KENYAMEDI

CALTRAI
NINGCOLLEGE

DEPARTMENTOFMEDI
CALENGI
NEERI
NG

ASTUDYTOESTABLI
SHCAUSESOFINEFFECTI
VESTERI
LIZATI
ONAT
MBAGATHIHOSPI
TAL,
NAIROBI

PRESENTEDBY:
MOHAMEDAHAMEDJESSEY

D/
UPMET/
19001/
020

ARESEARCHPROPOSALSUBMITTEDTOTHEDEPARTMENTOFMEDICAL
ENGI
NEERINGI
NPARTIALFULFILMENTOFAWARDINDIPLOMACOURSE

2020

DECLARATI
ON
IMohamedAhmeddecl
aret
hatt
hispr
oposal
ismyor
igi
nal
wor
kandhasnotbeen

1
pr
esent
edi
nanyot
heri
nst
it
uti
onf
oranawar
dindi
ploma.
NAME: MohamedAhmed
ADM NO: D/
UPMET/
19001/
020
SI
GNATURE:
DATE:

2
CERTI
FICATI
ON

3
DEDI
CATI
ON
Idedicatethi
sworktomymot herandbrot
herEdhow maal
i
m whosuppor
tedand
encouragedmethr
ought
heper
iodoft
hestudy
.

4
ACKNOWLEDGEMENT
Iwi
shtoacknowledgeandappreci
atethedepar
tmentofbiomedi
calengi
neer
sand
CSSDofmbagathihospi
tal
foropportuni
tyandsuppor
tthatwasgi
ventomef orper
iod
ofmystudi
es.
Iam gr
atef
uloft
hebi
omedi
cal
engi
neer
sofmbagat
hihospi
tal
foraccept
ingt
het
opi
c
ofmystudy.
Iam t
hankf
ultomysupervi
sormadam Agathawhosuppor
tedanddedi
cat
edt
ime
towar
dsthesuccessf
ulpr
ogressunt
ilcompl
eti
onofmystudy.

5
LI
STOFABBREVI
ATI
ON
C.
S.S.
D cent
ral
ster
il
esuppl
ydepar
tment
I
.D.
H i
nfect
iondi
seasehospi
tal
Mi
n mi
nut
e
PPE per
sonal
prot
ect
iveequi
pment
PPM pr
event
ivemai
ntenance
ATM at
mospher
e
KNH Keny
att
anat
ional
hospi
tal

6
TABLEOFCONTENT

Cont
ent
s
DECLARATI
ON 2
CERTI
FICATI
ON 3
DEDI
CATI
ON 4
ACKNOWLEDGEMENT 5
LI
STOFABBREVI
ATI
ON 6
TABLEOFCONTENT 7
ABSTRACT 9
CHAPTERONE 10
1.
0BACKGROUNDOFTHESTUDY 10
1.
1PROBLEM STATEMENT 11
1.
2MAI
NOBJECTI
VE 11
1.
3SPECI
FICOBJECTI
VE 11
1.
4RESEARCHQUESTI
ON 11
1.
5JUSTI
FICATI
ON 11
1.
6LI
MITATI
ONS 11
1.
7DELI
MITATI
ON 12
1.
8SCOPEOFTHESTUDY 12
CHAPTERTWO 13
2.
0LI
TERATUREREVI
EW 13
2.
1CAUSESOFI
NEFFECTI
VESTERI
LIZATI
ON 13
2.
1.1CHOOSI
NGTHEWRONGCYCLEOFAUTOCLAVECONTENT 13
2.
1.2I
NAPPROPRI
ATEPACKI
NGORLOADI
NG 13
2.
1.3POORSTEAM QUALI
TY 13
2.
1.4I
NADEQUATETEMPERATURE 14
2.
2METHODSANDPROCEDURESUSEDFORSTERI
LIZATI
ONATMBAGATHI 14
2.
2.1STEAM STERI
LIZATI
ON 14
2.
2.2DRYHEATSTERI
LIZATI
ON 15
2.
2.3PROCEDUREFORAUTOCLAVI
NG(
STEAM STERI
LIZATI
ON) 15
2.
2.3.
1MATERI
ALPREPARATI
ON 15
2.
2.3.
2PREPAREANDPACKI
NGMATERI
ALSUI
TABLY 15
2.
2.3.
3PLACEI
TEMSI
NSECONDARYCONTAI
NERSTOSECUREANDCONTAI
NSPI
LS 16

7
2.
2.3.
4LOADI
NGAUTOCLAVE 16
2.
2.3.
5OPERATI
NGAUTOCLAVE 16
2.
2.3.
6UNLOADI
NGAUTOCLAVE 16
2.
3UTI
LIZATI
ONOFAUTOCLAVE 16
CHAPTER3 18
3.
0INTRODUCTI
ON 18
3.
1STUDYDESI
GN 18
3.
2STUDYAREA 18
3.
3STUDYVARI
ABLE 18
3.
3.1DEPENDENTVARI
ABLE 18
3.
3.2I
NDEPENDENTVARI
ABLE 18
3.
4STUDYPOPULATI
ON 18
3.
5SAMPLETECHNI
QUE 18
3.
6SAMPLEPROCEDURE 18
3.
7SAMPLESI
ZEDETERMI
NATI
ON 18
3.
8DATACOLLECTI
ONTOOLS 19
3.
9DATAANALYSI
SANDPRESENTATI
ON 19
3.
10ETHI
CALCONSI
DERATI
ON 19
REFERENCES 20

8
ABSTRACT

9
CHAPTERONE

1.
0BACKGROUNDOFTHESTUDY
Steri
li
zati
onist hepr
ocessofki
l
li
ngal
lmi
croor
gani
smsi
ncl
udi
ngbact
eri
alspor
es.
(Clussi
e,2000)
TheresearchofRobertKochandhi sassociat
esin1881onst er
il
izati
onpropert
iesof
steam andhotmarkthebeginni
ngofthesciencester
il
izati
onanddisinf
ect
ion.(Cl
ussi
e,
2014).Theydev
elopedthefi
rstnon-
pressur
esteri
l
izerfol
lowingst
eam ster
il
izer
s.
I
n 1881 st er
il
izati
on byboi l
i
ng was introduced,ev er
y thi
ng used during operati
on,
i
ncludinglinen,dressing,andgowns,wasboi l
ed.Duringt he1885t o1900t heGer mans
madenot ablecontributi
ont otheprinci
plegov er
ningsteam st eri
l
izati
onandchemi cal
di
sinfect
ionwi despr eadofapplicati
onofappl i
cati
onoft hispri
ncipl
esi ncludi
ngthe
adaptati
ont osteri
li
zeequi pment.Ittookaboutt hir
tyy earslaterwithintroducti
onof
moder ntemper aturecontrol
ledster
il
izer
s-apr oductofAmer i
canmanuf acture(skel
li
es,
2016).
Lat
erin1968Amer i
canphy
sici
anpr
oposedonhow anobj
ecti
ntendedt
ouse.He
cl
assi
fi
edobj
ectas:
1.Cri
ticalitems:cri
ti
cali
tem penetr
atessoftandhardsteri
l
izedtissuesort he
vascularsystem andconferahighdegreeofri
skofinfect
ionifcontaminated
with pathogens.Thisit
emsi ncl
udesur gi
cali
nst
rument,cardi
acand ur i
nary
catheterandimplant
s.
2.Semicrit
icalit
ems:it
emst hatconductthemucousmembr anesornon-
int
act
ski
n,t
hisitem i
ncl
udesrespi
rat
oryt
herapyandanest
hesi
aequi
pment.
3.Noncri
ti
cali
tems:arethosethatcomeint
ocontactwi
thintactski
nbutnot
mucous membrane. I
ntact ski
n act
s as an eff
ect
ive barr
ier t
o most
micr
oor
gani
sms.
Mbagathicount yhospit ali
slocatedatNai robiCountyal ongmbagathiroad.Itwas
ori
ginal
lyknown as i nfecti
ous disease hospit
al( I
DH)underKi ng George hospit
al,
curr
entl
yKeny attanationalhospital(KNH).Itwasbui ltin1950stoofferhealthcare
serv
ices,mainlyforinf ecti
ousdiseasewhi chr equi
reisolat
ionsuchast ubercul
osis,
measles,meni ngi
ti
s,andl eprosy.Inthey ear1995I DH wascur vedf r
om Keny at
ta
hospit
alandtransfor
medi ntoautonousdistri
cthospit
alforNair
obi(
okoth,2019).
Thehospi t
alusedmanualandsemi -
automat i
cautoclav
esunt i
lwheni twasupgr aded
tocount yhospit
alin2014.Mor esemi -
automaticautoclav
eswasi ntr
oducedint he
hospital
.However,someofthi
sautoclav
esf acedinef
fecti
vesteri
l
izat
ionduet osyst
em
err
or,humaner r
or,andsoon.Cur rent
lythehospi t
alhasCSSD depar tmentthatis
equippedwithtwoautocl
avesbutonl
yonei soperati
ng.

10
1.
1PROBLEM STATEMENT
Steri
li
zati
on is now an essent ialpre-requisitef orcer t
ain pr ocedur es and devi
ces.
Nowaday st here ar e sev eralt echniques of st eril
ization associ ati
ons such as
advancementofmedi cali nstrument at
ion.Butmostoft hehospi talssimplycarryon
with somepr ocedur esand t echniquei nvolved in steril
ization wi t
houtknowi ng the
vali
dityandef fi
ciencyoft het echnique.Thel argeststeril
izati
onanddi si
nfect
ionfai
lure
onr ecordinvolvedt hedi stributionofgl uteutaroldehydedi sinfectantsolutionthatthey
hadbeenusedi n60hospi talsi nBelgium.( Caroli
na,2016) .Howev erinKeny asuch
fai
lurewithlargenegat ivei mpacthav enotoccur red.
AtMbagat hiiti
snoteconomi calfeasibletost eril
i
zeequi pment ’sinalldepartmentsof
thehospitalsoi twast houghtbet t
ert osteri
lizeallsteri
li
zationact i
vit
iesofhospi t
alsin
asingledepar tment ,
wher eent ir
est eri
li
zati
oncy cl
ecanbecompl etedeffecti
vel
yunder
thedirectsuper visi
onoft rai
nedper sonnel.Howev erthehospi t
alhasonl ytwosemi -
automaticaut oclavesint heCSSDandcur r
ent l
yonl yoneaut ocl
av eoperatewhichmay
l
eadt oov erwor kingofthemachi neandsomet imest hesteri
lizeditemscomeoutdamp
duet oov erloadingwhi chmayf urtherleadr usti
ngandcor rosi
onoft heequi pment.
Amongot hercausesofi nef f
ecti
vest eri
li
zationi svaporpr essuremaybet olowduet o
defecti
ve doorgasket s orev en somet i
mes i nt
ernalv aporl eaks intot he another
autocl
av e component s also causes l i
ke human er r
orand sy stem er rormayal so
contri
butet oineffect
ivest eri
l
izati
on.

1.
2MAI
NOBJECTI
VE
 Toest
abl
i
shcausesofi
nef
fect
ivest
eri
l
izat
iont
oMbagat
hihospi
tal
.

1.
3SPECI
FICOBJECTI
VE
 Todet
ermi
net
hecausesofi
nef
fect
ivest
eri
l
izat
ioni
nmbagat
hihospi
tal
.
 To ascer
tai
nthemet
hodsand pr
ocedur
esused i
n st
eri
l
izat
ion i
n mbagat
hi
hospi
tal
.
 Tof
indouthowt
heaut
ocl
avesi
ntheCSSDdepar
tmenti
sut
il
ized.

1.
4RESEARCHQUESTI
ON
 Whatcausesofi
nef
fect
ivest
eri
l
izat
ionatmbagat
hihospi
tal
?
 Ar
ether
epr
ocedur
esandmet
hodsf
orst
eri
l
izat
ionatmbagat
hihospi
tal
?
 Howar
eaut
ocl
avei
nCSSDbei
ngut
il
ized?

11
1.
5JUSTI
FICATI
ON
Theaim ofthestudyi
stoestabli
shthecausesofineff
ect
ivesteri
li
zat
ionatmbagathi
hospit
al.I
twil
lbeuseful
toCSSDper sonnel
,staf
fs,andusersofthehospit
alli
nen
(pat
ient
s).Ther
eforer
educi
ngt herat
eatwhichnosocomi ali
nfect
ionoccurr
ingint
he
hospit
al.

1.
6LI
MITATI
ONS
Thest
udywi
l
lbecar
ri
edonl
yint
heCSSDandbi
omedi
cal
engi
neer
ingdepar
tment
.

1.
7DELI
MITATI
ON
Thestudycanbecarr
iedoutbecauset
hebi
omedi
cal
engi
neer
sar
ewi
l
li
ngt
ogi
vet
he
necessar
yinf
ormat
ion.

1.
8SCOPEOFTHESTUDY
Theresear
chwi ll
becar
riedoutinmbagathihospi
tal.Theresear
chf ocusesont
he
causesofineff
ecti
vest
eril
i
zati
on,method,andprocedureofster
il
izati
onusedand
fi
nall
ytheutil
i
zati
onofthemachine.

12
CHAPTERTWO

2.
0LI
TERATUREREVI
EW
Aliterat
urer ev
iew surv
ey s,scholarl
yarti
clesandot hersourcesrel
evanttopart
icul
ar
i
ssue,ar eaofr esear
ch,ort heory,andbysodoi ng,provi
dedescr i
pti
on,summaryand
cri
ti
calev aluat
ion ofthis wor ki nresearch pr
oblem being inv
esti
gated t
hatist o
determinethecausesofi neffect
ivester
il
izati
onatmbagat hi
hospit
al.(
Sage,2014)
.
Steam st eri
li
zati
onusingaut ocl
avesarev al
uabl
et oot hatbenefitawider angeof
hospit
ali ncludi
ngmbagat hihospit
alandmanyr esearchcenters.Aut
oclaveprotect
pati
entbyel iminat
ingpathogensfrom t
oolsandequi pment .Whenautoclav
esdon’ t
workpr operlytheyarenotbenefi
ti
nganybodytheymayev encausenegati
veimpactt o
pati
ent.Her earesomecommonr easonsthatst
eam autoclav
emaybei neff
ecti
ve.

2.
1CAUSESOFI
NEFFECTI
VESTERI
LIZATI
ON

2.
1.1CHOOSI
NGTHEWRONGCYCLEOFAUTOCLAVECONTENT
Nobodywantt ohearthatther eproblems,buthumaner r
orist her ootofmanycasesof
i
nef f
ectiv
est eri
li
zati
oni nalmostal lhospi
talst
eam aut oclavescanpr ocessav ari
etyof
diff
erentobject,notallmater i
alcanbest eri
li
zedatt hesamemanner( mer idian,2014),
forexampl e,ifyouarest er
il
izingwr appedmedicalt oolsusingst eam autocl ave,steam
steri
li
zingmaynotr eachev erypar toftheinstrumentduet oov erloading,st er
il
izing
diff
erentequipment ’
satt hesamet imewithoutpr operselectingoft heinst r
umentt obe
steri
li
zed.I fsucht hingshappen,begi nbyl ooki ngbackatwher ey oust ar
tedand
considerifyouchoset hecor rectcycleoftheautoclav econtent .

2.
1.2I
NAPPROPRI
ATEPACKI
NGORLOADI
NG
Someobj ect-
inst
rumentsuchasgl asswar e,maygoi ntoautocl
avecompl etel
ynot
cov er
ed,manysmal l
erobjects mustbe packed orwr apped pr
iorto steri
l
izati
on.
Wr appingensuresthatthesteam reachesallmater
iali
nevenmanner .Whenapacked
ofmat er
iali
snotwr appedcorrect
ly,thouitmayinter
fer
ewi t
haut ocl
avi
ngabi l
it
yt o
steril
i
ze.Thisisanotherwayofhumaner rormaybecausi
nginef
fect
ivester
il
izat
ion.
Whenl oadi
ngtheautoclav
echamber ,CSSDpersonnelatwor kshoul
dpl
acemater
ial
basedonequipmentmanuf actur
esmanualareguidance.I
fthemachinei
susedaway
othert
hanthatofmanufactur
eritmaycausei
nef
fectiv
esteri
l
izati
on.

13
Properwrappi
ngandloadi
ngpr ot
ocol
sshoul
dbepar toftr
aini
ngf
ort
echni
cianand
CSSDpersonnelwhoar
eclosel
yhandli
ngt
heautocl
avedai
l
y.

2.
1.3POORSTEAM QUALI
TY
Steam qual i
tyisoneoft hef act
ort obeconsi der
edwhenaut oclavi
ng,howev erthere
may becasesofi nef
fecti
vest eri
l
izati
onwhenmat erial,i
temsandobj ect ssteri
lizedare
wetorwetpacket s.Low steam qual i
tycanbecr eatedbyav arietyoff actors.Ifthe
wat ercont ent(vaporormoi stur
e)ofst eam isout sideofdesi r
edpar ameters,itmay
i
nt erferewiththeaut ocl
avesabi l
it
ytof unct
ionasdesi gned,super-heat edsteam, st
eam
heat edabov eapoi ntatwhichal lli
quidhasv apori
zedi salsoconsider edl owqual it
yfor
sterili
zati
on.Itisi mport
antthatt hemachi neshouldhav eaprinterwhi chwi l
lpr i
ntthe
sterili
zati
onpr ocess.

2.
1.4I
NADEQUATETEMPERATURE
Steam autoclavi
ng does notoccurort ake place withouttemperatur
e,t his high
temperat
urear egenerat
edf r
om steam generat
ingchamberwhi chi sequi ppedwi th
mostlysingl
ephaseheat er
s.Thespeci
fi
ct emperatur
eatwhi chster
il
izati
onwi lloccur
dependonav ar
iet
yoffactor
ssuchasnat ureofwor k,goodmanufact ur
ing,orCSSD
pract
ice.
Temperat
urewi t
hinautoclav
ecanbedoubl echeckedusingthetemper
atur
egaugeson
fr
ontsi
deoft hemachi neorthechartdrawnbythepri
nterattheendofthepr
ocess,
or
usi
ngtemperaturedataloggerorsi
milardev
ice.
Whet heriti
shumanerrororequi
pmentmalf
uncti
on,steri
l
izati
onfai
l
urecancostti
me,
energy,andmoney.I
nordertoaut
ocl
aveval
i
dationpl
ani nplaceandtr
ainanyaut
ocl
ave
userinproperpr
epar
ati
onanduseofthedevi
ce.(Meredi
th,2014).

2.
2METHODSANDPROCEDURESUSEDFORSTERI
LIZATI
ONAT
MBAGATHI
Amongt hevar
iousmet hodsfoll
owedf orcontr
oll
i
ngmi cr
obialacti
vi
ties,t
hebesti s
st
eri
l
izat
ionasiteli
minatesallmicrobesincl
udi
ngbacteri
alspores.(Taboola,2017)
.
St
eri
li
zat
ioncanbeachievedbythefoll
owingmethods:

2.
2.1STEAM STERI
LIZATI
ON
Exposur eofmi croorganismst o sat ur atedst eam underpr essureinanaut oclavi
ng
achieves thei
rdest ructi
on by i rr
ev er sible denatur
ati
on ofenzy mes and str
uctural
protei
ns.Thet emperat ur
eatwhi chdenat urati
onoccursv ar
iesi nver
sel
ytheamountof
waterpr esent.Ster
il
izati
oni nsat urat edst eam thusrequir
espr eci
secont
roloft i
me,
temper at
ure,andpressur e.Thismet hodshoul dbeusewhenev erpossi
bleforaqueous
preparati
onandf orsurgicaldressingandmedi caldevi
ces.
The r
ecommendati
on forster
il
iz
ati
on i
n an autocl
ave ar
e 15 minut
es at121-134
degr
ees(200kpa)(Tabool
a,2017).
thetemperat
ureshould beused to cont
roland

14
moni
torthe process;the pr
essureis mainl
y used t
o obtainthe r
equi
red st
eam
t
emperat
ure. Alt
ernati
ve condi
ti
ons, wit
h differ
ent combinat
ions of ti
me and
t
emperat
uresaregivenbel
ow( Meredi
th,
2014)
Temper
atur
e(i
ndegr
ees) Appr oxi
mate Minimum st
eri
l
izat
iont
ime
correspondi
ng pr
essur
e (
mi n)
(kpa)
126-
129 250(
-2.
5at
m) 10
134-
138 300(
-3.
0at
m) 5
(
Sour
ceMer
edi
th,
2014)(
Tabl
e1)
Minimum st eri
lizati
on t i
me shoul d be measur ed from t he momentwhen al lthe
mat erial
st o best eril
i
zed haver eached ther equir
ed informat ion,t hetemperatur
e-
moni toringpr obesshoul dbei nsert
edi nt
opr esensentat
ivecont ainers,withaddi
ti
onal
probespl acedi nt hel oadatt hepot enti
all
ycoolestpart soft hel oadedchamber( as
establishedi nt hecaseoft hevali
dationoft heprogramme) .Thecondi ti
onshouldbe
within( +or–2degr ees)and(+or–10Kpa)oft herequiredv al
ue.Eachcy cleshoul
dbe
recordedont imet emper at
urechartorbyot hersuit
ablemeans.( Smi th,2017).

2.
2.2DRYHEATSTERI
LIZATI
ON
Indryheatpr ocess,thepri
mar ylethalprocessi sconsi
deredtobeoxi dat
ionofcel l
consti
tuent
s.Dryheatsteri
li
zati
onr equi
resahi ghertemperat
urethanmoi stheatanda
l
ongerexposur etime.Themet hodi stherefor
e,mor econveni
entf orheatstable,non-
aqueousmat eri
alsthatcannotbest eri
l
izedbyst eam becauseofdel et
eri
ousef fector
fai
lur
et o penetrat
e,such mat er
ialincludes glass war
e,oils and some oi lbased
i
nject
able.
Preparati
ons t o steri
l
ize bydr yheataref i
ll
ed in uni
tsthatare ei
thersealed or
tempor ar
il
ycl osedforster
ili
zati
on.Theent
ir
econtentofeachcont
aineri
smaintainedin
theov enfort het i
meandatt emperat
uregiv
enothercondit
ionsmaybenecessar yfor
dif
ferent pr eparati
ons to ensur e the eff
ecti
ve elimi
nati
on of all undesir
able
microorganisms.( Venocombe, 2016)
.
Temper
atur
e(i
ndegr
ees) Mi
nimum st
eri
l
izat
iont
ime(
Min)
160 120
170 60
180 30
(
Sour
ceVenocombe,
2016)(
Tabl
e2)
Speci
fi
c condi
ti
on oftemper
atur
e and t
ime f
orcer
tai
n pr
epar
ati
on ar
e st
ated i
n
i
ndivi
dualmonogr
aph.

15
The oven should normall
ybe equipped wi t
haf or
ced airsyst
em to ensure even
di
str
ibuti
onofheatt hr
oughoutal
lthemat eri
alsprocess.Thi
sshouldbecontrol
ledby
monitor
ingt hetemperatur
eincont
ainersthathav ebeentemporari
l
yclosedduri
ngt he
st
eri
li
zationprocedureareseal
edafterster
il
izati
onusingasept
ictechni
questoprevent
micr
obial r
econtaminat
ion.

2.
2.3PROCEDUREFORAUTOCLAVI
NG(
STEAM STERI
LIZATI
ON)
Allper
sonnelwhouseaut ocl
avemusthavesuccessf
ulcompl
etedat
rai
ningsessi
on
fr
om thei
rsuper
visoronsaf
eoperat
ionpr
ocedur
e.

2.
2.3.
1MATERI
ALPREPARATI
ON
Ensuret hatthemateri
alsaresafeforaut
ocl
avi
ng.Samplescontai
ning sol
ventor
substancesthatmayemittoxi
cfumesshoul
dnotbeautocl
avedandglasswaremust
beinspectedforcr
ackpri
ortoaut
ocl
avi
ng.

2.
2.3.
2PREPAREANDPACKI
NGMATERI
ALSUI
TABLY
Loosedr ymaterial
smustbewr appedorbeggedi nsteam penetrat
ionpaperorloosely
covered wit
h alumi num foi
l
.Wr apping too t
ightl
ywi llimpede st eam penet
rat
ion,
decreasi
ng effecti
veness ofthe pr ocess.Glass ware and plastics mustbe heat
resi
stanceandal li
temsmustbet aggedbef oreautocl
aving.(Cooney,2016)

2.
2.3.
3PLACEITEMSI
NSECONDARYCONTAI
NERSTOSECUREAND
CONTAINSPI
LS
It
emsshoul dbepl acedinst
ainl
esssteelpanorotheraut
ocl
avi
ng.Thepanmustbe
l
ar geenoughtocontainatot
alspil
lofthecont
ent
s.Bagmustnotbehighl
yseal
edas
steam cannotpenet
rate.

2.
2.3.
4LOADI
NGAUTOCLAVE
Wearl abcoat,eyepr ot
ecti
on,heatinsul
at i
nggl ov
es,andcl osedtoeshoes.Place
materi
alin autocl
ave.Do notmi xi ncompat i
ble materials.Do notover
load:level
suf
fi
cientroom forsteam cir
cul
ati
oni fnecessary,placet hecontai
neronitssideto
maximizesteam penet
rat
ionandavoidentrapmentair.Closeandl at
chdoorf
irmly
.

2.
2.3.
5OPERATI
NGAUTOCLAVE
Closeandl ockdoor.Chooseappropr
iatecycl
ef ormater
ialaccor
dingtoautocl
ave
manual.Setappropr
iat
etimeandtemperatur
eifyouareusingacustomizedcy
cle.Do
notatt
emptt oopenthedoorwhi
l
eautoclavi
ng.(
Timothy
,2018).

2.
2.3.
6UNLOADI
NGAUTOCLAVE
Wearheatresistancegl
oves,ey
epr ot
ection,
labcoat,andclosedt oeshoes.Ensurethat
cycl
ehascompl etedandbothtemperatureandpr essurehaver etur
nedtosaf erange.
Wearingpersonalprot
ect
iveequipment(PPE),st
andbackf rom thedoorasapr ecaution
andcareful
l
yopendoornomor et haninch(Timothy,2018)
.Allowt heautocl
aveloadt o

16
standfor10mi nut
esi nthechamber .Thiswillal
lowsteam tocl
earandt
rappedairt
o
escapefrom hotliqui
dsorr educingrisktooper at
or.Weari
ngheatresi
stantr
emove
i
temsi nanar eawhi chclear
lyindi
cat eitem arehotuntiltheit
emscoolt oroom
temperat
ure.Shutautocl
avedoorandendt heprocedur
e.

2.
3UTI
LIZATI
ONOFAUTOCLAVE
Uti
li
zati
onofautocl aveessenti
all
ymeanst heuseoftheequipmentt othefullpotenti
al.
Uti
li
zati
oncoeffi
cientisani mportantparameterthatcanbemoni tor
edi ntheautoclave
atmbagathihospitaltothefuncti
onalstatus.Thi
sparameterassesthepr oducti
vi
tyofa
servi
ceorequipmentuseofcoef f
icient
=w/ m×100wher en=averagenumberofhour sto
equipmentperday .M=maxi mum numberofhour stheequipmentcanbeusedperday .
(Kantetal2016).I
ft hecoeff
ici
entislessthan50%, i
tisconsi
deredthattheautoclaveis
uti
li
zedproperl
y.
Usuall
yatmbagat hihospi
talt
heaut oclaveworksforalmost8hour s,oroneshif
t,si
nce
i
t’sonlyoneaut ocl
avethereishigherpossibil
it
yofconduct i
ngt woshi f
tswhichmay
l
eadov er
wor ki
ngoft hemachi ne.Accor di
ngt oKantetalt her earev ari
ousfact
ors
affect
ingutil
i
zationoftheequipment( Kant2000).Thesefactorsarealsov er
yimport
ant
formbagat hihospit
alinor
dertohav eef f
ect
ivesteri
l
izat
ionthef actor
sare:
1.Tr
aini
ngofst
affonhowt
hemachi
nei
susedandut
il
ized.
2.Pr
event
ivemai
ntenance
3.Ti
meschedul
i
ngoft
hehospi
tal
4.Usecoef
fi
ci
ent
.

17
CHAPTER31

3.
0INTRODUCTI
ON
Thischapt
erdeal
swit
hresear
chmethodol
ogyemploy
edint
hestudy.I
tconsi
stof
resear
chdesi
gns,t
hetar
getpopul
ati
on,
samplesi
zeandsampl
eprocedure.

3.
1STUDYDESI
GN
Adescr i
pti
veresearchdesignwil
lbeused.Descr
ipt
ivedesignisaprocessofcoll
ect
ing
datainordertotesthypothesi
soranswerquesti
onconcerningthecurr
entstat
usofthe
study.Thi
skindofst udywill
beusedsinceitwi
ll
beeasyt ofindthemajorcausesof
i
neffecti
vesteri
l
izati
onatmbagat hi
hospit
al.

3.
2STUDYAREA
Thestudywil
lbeconductedatmbagat hihospit
al.I
tislocatedki
ber
al ocat
ionabout
2KM fr
om C.B.
D.Thehospitali
sl ocat
edalongmbagat hiroadnearKenyatt
amar ket
.
Thehospi
tal
isundercount
ygovernmentofNairobi
.

3.
3STUDYVARI
ABLE

3.
3.1DEPENDENTVARI
ABLE
Cent
ral
ster
il
esuppl
ydepar
tmentofmbagat
hihospi
tal
.

18
3.
3.2I
NDEPENDENTVARI
ABLE
Toest
abl
i
shcausesofi
nef
fect
ivest
eri
l
izat
ionatmbagat
hihospi
tal
.

3.
4STUDYPOPULATI
ON
The tar
getpopul
ati
on wil
lbe 15 who ar
e member
s oft
he CSSD per
sonneland
bi
omedicalengi
neer
swhoat t
endthemachi nei
ncaseoffai
l
ureorduri
ngpl anned
prev
enti
vemaint
enance(
PMM).

3.
5SAMPLETECHNI
QUE
Si
mpl
erandom sampl
i
ngwi
l
lbeused.

3.
6SAMPLEPROCEDURE
Samplingprocedur
eenabl
esonetocol
lectdat
awhichwi
llenabl
erepr
esentt
hewhol
e
data.Random sampli
ngwil
lbeusedduri
ngthest
udybecauseeverymemberhast
he
chancetobeselect
ed.

3.
7SAMPLESI
ZEDETERMI
NATI
ON
Thesamplesizewil
lbe15wher
eby8wi
l
lbebi
omedi
cal
engi
neer
sandt
her
estwi
l
lbe
CSSDpersonnel.

3.
8DATACOLLECTI
ONTOOLS
Duri
ngthestudyquest
ionnai
reandobservat
ionmethodswi
l
lbeusedt
ocol
l
ectdat
a
fr
om theCSSDper
sonnelandbiomedi
calengi
neer
s.

3.
9DATAANALYSI
SANDPRESENTATI
ON
Aft
ercol
lect
ionofdatather
esear
chwil
lanaly
zedatabyuseoft
abl
esandscal
es,t
he
dat
awill
bethepresent
edusi
ngpiechar
ts,
tabl
esandgraph.

3.
10ETHI
CALCONSI
DERATI
ON
Permissi
on to carr
y outthe study wi
llbe soughtfrom the col
lege t
hrough the
depar
tmentandt hensubmi t
tedtorelev
antauthor
iti
es.Datacol
lect
edwi l
lbet r
eated
wit
hut mostconfi
denti
ali
tyandnotrespondentwil
lbecoercedtoprovidei
nformati
on.
Datacoll
ect
edwi l
lbeusedforresear
chstudyonl
y.

19
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engerTW, PahlkeM,KrassE,Ster
il
e,andcar
somicinstr
ument at
ioni
n
l
aparoscopysurgery
;experi
enceswith6000sur
gical
laparoscopy.12(
10)
:1996.
2.acuteheal
thdiv
isi
ondepartmentofhuman
serv
ice.
htt
p:/
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th.
vi
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inf
con2/
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(4/
01/
04)
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ersi
tyofBei
rutmedi
cal
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re.ht
tp:
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org/
cent
ral
-ss-
dept
.html.
(14/01/
04)
4.ht
tp:
//www.
bact
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au/
aut
ocl
ave.
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10/
04)
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thAmeri
caster
il
izat
ionandpacki
ng
company
.ht
tp:
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com/opti
mizi
nget
ost
eri
l
izat
ion.
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20/
10/
04)

20
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