Many years ago, I was admitted into the hospital following a particularly-determined flu. Lethargic and dehydrated, I generally did not feel very well at all. With the correct attention, I was back on my feet and I will always be grateful for the care I received at my hospital.
One of the things I remember was how carefully medical professionals dealt with me while I was recuperated in the hospital. Wearing protective clothing and gloves and cleaning constantly, I realized that they were eliminating the chances of spreading what I had and they did it in a very kind way. I felt guilty.
When I commented to a nurse one day that I was causing all that fuss for everyone, she sat down and explained that it worked both ways: that what others brought to my bedside could affect my health and recovery too – that is why they were taking the extra care. I felt better.
Now I work at North Wellington Health Care (NWHC). Though I don’t work directly with patients, I certainly understand the need for infection control. My colleagues and I are frequently reminded of the critical nature of infection prevention and what we need to do to protect others as well as ourselves. Through our example of simple things like frequent washing or sanitizing of hands, others less familiar with these practices observe and follow suit.
In an interview with Sandra Hamilton who is the Occupational Health – Infection Prevention & Control Coordinator at NWHC, I learned there is a much wider scope to managing infections than what we actually see. The first line of defense is prevention. That is why when visiting a hospital you are asked to use hand sanitizer and if necessary, wear a face mask.
However, hospitals deal with greater risks than what are found in homes or workplaces. By definition from the Provincial Infectious Diseases Advisory Committee, infection prevention and control is “evidence-based practices and procedures that, when applied consistently in health care settings, can prevent or reduce the risk of transmission of microorganisms to health care providers, patients and visitors.” Wow, that definition blew me away, especially the part that transmission can happen from or to anyone in the hospital.
Sandra continued, “The difference between infection prevention/control and sterilization is in the result we need to attain; sterilization destroys all forms of microbial life including bacteria, fungi, virus and spores. All equipment and medical devices used in a hospital are ‘reprocessed’ based on how it is used. Reprocessing can range from cleaning to disinfecting to sterilizing.
For example cleaning using enzymatic detergents is the basic level of reprocessing. Cleaning physically removes rather than kills microorganisms. All items must be cleaned before they reach the next step of reprocessing.
The next stage – disinfecting – is divided into 2 levels. Low level disinfecting is needed for devices that could contact skin such as a stethoscope, beds, stretchers, bed pan, etc. High level disinfecting is needed on probes used in diagnostic imaging or other semi-critical devices that come into contact with skin and mucous membranes but do not penetrate them. Examples of equipment that require high level disinfecting include masks for respiratory therapy, anesthesia equipment and ear syringe nozzles.
Items such as surgical instruments are considered critical medical devices and must be reprocessed through sterilization. These devices present a high risk of infection if they are contaminated with any microorganisms.”
The best practice in hospitals is (when possible) to use the highest level of reprocessing – in other words sterilization. In an operating room, items may be purchased sterile in a package to be disposed of after use. Devices that are re-used are removed to another area known as Central Sterilization and Reprocessing (CSR) to be sterilized. The most efficient CSRs use what is called a Pass Through Sterilizer. The item can be put inside one of these units from one side and then removed after sterilization from the other side.
Another piece of equipment is called a washer disinfector. Its cycles can be adjusted to meet the instructions provided by the manufacturer about the device’s materials. Some materials may not be able to withstand certain disinfectants. To reprocess separate components properly, some devices may be dismantled so the washer disinfector can perform the exact requirement for each part. Scopes receive up to 7 reprocessing procedures. Hospital equipment can cost ten times more than a similar item of the same purpose sold to the general public because the device must have the ability to withstand these strict cleaning and disinfecting procedures.
A CSR with specialty equipment like this makes it safer for staff because there is less handling, less manual work and therefore less exposure to chemicals and infectious agents. As you might have already guessed, the general public will never see the inside of the CSR department.
As a final caution, Sandra suggests that infection prevention is just as important outside of a hospital. Individuals seeking pedicures, tattoos and piercing should always ask before starting these procedures what safety measures are in place to sterilize tools. To obtain more information and participate in a survey about these procedures visit the Wellington Dufferin Guelph Public Health website at www.wdgpublichealth.ca
For more information on any public health issues, visit the Public Health Ontario website at www.publichealthontario.ca/en/Pages/efault.aspx or ask a medical professional.
And remember it is always better to be safe than sorry!