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CHOOSING ANTISEPTIC AND DISINFECTANT
IN THE NATIONAL HOSPITAL STANDARDS HOSPITAL
ACREDITATION
By: Saida Simanjuntak,SKp,. MARS.
Seminar and Workshop Jakarta Infection And Control Update
(JIPCU)
Jakarta, 2nd-3rd December 2017
OBJECTIONS
The aim of organizing the PCI program
is to identify and reduce the risk of
infection acquired and transmitted
between patients, staff, health
professionals, contractors, volunteers,
students and visitors.
• Increased Morbidity
• Prolonged L.O.S (Length Of Stay) 5-10 Days
• Risk of The Death approximately doubles
• HAIs Are Very Expensive And Constribute Significaly To The Escalating Cost
• Prevention and Infection Control in Hospital
To reduces or prevent the occurrence of the
Nosocomial Infection (hospital acquired
infection)
• Replaces with the new terms is Healthcare
Associated Infections (HAIs)
• World-wide: 1,400,000/day. infected
• ICU infection rate: 25%. death rate 44%
• Great Britain: 5,000 deaths/year.
• Brazil: 50 of newborns infected, 12-52% die.
• Worldwide: 4,500 children die of HAI.
• One surgical site infection may cost up to $15-
$30,000 to treat.
• One blood stream infection cost up to $50,000 to
treat.
• $40 – $75 billion dollars are spent to treat HAIs.
The Big Five
• Central line associated blood stream infection (CLABSI)
• Ventilator associated pneumonia (VAP)
• Surgical site infection (SSI)
• Catheter-associated UTI (CAUTI)
• Clostridium difficile associated disease (CDAD)
1 JUNI 2017
PROGRAM PCI
SURVEILANCE
ICRA
STERILIZATION &
LAUNDRY
HYGIENE & SANITATION
ISOLATION, APD, HAND
HYGIENE
HEALTY SAFETY WORK
Human Resources :
- Committee/PCI
Team
- IPCN
- IPCLN
PCI Training:
- Staff of Hospital
- Px & visitors
- The college
student
Budget
- Personal
protective
equipment
- Disinfectant
- Training
- Germs Chcecking
INTEGRATION OF
ACTIVITIES WITH PMKPManagement
Data System
Definition:Antisepsisi, The process of reducing the number of microorganisms on the skin, mucous membranes, or body tissues using antimicrobial materials
Antiseptic / anti-microbial ingredients:Chemicals used on the skin or other living tissues can inhibit or kill microorganisms (either temporarily or completely), thereby reducing the total number of bacteria.
Definition:
A process for eliminating / destroying microorganisms (viruses, bacteria, parasites, fungi) except endospores in various medical devices or objects using chemical liquids or therma
Decontamination:
a process for removing / destroying microorganisms and impurities that attached to medical devices / objects, to making it safe for subsequent use, including cleaning, disinfection, sterilization.
1 JUNI 2017
• The process that removes all microorganisms except for some bacterial endospores in inanimate objects by boiling, steaming or using chemical disinfectant
Table B1 Microbiology Activity and Potential Utility
Table B1 Microbiology Activity and Potential Utility (continued)
Criteria for choosing an antiseptic for Handwashing:
•Has broad effects, inhibits or damages large microorganisms (gram positive and gram negative, lipophilic virus, bacillus and tuberculosis, fungiserta endospore)•Effectiveness•Early effectiveness velocity•Residual effects, long action after useto reduce growth
Criteria for choosing antiseptic,
•Does not cause skin irritation
•Does not cause allergies
•The results to be achieved in hand hygiene is to
prevent infection, colonization of the patient and
prevent contamination from the patient to the
environment including the work environment of the
officer.
Standard Operating Procedures (SOP ) Decontamination of
Patient Care Equipment as follows:
a) Soak used equipment in water and detergent or enzyme then
cleaned with sponge before disinfection high level (DTT) or
sterilization.
b) Equipment used for infectious patients should be
decontaminated prior to use for other patients.
c) Ensure disposable equipment is disposed of and disposed of
in accordance with proper waste and waste disposal
principles.
d) For used equipment to be reused, after cleaning using
sponge, in DTT with chlorine 0.5% for 10 minutes.
e) Contaminated noncritical equipment can be disinfected
using 70% alcohol. Semicritical equipment is
disinfected or sterilized, while critical equipment must
be disinfected and sterilized.
f) For large equipment such as ultrasound and X-Ray,
can be decontaminated surface after use in isolation
room.
Flow Description:
1. Pre-cleaning:
The process of making inanimate objects safer to be handled
by the officer before being cleaned (eg, inactivating HBV, HBC,
and HIV) and reducing, but not eliminating, the number of
contaminating microorganisms.
2. Cleaning:
Processes that physically remove all dirt, blood, or other body
fluids from the surface of inanimate objects or dispose of a
number of microorganisms to reduce the risk for those who
touch the skin or handle the object.
3. High Level Disinfection (DTT):
The process of removing all microorganisms, except for some
bacterial endospores from objects, by boiling, vaporizing or
using chemical disinfectants.
4. Sterilization:
The process of removing all microorganisms (bacteria,
viruses, fungi and parasites) includes endospores using
high-pressure steam (autoclave), oven, sterilisechemical,
or radiation.
a. High Pressure Vapor Sterilisator (autoclave):
High-pressure steam sterilization is an effective method
of metodesterilization, but also the most difficult to do
correctly. Set the temperature to be at 121 ° C; the
pressure should be at 106 kPa; for 20 minutes for the
tool is not wrapped and 30 minutes for the tool wrapped.
b. Sterilization use dry heat (Oven):
Place the instrument and heat up to 170 ° C, for 1 (one)
hour and then cooled for 2-2.5 hours or 160 ° C for 2
(two) hours.
Standard PPI.7.2
The hospital reduces the risk of infection by
cleaning and sterilizing the equipment
properly and managing it properly
The intention and purpose of PPI. 7.2., & PPI.7.2.1
The risk of infection can be reduced through
decontamination, pre-cleaning, cleaning, disinfection
and sterilization. Cleaning of medical devices carried
out in accordance with the laws and regulations
include:
a. critical, for medical devices used for sterile tissues or
blood systems using sterilization techniques such as
surgical instruments
The intent and purpose of PPI. 7.2., PPI.7.2.1
b. semi-critical, associated with mucosa by using
high-level disinfection (DTT) such as naso gastric
tube (NGT) and endoscopic devices
c. non-critical, for equipment used on the surface of
the body by using low-level disinfection such as
tension meters and thermometers
Element Assessment of PPI.7.2
1. Hospitals establish regulations on
sterilization services according to the laws
and regulations. (R)
2. There is evidence of decontamination flow,
pre-cleaning, cleaning, disinfection, and
sterilization of medical equipment at the
sterilization center in accordance with the
principles of PPI. (D, O, W)
Element Assessment PPI.7.2
3. The hospital coordinates sterilization and
disinfection services outside the sterilization
center. (D, O, W)
4. The hospital ensures the sterilization and
disinfection process outside the uniform
sterilization center. (D, O, W)
TEKNIK PENGAMAN
APD
HAND HYGIENE
THE EXAMPLE CASE
COURTESY : WWW.BBC.CO.UK
• Luka Operasi Terinfeksi MRSA
SETIAP STAF KLINIS HARUS MENCUCI
TANGAN SESUAI STANDAR WHO, DAN
MENERAPKAN FIVE MOMENT FOR HAND
HYGINE
Acknowledgement : WHO World Alliance for Patient Safety
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