PREVENTING NOSOCOMIAL INFECTIONS IN A HOSPITAL SETTING

If I were managing a hospital, and in charge of decontamination, I would be circumspect in ensuring that items were sterilized, to prevent the transmission of nosocomial infections.

DEFINITIONS

It is important to note that decontamination renders an item safe for handling. When we refer to disinfection, we mean that we are reducing the number of microorganisms, particularly those that cause infection. Sterilization means that we are removing all microorganisms.

STERILIZING A MATTRESS

To sterilize a mattress used by a patient with bubonic plague, it is important to note that mattresses are a significant source of crossinfection. Mattresses should always be covered with an impervious layer, such as thick plastic, so that they can be cleaned thoroughly between patients. If the mattress had this layer, then it would be washed with warm water and detergent, and then sprayed with a disinfectant designed to kill bacteria. This would remove any chance of infection.

DAMAGED MATTRESS PRECAUTIONS

If the mattress was damaged, then it would be discarded as medical waste or incinerated if there were proper facilities available.

STERILIZING GLUCOSE-SALINE SOLUTIONS

To sterilize Intravenous glucose-saline solutions, it is important to note that if these were received from the manufacturer, they would already be sterile, according to federal regulations. If these had been used, then they would be placed into medical waste containers, and disposed of according to HIPAA regulations for medical waste. Typically, this means they are double-bagged and shipped to an approved disposal facility to be incinerated.

STERILIZING USED SYRINGES

To sterilize used disposable syringes, these are by law required to be placed in designated Sharps containers. These containers, when full, are transported out of the hospital and disposed of according to strict regulations imposed by the Centers for Disease Control.

SHARPS CONTAINER DISPOSAL

This usually means that these containers are shipped to disposal facilities, and are treated as a type of hazardous waste, as they often contain blood products from humans that may be highly infectious.

DISPOSING OF HUMAN TISSUES

In regard to tissue samples, it is important to note that all hospital waste should be disposed of, so that it presents no risk of injury to individuals or contamination. Clinical waste such as human tissues is generated in quantity during routine patient care and/or surgery. As it contains body fluids, it is potentially dangerous and therefore should be clearly labelled as high risk. Examples of clinical waste include body fluids, dressings, pathology waste and so forth. This clinical waste should be taken to an incinerator and burned by workers in adequate protective clothing.

LIMITATIONS OF AUTOCLAVES

The autoclave uses moist heat, and is a commonly used process to sterilize items, and is regarded as very reliable. Moist heat penetrates and kills bacteria and other microbes at lower temperatures than can be accomplished by dry heat. Because damp heat is used, products that are heat-labile, such as some plastics, cannot be sterilized this way, because they will melt. In addition, this method is unsuitable for paper and other products that can be damaged by steam. Therefore, those items must also be sterilized using a different method. It is also important to note that when using an autoclave, items should be separated in order to allow the steam to penetrate evenly.

NOSOCOMIAL INFECTION POLICY

By employing a rational disinfection policy, hospital administrators can greatly reduce nosocomial infections, and therefore contribute greatly to the health of healthcare workers as well as patients. It is important to understand the nature of microbes, so that infectious and potentially harmful strains can be managed appropriately with effective biocides.