ASHCSP News
Central sterile processing departments frequently contain an area called decontamination. It takes in all types of items and equipment used for patient care—some of it used for surgical procedures, some to help monitor medicine as well as items that hold surgical waste. All of these items should be considered contaminated, which means that each item has actually or potentially been in contact with microorganisms. As a result, these items end up in the decontamination area of our facilities and are po-tentially a source of microorganisms that could cause infections in personnel and patients if not handled properly.
Decontamination is the use of a physical or chemical means to remove, inactivate or destroy bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles. Decontamination renders contaminated items safe for handling by persons who are not wearing protective attire.
What are bloodborne pathogens? These are the pathogenic microorganisms present in all human blood and can cause disease. There are many potentially hazardous bloodborne pathogens in the decontamination area, which is why personal protective equipment (PPE) is so important to protect yourself, other staff and patients. PPE is especially necessary because the change of contamination from airborne microbial and particulates is high in decontamination.
Cross-contamination occurs with everything that comes into contact with you, your uniform, shoes, etc. Because microorganisms aren’t readily visible, you won’t know if there are any present. Humans are very susceptible to cross-contamination because of several portholes of entry in which a microorganism can enter the body, including mucous membranes, mouth, eyes and any cuts or abrasions.
Many can only enter through certain portholes and disease can be contained in a number of potentially hazardous infectious materials that health care staff come into contact with every day, e.g., blood, semen, vaginal secretions and saliva.
Some organizations such as OSHA and the CDC recognize that health care workers are as much at risk for an infection as patients. These agencies have published recommendations for bloodborne pathogens. In 1991, OSHA published its current rule on bloodborne pathogens, which is standard 29 CRF 1910.1030. This rule was created to help protect health care and related workers from all occupational potentially infectious material. This approach to infection control is called Standard Precautions, in which all blood and bodily fluids are to be considered infectious. The OSHA standard outlines potential hazards that staff may come in contact with while doing their job. The standard also identifies engineering controls, which involve isolating or removing hazards from the work place. Work practice controls also reduce the likelihood of an exposure by altering how tasks are performed. Also recommended are training programs for employees whose jobs create the potential for exposure to an infectious hazardous material. In this standard, OSHA requires employers to provide PPE to staff who are at risk of coming in contact with potentially infectious hazardous materials in an effort to prevent exposure. According to the OSHA standard, PPE is “Special clothing or equipment worn to protect an employee against a hazard.”
The standard recommends a clean uniform and clean shoes to be worn only at the facility, general-purpose utility gloves and fluid-resistant covering such as a gown, apron or jumpsuit. If staff runs the risk of being splashed or their job involves using aerosols, they should be protected with high-filtration masks and eye protection or goggles or a full-length face shield used with a hair cover and shoe covers.
The Association for the Advancement of Medical Instrumentation also recommends the use of PPE to help protect health care workers in much the same way as OSHA and CDC standards. In addition, each health care facility has policies and procedures to ensure that the risks of exposure are kept to a minimum.
There are organizations that continue to research cross-contamination and related statistics and publish standards and guidelines to help protect health care staff. Guidelines and standards should always be followed, in addition to the policies and procedures created by our health care faculties.
Diane Gantt
Director
Supply Chain Contract Management Services
12225 Banyan Lane
Oklahoma City, OK 73162
(704) 733-5857 | diane_gantt@premierinc.com
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