كتاب برنامج التعقيم
كتاب برنامج التعقيم
كتاب برنامج التعقيم
Index :
1. Learning Outcomes
2. Introduction
3. Pre - Module Quiz
4. Product Release
5. Product Rejection
6. Product Recall
7. Sterile Storage Room
8. Event Related Expiration
9. Sterile Supply Expiration
10. Quality Assurance Checks
11. Time Versus Event Related Sterility
12. Consumable Inventory Management
13. Sterile Transportation
14. EVENT- RELATED STERILITY
15. CONCLUSION
16. Exercises and Checklists
Learning Outcomes
By the end of this module you will be able to:
> Clearly understand product release practices for processed goods
> Describe environmental requirements for storage areas
> Understand the need to segregate items produced in -house from
commercially produced items
> Understand health and safety requirements for manual handling and
movement
> Describe the tracking and traceability requirements for medical devices
> Demonstrate understanding of potential damage to sterile items when
being transported
> Outline procedures for product recalls
Introduction
This module will give you an understanding of Time related and Event
related sterility practices and the elements that can impact these
practices . We focus specifically on the importance of appropriate storage
locations and conditions , maintenance of sto ck levels and technician
handling.
Pre-Module Quiz
Keep these questions in mind as you go through the content and don't
worry if you don't know the answers yet -that's what you're here to learn.
Q: What does time related expiration mean?
Q: What does event related expiration mean?
Q: With your understanding of CSSD design, what do you think are the
key environmental aspects that would need to be monitored for sterile
storage?
Q: Where do risks occur when transporting sterile sets?
Q: What would you do if you dropped a sterile set on the ground or found
one on the floor? Q: What PPE precautions need to be taken when
transporting sterile items?
Q: With your understanding of the sterilization process and its monitoring,
what conditions must be met to release sterile products for use?
Q: What are some important features of a transport cart?
Product Release
Before we explore the storage, handling and transportation of processed
items we must ensure we have met the requirements for safe product
release. As we explored in module 7, there are key aspects that must be
assured after the sterilization process befor e we can release for storage or
patient use, such as:
Biological Monitoring
Monitoring must be carried out according to your local policy, but
generally you monitor with the first full load of the day and with all
implant loads. Biological indicators require anywhere from 1 -48 hours of
incubation before release so it is important to know your IFU
Did the biological monitor pass and was this documented?
Chemical Monitoring
Have chemical indicators been placed inside all packages and external
indicators used on packages that can't be viewed, like containers and
wraps? Was an additional process challenge device (PCD) run with the
cycle for assurance? Did the PCD chemical indic ator pass and was this
documented? Do the users in your facility check the indicator before using
on a patient?
Cooling
Was an adequate amount of time given for the items to cool after
sterilization before moving to storage? For most items a marked set of 30
minutes is allowed for cooling but longer times are required for larger and
heavier sets.
Physical Inspections
Was a physical inspection made of all packs to ensure the following:
· Items were correctly placed on sterilization racks and shelves with small
and lighter items on top and heavier on bottom?
· Correct packaging and sterilization methods were used, for low
temperature steam?
· Identification labels are correctly attached?
· No residual moisture on outside of package?
· Tapes and identification labels are attached?
Product Rejection
During the product release checks above, all must be fully met or the
item(s) will not be released for use. For all release check failures, the
item must go through the full reprocessing starting from
decontamination - no short cuts can be made.
Product Recall
There is always a possibility that items have been released but later
recognized as items that should have been rejected. Some reasons for
this include:
· Biological or chemical indicator wasn't used or didn't pass
· Documentation wasn't correctly completed
· Manufacturer recalled a defective item
When any of these things occur, it is critical to use your process
documentation to identify all items that are affected by the error and
carry out an immediate recall. Your facility should have a procedure for
recall that includes at minimum, notifying all users impacted and
documenting all actions in an adverse occurrence report.
Sterile Storage Room
CSSD requires multiple storage locations , one for storing sterile products
and another for storing clean ( unsterile ) supplies that are used in
production . For this module we will focus on the sterile storage room
where the items we released from the sterilizer room will be kept until
required or staged for later delivery.
Time date
This method is particularly important for perishable items like food that
can spoil or grow dangerous levels of bacteria and relies on the ‘first in -
first out’ principle where items with the shortest expiration date are
always used first.
Quality Assurance Checks
We explored the events that can negatively impact sterile items but since
we can't watch items 24/7 we must carry out quality assurance
monitoring of our environment and safety checks each time we interact
with the sets.
Environmental Monitoring
Monitoring the environment ensures the conditions have been maintained
consistently and no events have occurred that could reduce package
integrity.
· Are you measuring temperature, humidity and room pressure regularly
and documenting the results?
· Is there a regular schedule of environmental cleaning and is this
documented?
· Are heating ventilation and air conditioning (HVAC) units serviced
regularly and documented ?
Safety Checks when Handling
Like the environment, we can never assume our colleagues have always
handled items correctly so we should always look for signs of events that
may impact sterility:
· Tears or abrasions?
· Tracks, or fuzzy or worn areas from dragging?
· Dents or punctures?
· Dirt?
· Moisture or evidence of moisture -like spotting?
· Sterilization label with date?
· Chemical indicator inside set or view pack?
Sterile Transportation
In module 4 we discussed how transport carts play a key role in
protecting us and the environment from contaminated items during
transportation . For sterile ite transport carts play an equally important
role but instea they protect the sterile items from us and the environment
as we move them through the hospital . The same principles for carts
apply:
Closed Cart
Ideally closed or at minimum covered , to protect sterile items from
contamination risk when travelling through public areas Closed carts also
reduce the chance of items falling out of the cart.
Correct Size and Weight
The cart should be an appropriate size with adequate shelves to hold the
items being collected without stacking , stuffing , or overfilling as this
counts as an event that can negatively impact sterility . The size must
also be appropriate so users have sa fe visibility when moving them
through corridors and be of an appropriate weight that allows them to be
moved in a controlled manner . Larger and heavier carts may need two
people to move safely.
Washable
This cart is used for sterile items but will be travelling outside sterile
areas so needs to be cleaned effectively before returning to use in CSSD .
The cart should ideally be compatible with a cart washer if available , or
be designed to facilitate effective manual cleaning and disinfection
between uses.
Servicing
The carts should be constructed from robust materials to withstand the
rigors of daily use . Doors , shelves and wheels must be maintained to
ensure safety and ease of use to the users transporting items in the
facility.
Handling
We discussed the key requirements for minimal handling to meet event
related sterility but for transportation we must also consider:
·Select the most appropriately sized cart for the collection process and
ensure it is functioning correctly.
· Bring any required documentation necessary to log items being
delivered .
· Perform hand hygiene before loading or unloading carts.
· Before transferring items , move the transport cart as close as possible
to the destination to reduce the distance you carry items and minimize
the risk of dropping them.
· Place heavier items on the middle or lower shelves and never on high
shelves to reduce the risk of dropping.
Handling
Lack of proper handling can cause items to become unsterile. Handling
items while they are still warm, over handling items and the hygiene of
the personnel handling the items are all considered events. All sterile
items should be monitored for events that may render them unsterile. If
any event occurs to jeopardize an item, the item in question must be
removed and processed or disposed of according to the facility's policy.
Whenever there is doubt regarding the sterility of a package, the item
should be con sidered unsterile.
CONCLUSION
Maintaining product sterility during storage and transport is one of the
most important Central Service job tasks. If unsterile instruments or
supplies are used, patients could acquire an infection. Carefully following
written storage and transport procedures, and keeping the area clean and
maintained will help keep patients safe.
INDEX:
1. INTRODUCTION
2. RISK MANAGEMENT
3. COMMON WORKPLACE SAFETY HAZARDS
4. GENERAL PHYSICAL HAZARDS
5. AREA - SPECIFIC SAFETY CONCERNS
6. DISASTER PREPAREDNESS
7. EMPLOYEE ACCIDENTS AND INJURIES
8. PATIENT ACCIDENTS AND INJURIES
9. EMPLOYEE INFORMATION AND TRAINING
10. EMPLOYEE PREPAREDNESS
11. CONCLUSION
INTRODUCTION
It has been said that "safety is no accident," and that statement couldn't
be more true, especially for healthcare professionals who are responsible
for keeping patients, employees and visitors free from injury. Safety
requires ongoing education, safeguards, proper planning and the
combined implementation of safety systems to reduce risks, prevent
injury and save lives. The Central Service (CS) decontamination area is a
perfect example of how safety systems and due dilig ence is essential for
ensuring safety. Employees are educated in biohazard safety and must
follow specific regulations, such as those established by the Occupational
Safety and Health Administration (OSHA), to reduce the risk of injury.
This chapter will identify common risks found in the CS work areas and
discuss ways to minimize the risk of injury.
RISK MANAGEMENT
Risk management is a method used to assess the risks of a specific
activity and develop programs to reduce that risk. It also involves injury
prevention and claims management (the settlement, defense and
prevention of lawsuits). Healthcare facilities must effectively manage
injury prevention for patients and employees as part of a risk
management program. Various authorities, including The Joint
Commission (TJC), require that healthcare facilities develop and
implement procedures to ensure that they meet mi nimum safety
standards - prevent accidents and/or injuries, and ensure accurate
reporting and follow up to help prevent similar incidents. After a situation
is examined and hazards or unsafe practices have been discovered, risk
management personnel ensure t hat corrective actions are taken to
improve systems, behaviors and/or physical conditions to help prevent
employee and patient accidents and injuries. as well as the
manufacturer's Instructions for Use (IFU), standards and regulations, and
CS technicians support patient safety.
COMMON WORKPLACE SAFETY HAZARDS
All jobs involve some risks. The key to working safely in any work
environment is to understand those risks and take appropriate steps to
minimize them. CS technicians must understand potential hazards and
pay close attention in work areas within and somet imes outside of their
department. The belief that "an accident or injury will never happen to
me" creates a false sense of security that results in many injuries each
year. Following safety protocols and incorporating them into all work
practices is necessary for preventing injuries and accidents.
Central Service Occupational Hazards
In CS, there are three different types of occupational hazards: physical,
biological and chemical hazards. Some of those occupational hazards can
be present in all areas of the department. Other hazards may be confined
to a specific work area.
Physical safety hazards may be caused by the environment and the tasks
performed within that environment, Due to the nature of the tasks
performed, there are many potential physical hazards in the CS
department. Physical hazards may include: wet floors, cl uttered
walkways, heavy carts and sharp instruments. Fire is also a physical
safety concern. Biological safety hazards (infectious waste and blood
borne pathogens) can potentially be found in any area of the department.
Obviously, the decontamination area is the main area of concern for
biological hazards.
Chemical safety hazards may be found throughout the work area. For
example, solutions used in the decontamination area, sterilants used in
the sterilization area and some patient care products may pose chemical
hazards within the department. The following sections examine general
safety hazards and then outline specific safety hazards by work area. The
risk of injury from all of these hazards can be minimized by following
safety protocols.
Index :
1. Introduction
2. Personal development : what is it
and why is it important?
3. Professional development : what is it
and why in it important?
4. Central Service Career Paths
5. Planning Your Career Goals
6. The Importance Of Resources
7. Professional Development activities
8. Understanding the interview
process
9. Personal and professional
development timelines
10. Conclusion
Introduction
Learning is a lifelong endeavor , and change is inevitable . Never have
these statements been truer than when applied to the field of Central
Service ( CS ) . CS professionals must be prepared to encounter growth
regularly , and sometimes profoundly , in their positions . Whether cs
professionals wish to stay in their department or seek advancement or
promotion , personal and professional development will enable them to be
proactive and more easily prepare for change . This chapter will highlight
some of the resources and strategies available to help CS professionals
grow and advance in their career.
Personal development : what is it and why is it important ?
In some ways , personal development is the first step toward professional
development . Personal development may be defined as any activity that
identifies and develops talent and personal potential , and improves
employability and enhances quality of life . Personal development can
help individuals develop personally rewarding goals.
Personal development is usually an individual endeavor - something a
person does on their own time , however , more employers are
recognizing the importance of investing in personal development .
Employers may offer educational programs as part of employee benefit
programs to help staff learn more about time management stress
management , teamwork , healthy lifestyles , competency development
and career development . Ultimately , these programs are a win - win for
both employees and the healthcare facility because personal development
can create a workplace that is happier , healthier and more fulfilling . This
environment can lead to greater productivity and quality in a department
, which helps the healthcare facility meet its strategic goals.
Conclusion
The field of Central Service is dynamic and ever - evolving, and it requires
professional and dynamic individuals to help lead the way in education,
systems development, and departmental management. Through personal
and professional development, CS technici ans can not only enhance the
skills necessary to improve upon their current positions, but they can also
create new opportunities for career fulfillment and growth.