Lecture Medical assisting: Administrative and clinical procedures with anatomy and physiology (4e) – Chapter 33

MA’s Role in Infection Control cont.• Follow correct sanitization, disinfection, and sterilization procedures • Help patients understand basic disease prevention • Educate patients a

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Infection Control

Techniques

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Learning Outcomes

33.1 Describe the medical assistant’s role in

infection control.

33.2 Describe methods of infection control.

33.3 Compare and contrast medical and surgical

asepsis.

33.4 Describe how to perform aseptic hand

washing.

33.5 Compare and contrast the procedures for

sanitization, disinfection, and sterilization

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Learning Outcomes (cont.)

33.6 Describe measures used in sanitization.

33.7 List various methods used in disinfection

and the advantages and disadvantages of each.

33.8 Discuss the goal of surgical asepsis.

33.9 Explain what an autoclave is and how it

operates.

33.10 List the steps in the general autoclave

procedures

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33.11 Explain how to wrap and label items for

sterilization in an autoclave.

33.12 Describe how to complete the sterilization

procedure using an autoclave.

33.13 Define the Blood-Borne Pathogens Standard

and Universal Precautions as described in the rules and regulations of the Occupational Safety and Health Administration (OSHA).

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33.14 Explain the role of Universal Precautions in

the duties of a medical assistant.

33.15 List the procedures and legal requirements

for disposing of hazardous waste.

33.16 Describe Centers for Disease Control and

Prevention (CDC) requirements for reporting cases of infectious disease.

33.17 Discuss the need for specific guidelines for

isolating patients in health-care settings

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33.18 Describe the appropriate use of personal

protective equipment in various situations.

33.19 Explain the purpose of immunization.

33.20 Describe your role in educating patients

about immunizations.

33.21 Explain how to educate patients in

preventing disease transmission

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methods of infection control

You will be introduced to Occupational Safety and Health Administration (OSHA) guidelines, the Blood-Borne Pathogen Standard, reporting

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MA’s Role in Infection Control

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MA’s Role in Infection Control (cont.)

• Follow correct

sanitization, disinfection,

and sterilization

procedures

• Help patients understand

basic disease prevention

• Educate patients about

immunizations

• Administer

immunizations

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Apply Your Knowledge

What is your role as a medical assistant in

controlling infection in the medical office?

ANSWER: To apply principles of infection control by

following correct sanitization, disinfection, and

sterilization procedures.

Correct!

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Infection Control Methods

• Eliminate elements needed for disease

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Medical Asepsis

• Keep office clean:

– Reception area: sick vs well

patients– Reception room clean, well

lit, and ventilated – Keep furniture in good repair

– Strict “no food or drink”

policy– Empty trash as necessary

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Medical Asepsis (cont.)

• During medical assistant

– Before and after each patient

– Before and after handling

equipment or specimens– After blowing your nose or

coughing

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Medical Asepsis (cont.)

• Other precautions

– Avoid leaning against sinks, supplies, equipment

– Avoid touching your face and mouth

– Use tissues when you cough or sneeze, and always

wash your hands afterward– Avoid working directly with patients when you have a

cold; wear gloves and mask if you must– Stay home if you have a fever

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Describe the difference between medical and

surgical asepsis.

ANSWER: Medical asepsis is based on cleanliness and

reducing the number of microorganisms as much as

possible Surgical asepsis is maintaining a sterile

environment by eliminating all microorganisms.

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Sanitization

• Scrubbing with a brush and

detergent to remove blood,

mucus, and other

contaminants or media where

pathogens can grow

• For cleaning items that touch

only healthy, intact skin

OR

• First step in disinfection and

sterilization for other

equipment

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– Separate sharps from other

equipment

• Scrub items

– Follow manufacturers’

guidelines – Dry thoroughly

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Sanitization (cont.)

• Rubber and plastic items

• Syringes and needles – use disposable whenever

possible

• Ultrasonic cleaning

– For delicate instruments and those with

moving parts– Sound waves generated through a cleaning solution

to loosen contaminants

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What is sanitation, and what types of items is it

adequate for cleaning?

ANSWER: Sanitation is scrubbing with a brush and

detergent to remove blood, mucus, and other

contaminants or media where pathogens can grow It

is adequate for cleaning items that touch only healthy,

intact skin.

Nice Job!

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Disinfection

• Adequate for instruments that do not penetrate skin or

mucous membranes and surfaces not considered sterile

OR

• Second step in infection control prior to sterilization

• Will not kill spores, certain viruses

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Disinfection (cont.)

• Using disinfectants

– Cleaning products

applied to inanimate materials to reduce or eliminate infectious organisms

• Antiseptics are infective

anti-cleaning agents used

on human tissue

– Follow manufacturers’

guidelines

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– Factors impacting effectiveness

of disinfectants

• Number of times solution is used

• Wet items – surface moisture may dilute solution

• Traces of soap left from sanitization – alters chemical composition

• Evaporation

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• Choose the correct disinfectant

– Germicidal soap products

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• Handling disinfected supplies

– Prevent contamination with

other surfaces– Use sterile transfer forceps

– Wear gloves

– Store in clean, moisture-free

environment

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What is the difference between a disinfectant and

an antiseptic?

ANSWER: Disinfectants are cleaning products applied to

inanimate materials to reduce or eliminate infectious

organisms Antiseptics are anti-infective cleaning agents

used on human tissue.

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• Used for even minor

operations and injections

• The more extensive the

procedure, the greater the

risk of infection

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• Required for all instruments or supplies that

– Penetrate the skin

– Contact normally sterile areas of the body

• Object is either sterile or not sterile

– If unsure of sterility, consider it not sterile

• Prior to sterilization

– Sanitize

– Disinfect

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The Autoclave (cont.)

• Wrap sanitized and disinfected items

– Special porous fabric, paper, or plastic

– Items should not touch– Label

• Check water level – distilled water only

• Preheat, but do not overheat

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• Load, choose correct setting, run cycle

– Temperature 250°to 270°F

– Pressure 15 to 30 pounds

• Unload

• Store items properly

– Clean, dry location

– Shelf life based on packaging, but generally 30 days

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• Clean autoclave and area

• Quality control checks

– Biological indicators – contain bacterial spores and

confirm that sterilization occurs

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• Prevent incomplete sterilization

– Correct timing

– Adequate temperature

– Properly wrapped packs

– Adequate steam levels

• Timing

– Preset for load types

– Use sterilization indicators

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• Temperature

– Too high – steam too little moisture

– Too low – steam too much moisture

• Do not overcrowd autoclave

• Steam level

– If incorrect, items will not be sterile at end of cycle

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Sterile Technique

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Surgical Asepsis

• During surgical procedures

– Do not touch sterile items

without sterile gloves

or transfer forceps

– Aseptic technique

• Throughout surgical procedures

• Caring for surgical wounds

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Surgical Asepsis (cont.)

• After procedures

– Sanitize, disinfect, and sterilize reusable

items– Disinfect surfaces

• Waste disposal

– Biohazard waste containers

• Leak-proof containers either color-coded red or labeled with biohazard symbol

– Biohazardous materials

• Biological agents that can spread disease

to living things

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ANSWER: Sterilization is required for all instruments or

supplies that penetrate the skin or come in contact with

normally sterile areas of the body.

1 What items need to be sterilized?

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ANSWER: Use medical asepsis while preparing the patient,

and then use surgical asepsis during the procedure

2 The physician is going to remove a small growth

from your patient’s back In order to prepare for

this procedure, what steps would you take to

prevent the spread of infection?

Right!

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OSHA Guidelines

• Blood-Borne Pathogen Standards

– Protect health-care workers from health hazards on

the job– Also protect patients and others who come to medical

facilities– Dictate how to handle infectious or potentially

infectious wastes

• Discarded

• Held for processing

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OSHA Guidelines (cont.)

• Blood-Borne Pathogen

Standards

– Measures to prevent the

spread of infection– Provide a margin of safety

by ensuring that medical facilities meet minimal standards for asepsis– Requirements for training,

keeping records, housekeeping, and personal protective gear

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• Categories of tasks

I Tasks that expose a worker to blood, body fluids,

or tissues and require specific protective measures

II Tasks that usually do not involve risk of exposure

but require precautions in certain situationsIII Tasks that have no risk of exposure, so no special

protection is required

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Respiratory Hygiene/Cough Etiquette

• Guidelines established by CDC

– Education

– Posting signs

– Controlling source or transmission

– Proper hand hygiene

– Separating patients with respiratory infections from

other patients

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Personal Protective Equipment

• Protective gear worn to protect

against physical hazards

• Employers must provide PPE at

no charge to the employee

• Disposable, sterile exam and

utility gloves

• Masks and protective eyewear

or face shields

• Protective clothing

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• Apply guidelines daily on the job

• Exposure incidents

– Contact with infectious substance

– Rules apply to all serious infections – HIV, HBV

– HBV vaccine

• Transmission to patients

– Nosocomial infection – an infection acquired by a

patient in a health-care facility

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ANSWER: There are three categories of risk:

Category 1: Expose a worker to blood, body fluids, or

tissues and require specific protective measures Category 2: Usually do not involve risk of exposure, but

precautions are required in certain situations Category 3: No risk of exposure, so no special protection is

required

OSHA divides medical tasks by level of risk

What are these risk categories?

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Reporting Guidelines

• Certain diseases must be reported to

state or county health department

• Information is forwarded to the CDC –

control of the spread of infection

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Reporting Guidelines (cont.)

• National Notifiable Disease Surveillance System (Table

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How is the information on reportable diseases

used by the CDC?

ANSWER: The CDC uses the information reported to

them to help control the spread of infection

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Isolation Guidelines

• CDC guidelines

– Types of precautions needed

– Patients requiring precautions

• Create an environment that protects against pathogens

• Standard Precautions

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Isolation Guidelines (cont.)

• Select appropriate PPE

– Gloves

– Masks, face shields,

respirators– Gowns

• Table 33-3

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Mrs Findley brings her child with chickenpox into the

medical office What type of personal protective

equipment should you use when caring for this child?

ANSWER: Chickenpox requires airborne and contact

precautions, so you should use gloves and a mask and goggles

or a respirator.

Nice!

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• Reduces risk of infection spread

– Decreases the susceptibility of the

host

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Immunization Recommendations

• Immunization schedules for children

– Advisory Committee on Immunization Practices

– American Academy of Pediatrics

– American Academy of Family Physicians

• Immunization schedules for adults

– The National Coalition of Adult Immunization (NCAI)

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Immunizations (cont.)

• When administering, you must explain

– The need for immunization

– Side effects

• Soreness at site

• Low-grade fever

• General malaise

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• Concerns

– Pediatric patients

• Do not give if child has fever

• Informed consent – explain benefits and risks

• Contraindications – symptoms that render the use of a remedy or procedure

inadvisable because of the risk

• Immunization records

– National Childhood Vaccine Injury Act of 1988 – Instruct parents keep record as proof of immunization

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– Pregnant patients

• Avoid live virus vaccines

• FDA categories A, B, C, D, and X

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– Immunocompromised patients

• May experience minimal to dangerous effects

• Adjust dosage or delay administration

• Must also consider immunization status of family and caregivers

– Health-care workers

• Hepatitis B vaccination offered by employer at no cost to employee

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