WFHSS W/S Muscat IQ 1 - deconidi.ie · ÜIn1968,DrE.H.Spauldingclassified...

⇔⇔WFHSS W/S MuscatWFHSS W/S Muscat20062006

IQIQ 11


IQIQ 22

ÜÜ Even with the tremendous strides beingEven with the tremendous strides beingmade in the health care facilities,made in the health care facilities,nosocomial infectionsnosocomial infections or hospitalor hospital--acquired infection (HAI)acquired infection (HAI) continued to becontinued to bea significant drain on human and economica significant drain on human and economicresources causing human suffering andresources causing human suffering andhigher healthhigher health--care costs.care costs.

INTRODUCTIONINTRODUCTION


IQIQ 33

ÜÜ One aspect of preventing these nosocomialOne aspect of preventing these nosocomialinfections in health care facilities is theinfections in health care facilities is theeffective decontamination of medicaleffective decontamination of medicaldevices.devices.

ÜÜ The provision of well controlled andThe provision of well controlled andvalidated decontamination processes willvalidated decontamination processes willhave far reaching effects.have far reaching effects.


IQIQ 44

Goal of infection control &Goal of infection control &CSSDCSSD

ÜÜ Sterilization Department and InfectionSterilization Department and InfectionControl teams work together to preventControl teams work together to preventcross infection tocross infection to

1.1. PatientsPatients

2.2. EmployeesEmployees

3.3. EnvironmentEnvironment

4.4. OthersOthers


IQIQ 55

Relationship between infectionRelationship between infectioncontrol and sterilizing servicescontrol and sterilizing services

ÜÜ Most departments that areMost departments that aresupported by Central Servicesupported by Central Servicehavenhaven’’t fully oriented their staff tot fully oriented their staff tothe role of CSSD in infectionthe role of CSSD in infectioncontrol.control.

ÜÜ Infection control and CSSD mustInfection control and CSSD mustjointly be involved in thejointly be involved in thedevelopment of sterilization anddevelopment of sterilization anddisinfection policies anddisinfection policies andproceduresprocedures


IQIQ 66

The Role of CSSDThe Role of CSSD

ÜÜThe Central Sterile SupplyThe Central Sterile SupplyDepartment's major function is toDepartment's major function is toprovide surgical instruments andprovide surgical instruments andmedical equipment that have beenmedical equipment that have beenthoroughlythoroughly DECONTAMINATED ,DECONTAMINATED , totorender them bacteria free and safe torender them bacteria free and safe touse during patientuse during patient’’s operation ors operation ormedical procedure.medical procedure.


IQIQ 77

ContCont------

It also follows thatIt also follows that

ÜÜ CSSD personnel should be aware of localCSSD personnel should be aware of localand state wide infection control policies thatand state wide infection control policies thatmay affect the service they provide.may affect the service they provide.

ÜÜ CSSD personnel have a responsibility forCSSD personnel have a responsibility forachieving consistent production andachieving consistent production andmanagement standards in the reprocessingmanagement standards in the reprocessingof reusable instruments and equipment.of reusable instruments and equipment.


IQIQ 88

They should realize thatThey should realize that

Reusable medical instruments if notReusable medical instruments if not

properly handled, cleaned, disinfectedproperly handled, cleaned, disinfected

or sterilized will be a source ofor sterilized will be a source of

infection risk to both patients andinfection risk to both patients and

staff.staff.


IQIQ 99

The role of infection controlThe role of infection control

ÜÜOne of the major roles of infectionOne of the major roles of infection

control with respect to CSSD is tocontrol with respect to CSSD is to

prevent healthcare nosocomialprevent healthcare nosocomial

infections, necessitating a closeinfections, necessitating a close

working relationship with the CSSD.working relationship with the CSSD.


IQIQ 1010

Implementation of infectionImplementation of infection

control policies in CSSDcontrol policies in CSSD

ÜÜ Infection control policies andInfection control policies and

procedures are bared in mind fromprocedures are bared in mind from

the first moment ofthe first moment of Designing andDesigning and

Construction of CSSDConstruction of CSSD andand

throughout the wholethroughout the whole

Decontamination Life CycleDecontamination Life Cycle


IQIQ 1111

CSSDCSSD –– Basic DesignBasic Design

PrinciplesPrinciples

ÜÜ The physical design of CSSD is an essentialThe physical design of CSSD is an essentialcomponent of infection control strategy,component of infection control strategy,incorporating infection control issues toincorporating infection control issues tominimize the risk of infection transmissionminimize the risk of infection transmission..

ÜÜ It makes sense, therefore, that the area inIt makes sense, therefore, that the area inwhich the medical device is prepared, packed,which the medical device is prepared, packed,processed and stored should be free fromprocessed and stored should be free fromsources of contamination.sources of contamination.


IQIQ 1212


IQIQ 1313

Design of CSSDDesign of CSSD

Internal Design of CSSD gives specialInternal Design of CSSD gives specialconsideration to the following :consideration to the following :

11-- Material of construction and interiorMaterial of construction and interiorfinishes ,ventilation ,etcfinishes ,ventilation ,etc……

22-- Design of work flow during theDesign of work flow during theDecontamination Life CycleDecontamination Life Cycle


IQIQ 1414

Material of construction andMaterial of construction and--11interior finishesinterior finishes

Material of construction and interior finish is ofMaterial of construction and interior finish is ofprime importance to control spread of infection.prime importance to control spread of infection.

FINISHES

Ü In processing areas, finishes should besuitable for frequent cleaning and tolerantto surface-cleaning agents.


IQIQ 1515

ContCont------

Ü Joints( walls &floors)should be avoided asthey can hold moisture,encouraging the growthof organisms.

Ü Exposed drains shouldbe avoided specially inthe clean zones

X


IQIQ 1616

ContCont------

Ü Worktops, sinks etc– should be built upto walls and any gaps sealed

Ü Where gaps are unavoidable, theyshould be wide enough for easycleaning.


IQIQ 1717

ContCont------

Ü To enable easycleaning andmaintenance of theclean zone, it isadvisable thatworkstations andstorage units shouldnot be fixed.

CSSD in Kuwait


IQIQ 1818

ContCont--------FLOORINGFLOORINGÜÜ Should have an impermeable, nonShould have an impermeable, non--

slip floor covering uplifted at theslip floor covering uplifted at theedges onto the walls.edges onto the walls.

ÜÜ PVC sheet is recommended withPVC sheet is recommended withwelded seams.welded seams.

ÜÜ This construction ensures aThis construction ensures awatertight, hygienic surface, whichwatertight, hygienic surface, whichwill withstand daily cleaning.will withstand daily cleaning.

ÜÜ Carpet or similar soft flooring shouldCarpet or similar soft flooring shouldbe avoidedbe avoided


IQIQ 1919

ContContWALLSWALLS

ÜÜ surfaces should be smooth, freesurfaces should be smooth, freefrom crevices to hide or harbourfrom crevices to hide or harboursoilsoil

ÜÜ Exposed piping connectionsExposed piping connectionsshould be avoidedshould be avoided

ÜÜ Epoxy coating or a sprayed paintEpoxy coating or a sprayed paintfinish is appropriate in processingfinish is appropriate in processingareasareas

ÜÜ Walls should be protected againstWalls should be protected againstaccidental damage from wheeledaccidental damage from wheeledtraffic .traffic .


IQIQ 2020

ContCont--------

CeilingÜ should be to clean-room standard

and sealed to prevent ingress ofairborne particles or othercontaminants from the ceilingvoid”

Ü Ceilings should be resistant tohumidity in zones where steamand moisture may take place

(BS EN ISO 14644-4: 2001, E.2.1.2).CSSD in Kuwait


IQIQ 2121

ContCont------Lightening

Ü Light fittings and controls inprocessing and storage areasshould be carefully selected toavoid ledges or crevices wheredust can collect.


IQIQ 2222

ContCont----------

Windows

Ü Windows in the wash room and cleanzones should be non-opening, sealed andflush fitting.

Ü Windows should not be installed in storageareas.

Ü Good access, internally and externally,should be provided to all windows tofacilitate cleaning.

X


IQIQ 2323

ContCont------Doors

Ü Automatic/semi-automatic doors make iteasier for collection and distributiontrolleys to pass unimpeded

ÜÜ self closing doors and air locks to provide aself closing doors and air locks to provide abarrier against loss of pressure and againstbarrier against loss of pressure and againstentry / exit of contaminated air intoentry / exit of contaminated air into cleancleanareaarea..


IQIQ 2424

Design of Air Conditioning and ventilation isDesign of Air Conditioning and ventilation isgoverned by IC to:governed by IC to:

ÜÜ Prevent less clean air from neighboring areasPrevent less clean air from neighboring areasentering the clean area byentering the clean area by different air pressures.different air pressures.

ÜÜ Create an air flow pattern that carries contaminatedCreate an air flow pattern that carries contaminatedair away from the clean areaair away from the clean area

Ventilation


IQIQ 2525

ContCont--------ÜÜ Provide a comfortable environment for theProvide a comfortable environment for the

staff with controlled temperature, humiditystaff with controlled temperature, humidityand ventilationand ventilation

ÜÜ Grant the required number of air changesGrant the required number of air changes

per hour suitable for each area .per hour suitable for each area .

ÜÜ Air Fans should not be used in theAir Fans should not be used in theprocessing zonesprocessing zones

X


IQIQ 2626

Design of work flow throughout theDesign of work flow throughout the--22Life CycleLife CycleDecontaminationDecontamination

ÜÜ Work flow should be designedWork flow should be designedin such a way to achieve thein such a way to achieve thefollowing minimum ICfollowing minimum ICrequirementsrequirements

ÜÜ Zoning i.e sequence ofZoning i.e sequence ofincreasingly clean zonesincreasingly clean zones


IQIQ 2727

ContCont----------

ÜÜ The flow of both theThe flow of both the STAFFSTAFF and theand theEQUIPMENTEQUIPMENT must allow no crossmust allow no cross--over of soiledover of soiledand clean materials.and clean materials.


IQIQ 2828


Success in decontaminatingSuccess in decontaminatingmedical devices is dependantmedical devices is dependanton the successful completionon the successful completionof each stage of theof each stage of the

Decontamination Life CycleDecontamination Life Cycle..


IQIQ 2929



IQIQ 3030

INFECTION CONTROL POLICIESINFECTION CONTROL POLICIES

ÜÜ CSSD must have a written policies,CSSD must have a written policies,procedures and guidelines thatprocedures and guidelines that cover allcover allstages of thestages of the Decontamination Life CycleDecontamination Life Cycleand other related critical issues such as:and other related critical issues such as:--


IQIQ 3131

ContCont--------ÜÜ Hand Hygiene and Skin CareHand Hygiene and Skin CareÜÜ The Use of Personal Protective EquipmentThe Use of Personal Protective Equipment

(PPE)(PPE)ÜÜ Risk assessmentRisk assessment

ÜÜ Spillage ManagementSpillage ManagementÜÜ Management and treatment of needleManagement and treatment of needle

stick/sharps injuries.stick/sharps injuries.ÜÜ the Safe Handling and Management of Clinicalthe Safe Handling and Management of Clinical

WasteWasteÜÜ Environmental CleaningEnvironmental Cleaning


IQIQ 3232

Hand Hygiene and Skin CareHand Hygiene and Skin Care

P R E V E N T IO NIS P R IM A R Y !

P ro te c t p a t ie n ts… p ro te c t h e a lth c a re p e rs o n n e l…

p rom o te q u a lity h e a lth c a re !

X


IQIQ 3333

The Use of Personal ProtectiveThe Use of Personal ProtectiveEquipment (PPE)Equipment (PPE)


IQIQ 3434

Risk assessmentRisk assessment

ÜÜ Staff must decontaminate allStaff must decontaminate all reusablereusablemedical devicesmedical devices following each episode offollowing each episode ofuseuse

ÜÜ In 1968, Dr E.H. Spaulding classifiedIn 1968, Dr E.H. Spaulding classified

medical devices into three groups thatmedical devices into three groups that

require differentrequire different levels of processing.levels of processing.

"ヴャゅわャや"ヲエレャや"ヴヤハ"ゅヰヘレタ"ギホヱ"ヴャゅわャや"ヲエレャや"ヴヤハ"ゅヰヘレタ"ギホヱ::--


IQIQ 3535

Classifying Medical DevicesClassifying Medical Devices

before Processingbefore Processing

ÜÜ NonNon--criticalcriticalÜÜ SemiSemi--critical Acritical AÜÜ SemiSemi--critical Bcritical BÜÜ Critical ACritical AÜÜ Critical BCritical BÜÜ Critical CCritical C

-- Robert KochRobert KochInstituteInstitute ––( RKI )( RKI )


IQIQ 3636

Spillage ManagementSpillage Management


IQIQ 3737

Management and treatment ofManagement and treatment ofneedle stick/sharps injuries.needle stick/sharps injuries.


IQIQ 3838

The Safe Handling andThe Safe Handling andManagement of Clinical WasteManagement of Clinical Waste


IQIQ 3939

Precautions with end usersPrecautions with end usersÜÜ Another IC issue is to maintain theAnother IC issue is to maintain the

sterility of sterile goods till used bysterility of sterile goods till used byend users.end users.

ÜÜ Therefore all necessary precautionsTherefore all necessary precautionsand guide lines for proper handlingand guide lines for proper handlingshould be strictly adheredshould be strictly adhered


IQIQ 4040

CSSD StaffCSSD Staff

ÜÜ Enough investment should be paid toEnough investment should be paid tomake the staff well trained to and havemake the staff well trained to and havefaith on what they are doingfaith on what they are doing

ÜÜ Qualified and faithful staff will make ICQualified and faithful staff will make ICpolices implementalpolices implemental


IQIQ 4141

To give room for continuous improvementTo give room for continuous improvement

and updating the procedures and policesand updating the procedures and policesfollowing tools are recommended:following tools are recommended:

ÜÜ Customer (end user ) satisfactionCustomer (end user ) satisfactionquestionnairesquestionnaires

ÜÜ IC team feed back and commentsIC team feed back and comments

FEEDBACKFEEDBACK


IQIQ 4242

Kuwait experienceKuwait experienceIntegration between IC&CSSD was given the priority from the earlIntegration between IC&CSSD was given the priority from the early stagesy stages

of the service in Kuwaitof the service in Kuwait

ÜÜ IN 1978 CSSD was put under the supervision of theIN 1978 CSSD was put under the supervision of theInfection Control Committee, and this was the starting point.Infection Control Committee, and this was the starting point.

ÜÜ In 1983, the Directorate of Sterilization and Infection ControlIn 1983, the Directorate of Sterilization and Infection Controlwas established.was established.

ÜÜ In 1984 specialized training programs to graduate qualifiedIn 1984 specialized training programs to graduate qualifiedtechnicians had started in cotechnicians had started in co--operation with the Publicoperation with the PublicAuthority for Applied Education & Training.Authority for Applied Education & Training.

ÜÜ Since then, the Directorate of Infection Control set specialSince then, the Directorate of Infection Control set specialemphasis on introducing the latest technologies in the fieldemphasis on introducing the latest technologies in the fieldof sterilization parallel with continuous training programs.of sterilization parallel with continuous training programs.


IQIQ 4343

CSSD in Kuwait


IQIQ 4444

CSSD in Kuwait


IQIQ 4545

CSSD in Kuwait


IQIQ 4646

CSSD in Kuwait


IQIQ 4747

CSSD in Kuwait


IQIQ 4848

ReferencesReferencesÜNHS (E states training program)

HBN 13 Sterile Services Department

ÜÜ BS EN ISO 14644BS EN ISO 14644

ÜÜ HTM 2025:HTM 2025: ‘‘Ventilation in healthcareVentilation in healthcare

premisespremises’’.).)

ÜCDC


IQIQ 4949

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