accesscontinuingeducation.com Online New York State Mandated Infection Control Training

Element V: The creation and maintenance of a safe environment for patient care through application of infection control principles and practices for cleaning, disinfection, and sterilization.

Cleaning involves the physical removal of organic matter to reduce microbial growth prior to the reduction and/or destruction of microbes through the sterilization or disinfection process. Organic matter may interfere with the action of antiseptics, disinfectants, sterilants and prevent adequate penetration. Soap and water with friction is the standard.

Sterilization involves the removal or destruction of all microorganisms and their spores.

Disinfection involves the reduction in number and type of microorganisms -

High-level includes pasteurization or use of gluteraldehyde. All life is destroyed except spores. Items (except dental) that touch mucous membranes should receive high-level disinfection i.e. flexible endoscopes, laryngoscopes and other similar instruments.
Intermediate level hospital-grade disinfectant - an Environmental Protection Agency (EPA) approved Tuberculocidal cleaner/disinfectant. Items that touch mucous membranes or skin that is not intact should receive intermediate- level disinfection i.e. thermometers, hydrotherapy tanks.
Low-level sanitizers reduce bacteria to what is considered a "safe level". Items that touch intact skin should receive low - level disinfection i.e. stethoscopes, beds, whirlpools, and equipment which are non-invasive to patients.

Antisepsis is the inhibition of microorganism's growth on living tissue such as skin preparation before vascular line insertion or other invasive procedure. Alcohol, chlorhexidine, and Iodophors, i.e., betadine are most frequently used solution for antisepsis. Germicidal chemicals used for antisepsis are not generally adequate for decontaminating environmental surfaces.

In the CDC's (2003) Recommendations for Environmental Infection Control for Health-Care Facilities provided the following recommendations:

Appropriate use of cleaners and disinfectants;
Appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment);
Adherence to water quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and
Prompt management of water intrusion into the facility.

The topics addressed in this report are applicable to the majority of healthcare facilities in the US. This report is intended for use primarily by infection-control practitioners, epidemiologists, employee health and safety personnel, engineers, facility managers, information systems professionals, administrators, environmental service professionals, and architects. Select sections of the CDC's (2003) recommendations that are relevant to a broad range of healthcare workers are provided in the following sections: