Disinfection and sterilization

2019 ◽  
pp. 95-142
Author(s):  
Nizam Damani
Keyword(s):  
Risk Assessment ◽  
Antimicrobial Activity ◽  
Healthcare Facility ◽  
Healthcare Facilities ◽  
Practical Advice ◽  
Key Points ◽  
Practical Guidance ◽  
Chemical Disinfection

The chapter on decontamination examines various methods of heat sterilization and chemical disinfection. It outlines how to carry out a risk assessment of contaminated items and equipment based on the Spaulding classification and provides practical guidance on how to decontaminate various items in healthcare facilities. It also discusses how to transport items, clean, disinfect, and sterilize various items and equipment in healthcare facility. It outlines various heat sterilization procedures and gives practical advice on how to maintain various types of sterilizer or autoclave and how to safely store sterile items. Detail is also provided on how to use chemical disinfectants in healthcare facilities and summarizes the use and antimicrobial activity of various disinfectants and antiseptics. This chapter also includes advice on decontamination of endoscopes and maintenance of automatic endoscope reprocessors. It also provides practical advice and summarizes the key points on how to investigate and follow up cases after a failure of decontamination process.

scholarly journals Interconnectedness and Contagion Analysis

2019 ◽  
Vol 19 (220) ◽  
Author(s):  
Jana Bricco ◽  
TengTeng Xu
Keyword(s):  
Risk Assessment ◽  
Financial Stability ◽  
Financial System ◽  
Comprehensive Analysis ◽  
Policy Recommendations ◽  
Practical Advice ◽  
Assessment Program ◽  
Cross Border ◽  
Depth Analysis ◽  
Practical Guidance

The analysis of interconnectedness and contagion is an important part of the financial stability and risk assessment of a country’s financial system. This paper offers detailed and practical guidance on how to conduct a comprehensive analysis of interconnectedness and contagion for a country’s financial system under various circumstances. We survey current approaches at the IMF for analyzing interconnectedness within the interbank, cross-sector and cross-border dimensions through an overview and examples of the data and methodologies used in the Financial Sector Assessment Program. Finally, this paper offers practical advice on how to interpret results and discusses potential financial stability policy recommendations that can be drawn from this type of in-depth analysis.

scholarly journals Successful Disinfection of a New Healthcare Facility Contaminated with Pseudomonas aeruginosa

Hygiene ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 1-13
Author(s):  
Alain Ficheux ◽  
Jérémy Réthoret ◽  
Jonas Laget ◽  
Cristel Baux ◽  
Nathalie Gayrard ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bacterial Contamination ◽  
Bacterial Load ◽  
Healthcare Facility ◽  
Water Systems ◽  
Water Networks ◽  
Healthcare Facilities ◽  
Biofilm Development ◽  
Positive Results

Contamination of water use points in health establishments is a frequent and concerning problem. Maintenance and disinfection of water systems can be inefficient. Sterilizing filters are commonly used at selected taps. We report diagnostic and corrective approaches that have succeeded in making a contaminated health facility sustainably compatible with its activity without restriction in taps use. The zones contaminated with pseudomonas as well as those, along the water networks, at risk of biofilm development were identified. Corrective measures on the network and various types of decontamination were carried out. At the end of this work, the bacterial load in the water significantly decreased and 219 out of 223 controls were negative for P. aeruginosa over 3 years of follow-up. Four positive results were linked to three taps not used for care which were satisfactorily treated locally. Errors at the design and setup phases of health facilities may result in resistant bacterial contamination. P. aeruginosa contamination of newly built healthcare facilities is an underreported problem. Guidelines on design, disinfection, and monitoring procedures of water networks of healthcare facilities should be adapted consequently and would certainly improve the offered care limiting patients’ risk and avoid many unwanted financial situations for the providers.

scholarly journals DEEP SCOPE: A Framework for Safe Healthcare Design

2021 ◽  
Vol 18 (15) ◽  
pp. 7780
Author(s):  
Ellen Taylor ◽  
Sue Hignett
Keyword(s):  
Human Factor ◽  
Healthcare Facility ◽  
Built Environments ◽  
Facility Design ◽  
Healthcare Facilities ◽  
Healthcare Design ◽  
Accident Causation ◽  
Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

scholarly journals Risk assessment in precapillary pulmonary hypertension: a comparative analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Thomas Sonnweber ◽  
Eva-Maria Schneider ◽  
Manfred Nairz ◽  
Igor Theurl ◽  
Günter Weiss ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Pulmonary Hypertension ◽  
High Risk ◽  
Risk Stratification ◽  
Risk Prediction ◽  
Mortality Risk ◽  
Assessment Tool ◽  
Risk Models ◽  
Non Invasive

Abstract Background Risk stratification is essential to assess mortality risk and guide treatment in patients with precapillary pulmonary hypertension (PH). We herein compared the accuracy of different currently used PH risk stratification tools and evaluated the significance of particular risk parameters. Methods We conducted a retrospective longitudinal observational cohort study evaluating seven different risk assessment approaches according to the current PH guidelines. A comprehensive assessment including multi-parametric risk stratification was performed at baseline and 4 yearly follow-up time-points. Multi-step Cox hazard analysis was used to analyse and refine risk prediction. Results Various available risk models effectively predicted mortality in patients with precapillary pulmonary hypertension. Right-heart catheter parameters were not essential for risk prediction. Contrary, non-invasive follow-up re-evaluations significantly improved the accuracy of risk estimations. A lack of accuracy of various risk models was found in the intermediate- and high-risk classes. For these patients, an additional evaluation step including assessment of age and right atrium area improved risk prediction significantly. Discussion Currently used abbreviated versions of the ESC/ERS risk assessment tool, as well as the REVEAL 2.0 and REVEAL Lite 2 based risk stratification, lack accuracy to predict mortality in intermediate- and high-risk precapillary pulmonary hypertension patients. An expanded non-invasive evaluation improves mortality risk prediction in these individuals.

scholarly journals Comparison of Two Novel Methods for Sink Drain Disinfection

2020 ◽  
Vol 41 (S1) ◽  
pp. s180-s180
Author(s):  
Muhammed Fawwaz Haq ◽  
Lucas Jones ◽  
Natalia Pinto Herrera ◽  
Jennifer Cadnum ◽  
Philip Carling ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Contact Time ◽  
Healthcare Facility ◽  
Gram Negative ◽  
Disinfection Methods ◽  
Initial Reduction ◽  
Repeated Measures Analysis ◽  
Potential Reservoir ◽  
Cleaning And Disinfection

Background: Sink drainage systems are a potential reservoir for the dissemination of gram-negative bacilli but are not amenable to standard methods of cleaning and disinfection. Pouring liquid disinfectants down drains has only a limited and transient effect on drain colonization, presumably due to inadequate disinfectant contact time and suboptimal penetration into areas harboring biofilm-associated organisms. Methods: We compared the antimicrobial efficacy of 2 novel sink disinfection methods intended to enhance disinfectant contact time and penetration. Healthcare facility sinks were randomly assigned to disinfection with 300 mL hydrogen peroxide-based disinfectant applied either as a foam (N = 13 sinks) or instilled for 30 minutes behind a temporary obstruction created by an inflated urinary catheter balloon (N = 12 sinks). Swabs were used to collect quantitative cultures from the proximal sink drain to depth of 2.5 cm (1 inch) below the strainer before treatment and at 15 minutes and 1, 2, 3, 5, and 7 days after treatment. Repeated measures analysis of variance was performed to compare the efficacy of the 2 treatments. Results: As shown in Fig. 1, both methods yielded an initial reduction of >3 log10 CFU of gram-negative bacilli. Over the 7-day follow-up period, disinfectant instillation resulted in significantly greater reduction than the foam application (P < .01). Recovery of sink colonization to >2 log per swab occurred at day 3 for both treatments, whereas recovery to >3 log per swab occurred on day 3 for the foam treatment versus day 7 for disinfectant instillation. Conclusions: Two novel disinfection methods were effective in reducing sink drain colonization for several days. The instillation method was more effective than the foam method in maintaining reductions over 7 days.Funding: NoneDisclosures: NoneDisclosures: NoneFunding: None

Antimicrobial Activity of N-Halamine–Coated Materials in Broiler Chicken Houses

2018 ◽  
Vol 81 (2) ◽  
pp. 195-201 ◽  
Author(s):  
Tian Ren ◽  
Mingyu Qiao ◽  
Lei Zhang ◽  
Jean Weese ◽  
Tung-Shi Huang ◽  
...  
Keyword(s):  
Antimicrobial Activity ◽  
Salmonella Typhimurium ◽  
Broiler Chicken ◽  
Treated Wood ◽  
Antimicrobial Activities ◽  
Complete Inactivation ◽  
Coated Materials ◽  
Metal Aluminum ◽  
Broiler House

ABSTRACT The antimicrobial activity of 1-chloro-2,2,5,5-tetramethyl-4-imidazoidinone (MC), a nonbleaching N-halamine compound, was investigated on materials commonly used in broiler production, including stainless steel, galvanized metal, aluminum, plastic, and pressure-treated wood. MC aqueous solutions at 0.02, 0.04, and 0.06% were challenged with Salmonella Typhimurium and Campylobacter jejuni at 6 log CFU/mL, resulting in complete inactivation of both bacteria in 30 min with 0.06% MC. Follow-up experiments were performed using test materials treated with 0.1 and 1% MC and challenged with Salmonella Typhimurium and C. jejuni at 6 log CFU per coupon. Stability of MC on the various surfaces of testing materials was assessed, and the chlorine content of the materials was measured using iodometric thiosulfate titration over a 4-week period. Antimicrobial activities were evaluated by a sandwich test on each sampling day during 4 weeks of storage. On the samples treated with 1% MC, bacteria at 6 log CFU per coupon were completely inactivated within 2 h of contact time. The antimicrobial activity extended to 4 weeks, and the active chlorine atoms in the treated materials decreased from the initial 1016 to 1015 atoms per cm2. Overall, MC had high stability and long-lasting antimicrobial activity, which suggests that MC has high potential for use as a novel antimicrobial agent to lower the microbial load on broiler house materials.

scholarly journals Peripheral atherosclerosis and abdominal aortic aneurysm as a new risk factors of upper gastrointestinal bleeding in patients with stable CAD receiving long-term antithrombotic therapy

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
V Korobkova ◽  
AL Komarov ◽  
OO Shakhmatova ◽  
MV Andreevskaya ◽  
EB Yarovaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Antithrombotic Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Atherosclerotic Burden ◽  
Abdominal Aortic ◽  
Stable Cad ◽  
Upper Gastrointestinal

Abstract Funding Acknowledgements Type of funding sources: None. Background Upper gastrointestinal bleeding (UGIB) is the most common hemorrhagic complication in stable CAD patients receiving antithrombotic therapy. It seems that atherosclerotic burden may increase the overall bleeding frequency. However, this factor has never been taken into account with UGIB risk assessment. We aimed to assess the predictive value of atherosclerotic burden (peripheral atherosclerosis – PAD and abdominal aortic aneurysm - AAA) for UGIB in patients with stable CAD receiving long-term antithrombotic therapy. Patients and Methods. A single center prospective Registry of Long-term AnTithrombotic TherApy (REGATTA-1 NCT04347200) included 934 pts with stable CAD (78.6% males, median age 61 [IQR 53-68] yrs). 77,3 %  of patients received dual antiplatelet therapy due to recent PCI with a switch to aspirin monotherapy after 6 months. 17,6% of patients received aspirin only, 5,1 % of patients received oral anticoagulants because of concomitant atrial fibrillation. Risk assessment of UGIB was performed according to the 2015 European Society of Cardiology guidelines (we were not able to identify only Helicobacter pylori infection). Additional ultrasound screening for PAD (lower limbs and cerebrovascular beds) and AAA was applied. The primary outcome was any overt UGIB (BARC ≥2). Results  The frequency of PAD was 18,8%, AAA – 2,4%, PAD and/or AAA -  20,5%. In a total 2335 person-years of follow-up (median follow-up - 2,5 yrs, IQR 1,1 – 5.1), UGIB occurred in 51 patients (incidence at 1 year 1,9 per 100 patients).  The median time to first occurrence of UGIB was 72 [IQR 13-214] days. Comparing the Kaplan-Meyer curves, the UGIB developed three times more often in patients with coexisted PAD and/or AAA vs isolated CAD (19.8% vs 6.5%, Log-Rank p = 0.00006). The difference remains consisted in regression model taking in account 2015 ESC panel of UGIB risk factors (OR 3.4; CI 1.7–6.9, p = 0,0005). Conclusions Atherosclerotic burden (concomitant PAD and/or AAA) is an independent predictor of UGIB in patients with stable CAD receiving long-term antithrombotic therapy.

scholarly journals Prediction of functional loss in emergency surgery is possible with a simple frailty screening tool

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Davide Zattoni ◽  
Isacco Montroni ◽  
Nicole Marie Saur ◽  
Anna Garutti ◽  
Maria Letizia Bacchi Reggiani ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Emergency Surgery ◽  
Screening Tool ◽  
Functional Decline ◽  
Healthcare Facility ◽  
Nursing Home Admission ◽  
Emergency Setting ◽  
Senior Adults ◽  
Functional Loss

Abstract Background Senior adults fear postoperative loss of independence the most, and this might represent an additional burden for families and society. The number of geriatric patients admitted to the emergency room requiring an urgent surgical treatment is rising, and the presence of frailty is the main risk factor for postoperative morbidity and functional decline. Frailty assessment in the busy emergency setting is challenging. The aim of this study is to verify the effectiveness of a very simple five-item frailty screening tool, the Flemish version of the Triage Risk Screening Tool (fTRST), in predicting functional loss after emergency surgery among senior adults who were found to be independent before surgery. Methods All consecutive individuals aged 70 years and older who were independent (activity of daily living (ADL) score ≥5) and were admitted to the emergency surgery unit with an urgent need for abdominal surgery between December 2015 and May 2016 were prospectively included in the study. On admission, individuals were screened using the fTRST and additional metrics such as the age-adjusted Charlson Comorbidity Index (CACI) and the ASA score. Thirty- and 90-day complications and postoperative decline in the ADL score where recorded. Regression analysis was performed to identify preoperative predictors of functional loss. Results Seventy-eight patients entered the study. Thirty-day mortality rate was 12.8% (10/78), and the 90-day overall mortality was 15.4% (12/78). One in every four patients (17/68) experienced a significant functional loss at 30-day follow-up. At 90-day follow-up, only 3/17 patients recovered, 2 patients died, and 12 remained permanently dependent. On the regression analysis, a statistically significant correlation with functional loss was found for fTRST, CACI, and age≥85 years old both at 30 and 90 days after surgery. fTRST≥2 showed the highest effectiveness in predicting functional loss at 90 days with AUC 72 and OR 6.93 (95% CI 1.71–28.05). The institutionalization rate with the need to discharge patients to a healthcare facility was 7.6% (5/66); all of them had a fTRST≥2. Conclusion fTRST is an easy and effective tool to predict the risk of a postoperative functional decline and nursing home admission in the emergency setting.

Sharp Decrease of Reported Occupational Blood and Body Fluid Exposures in French Hospitals, 2003–2012: Results of the French National Network Survey, AES-RAISIN

2015 ◽  
Vol 36 (8) ◽  
pp. 963-968 ◽  
Author(s):  
N. Floret ◽  
O. Ali-Brandmeyer ◽  
F. L’Hériteau ◽  
C. Bervas ◽  
S. Barquins-Guichard ◽  
...  
Keyword(s):  
Body Fluid ◽  
Sharp Decrease ◽  
Healthcare Personnel ◽  
Significant Drop ◽  
Healthcare Facilities ◽  
National Network ◽  
The Past ◽  
Personnel Safety ◽  
Voluntary Basis

OBJECTIVETo assess the temporal trend of reported occupational blood and body fluid exposures (BBFE) in French healthcare facilities.METHODRetrospective follow-up of reported BBFE in French healthcare facilities on a voluntary basis from 2003 to 2012 with a focus on those enrolled every year from 2008 to 2012 (stable cohort 2008–12).FINDINGSReported BBFE incidence rate per 100 beds decreased from 7.5% in 2003 to 6.3% in 2012 (minus 16%). Percutaneous injuries were the most frequent reported BBFE (84.0% in 2003 and 79.1% in 2012). Compliance with glove use (59.1% in 2003 to 67.0% in 2012) and sharps-disposal container accessibility (68.1% in 2003 to 73.4% in 2012) have both increased. A significant drop in preventable BBFE was observed (48.3% in 2003 to 30.9% in 2012). Finally, the use of safety-engineered devices increased from 2008 to 2012.CONCLUSIONOf the 415,209 hospital beds in France, 26,158 BBFE could have occurred in France in 2012, compared with 35,364 BBFE in 2003. Healthcare personnel safety has been sharply improved during the past 10 years in France.Infect. Control Hosp. Epidemiol. 2015;36(8):963–968

Sign in / Sign up

Export Citation Format

Share Document