______________________________ Infection Control for New York Health Care Professionals ‒ 2024 Update
2. Semi-critical instruments and medical devices minimally require high-level disinfection. a. High-level disinfection kills all organisms, except high levels of bacterial spores, and is achieved using a chemical germicide cleared for marketing as a sterilant by the US Food and Drug Administration (FDA). b. An item that comes in contact with mucous membranes or non-intact skin minimally requires high-level disinfection. 3. Non-critical instruments and medical devices minimally require cleaning and low level dis- infection. An item that contacts intact skin but not mucous membranes requires low level disinfection that kills some viruses and bacteria with a chemical germicide registered as a hospital disinfectant by the EPA. B. Manufacturer’s recommendations must be followed. V. Effectiveness of Reprocessing Instruments, Medical Devices, and Equipment A. Cleaning prior to disinfection. B. Disinfection. C. Sterilization. VI. Recognizing Potential Sources of Cross-Contamination in the Healthcare Environment VII. Factors That Contributed to Contamination in Reported Cases of Disease Transmission A. At any point in reprocessing or handling, breaks in infection control practices can compromise the integ- rity of instruments, medical devices, or equipment. B. Specific factors: 1. Failure to reprocess or dispose of items between patients. 2. Inadequate cleaning. 3. Inadequate disinfection or sterilization. 4. Contamination of disinfectant or rinse solutions. 5. Improper packaging, storage, and handling. 6. Inadequate/inaccurate record keeping of repro- cessing requirements. VIII. Expectations of Health Professionals to Differing Levels of Disinfection: Sterilization methods and agents based on the area of professional practice setting and scope of responsibilities. A. Professionals who have primary or supervisory responsibilities for equipment, instruments, or medical device reprocessing (e.g., Sterile Processing Department staff or clinics and physician practices
a. Standard and Universal Precaution. b. Cleaning, disinfection, and sterilization described in Sections III and IV above. (See glossary) c. Appropriate application of safe practices for handling instruments, medical devices, and equipment in the area of professional practice.
d. Designation and physical separation of patient care areas from cleaning and repro- cessing areas is strongly recommended by NYSDOH [1]. 2. Determine appropriate reprocessing practices NOTE: Effective reprocessing is critical to reducing the risk of transmission of healthcare associated infections when single- use devices are reused. Reprocessing of single-use devices must be performed by an FDA-approved reprocessing facility and should not be done in individual facilities [24]. ELEMENT VI Prevention and control of infectious and communicable dis- eases in healthcare personnel [1]. See Element VI Glossary. Content Outline I. Pre-placement and periodic health assessments . A. Immunization/screening programs (e.g., measles, mumps, rubella, varicella, hepatitis B annual influ- enza, any other recommended or mandated require- ments); B. Tuberculosis screening: 1. Symptoms evaluation. 2. Tuberculin skin testing as required by regulation. C. Screening for other communicable. diseases: 1. Health assessments (history and physicals). D. Symptoms requiring immediate evaluation by a licensed medical professional and possible restric- tion from patient care activities and return to work
clearance: 1. Fever 2. Cough 3. Rash
4. Vesicular lesions 5. Draining wounds
6. Vomiting 7. Diarrhea.
where medical equipment is reprocessed onsite): 1. Understand core concepts and principles:
59
MDNY1026
Powered by FlippingBook