation devices
should be used to avoid the need for mouthto-mouth resuscitation.
14. Know the requirements for disposal of
waste materials and dispose of wastes in the
proper container.
15. Report any cut, injury, needle stick, or
splashing of blood or body fluids
immediately.
Sterilizing with an Autoclave
• Uses steam under pressure or gas
• Destroys ALL microbes, pathogenic and nonpathogenic- including spores and viruses
• Before wrapping, instruments must be
cleaned
• Wraps must allow for penetration of steam
– Muslin
– Autoclave paper
– Special plastic or paper bags
– Autoclave containers
Sterilizing with an Autoclave
• Indicators are used to ensure articles have been
sterilized
– Autoclave tape, sensitivity marks on bags or wraps,
indicator capsules
– Indicator will change appearance when sterile
• Autoclave must be loaded correctly
• Amount of time depends on the article to be
sterilized – usually 15 – 30 minutes
• If wrap becomes torn or wet, it is contaminated
• Expires in 30 days
Disinfection
• Chemicals are frequently used for aseptic control
• They do NOT kill spores & viruses so it’s NOT
sterilization
• Used to disinfect instruments that don’t penetrate
human body tissue:
– Dental instruments
– Percussion instruments
– thermometers
Disinfection
• Examples –
– 90% isopropyl alcohol
– Formaldehyde – alcohol
– 10% bleach solution
– Lysol
– Zephiran
• Boiling water disinfects but does not sterilize
• Satisfactory for home care where
instruments/supplies used for one person
only
• Usually 15 – 30 minutes
Disinfection
• Ultrasonic unit – used in dental and medical
offices to disinfect
• Uses sound waves to produce millions of
microscopic bubbles
– Cavitation – bubbles hit instrument and explode,
driving cleaning solution into article
Sterile Technique - Principles
• Surgical Asepsis – procedures that keep an
object or area free from living organisms
• Sterile – free from all organisms, including
spores and viruses
• Contaminated – organisms/pathogens are
present
– A clean, uncluttered work area necessary when
working with sterile supplies
Sterile Technique - Principles
• Sterile field – sterile area – never reach across
a sterile field – reach in from the side
• Never turn your back on a sterile field
• 2 inch border of sterile field is considered
contaminated
• Common techniques
– Drop technique
– Mitten technique
– Transfer forceps
Sterile Technique - Principles
• Keep sterile field dry (pathogens travel
through wet) and be careful when pouring
fluids
• Be sure sterile field is open and ready before
putting on sterile gloves
• Sterile gloves are contaminated on the inside
– once on, keep hands away from body and
above waist
• When in doubt, consider it contaminated
Opening Sterile Packages
• Check to be sure the sterile package has not
expired
• Open the distal end and pull it away from you,
reaching around the package, not across
• Open the sides without touching the inside
wrapper
• Pull the bottom down toward you
• Drop technique
• Mitten technique
• Transfer forceps