OTMANAGE CRITICAL CONTROL

INFECTION CONTROL, STERILIZATION & OT CLEANING

How does Air Entry Air Conditioning Effect Infection in OT?

There must be a positive pressure in the OT compared to wash rooms, utility rooms and corridors to prevent entry of contaminated air.

The temperature be kept at 68 to 700F (20-23 C) with a humidity of 30-60 percent.
-This reduces bacterial growth and static electricity.
-Each O.T. should have independent temperature controls.

Air in flow should be filtered through high efficiency particulate system (HEPA) with 15 air exchange per hour at least three of these must be fresh air.
-Air must enter the OT through vents in the ceiling and leaves through vents near the floor.

-The air ventilation system must have a regular routine for inspection and maintenance including change of filters.

-All these steps will control bacterial growth and thus wound infections.

What are Infection Control Mechanisms?

Infection will occur if high standards of preoperative,
intra-operative,
and postoperative rules are not observed in relation to the care of instruments and patients.
If there is any break of these rules by the surgical team;
-The occurrence of infection and cross-infection will rise.
-Resulting in anything from minor wound infections to a major disaster(tetanus)
-Standing rules and procedures need to be DEFINED by hospital Infection Control Committees (ICC) and OBSERVED by the surgical teams.

The infection control committee, usually headed by a physician, infection control nurse, or nurse epidemiologist.
Following the standards set by the ICC, provides the hospital with an effective program with the following goals:

-Investigate and identify source of the infection in each case.
-The source may be a person, a patient or an employee or may be the practice of one or more employees of poor aseptic technique. or
-A team member may be harboring a specific disease organism that is transmitted to the patients in his or her care.
-Provide effective isolation of infected patients.

-The ICC also identifies need for change in rule book to prevent a future outbreak

What are Common Bacteria on Skin and Surface?
Bacteria include staphylococci and streptococci these are responsible for the majority of cases of cellulites and abscesses seen on the skin.
-Most respond to an appropriate broad spectrum antibiotics.

-Abscesses in the perineal area are frequently infected with anaerobic bacteria or are mixed infections.
-In these situations metronidazole or some similar antibiotic needs to be given

• WHERE INFECTION is suspected in patent or staff, a bacterial SWAB should be taken, this will guide the treating physician to select the correct antibiotic.
• Fungal infection on toe-nails and finger-nails may be easily recognized by sending nail clippings or even the complete nail for mycology. Such action may avoid the need for surgery and establish a definitive diagnosis.
• Candida (fungus infection in mouth) infections are easily recognised and treated with any of the antimycotic agents.

Most cases of infection in surgery can be avoided by:
• Careful aseptic technique in the OT (given below).
• Attention to rules and procedures for sterilization of instruments and dressings (to be defined by the hospital administrators).
• However, in addition to problems of common bacterial pathogens, surgeons are now having to address themselves to the problems of viral agents such as HEPATITIS B, C, and HIV infection, which may have very many more serious long term consequences (guidelines at the end of this chapter).
• Infection is not always a one-way problem of patients infecting doctors and other patients: in a few instances an infected surgeon or his team can infect the patient, or other colleagues.
• It is therefore important for all members of the surgical team to be aware of the potential DANGER of their personal infections, and to know how to avoid them by strict personal hygiene and to treat these infections if they occur.
They must be freed from OT duties for the duration of their infection
Any questions be sent to drmmkapur@gmail.com