By G. Ducel, Fondation Hygie, Geneva, Switzerland J. Fabry, Université Claude-Bernard, Lyon, France L. Nicolle, University of Manitoba, Winnipeg, Canada
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Additional info for Prevention of hospital-acquired infections A practical guide 2nd edition
The object must be wrapped for sterilization. Only a wrapped sterilized object should be described as sterile: • Dry sterilization: exposure to 160 °C for 120 minutes, or 170 °C for 60 minutes; this sterilization process is often considered less reliable than the wet process, particularly for hollow medical devices. Chemical sterilization • Ethylene oxide and formaldehyde for sterilization are being phased out in many countries because of safety and greenhouse gas emission concerns. Materials for packaging include: — paper which prevents contamination if intact, maintains sterility for a long period, can act as a sterile field, and can also be used to wrap dirty devices after the procedure • Peracetic acid is widely used in the United States and some other countries in automatic processing systems.
12 CHAPTER VI Prevention of common endemic nosocomial infections T he four most common nosocomial infections are urinary tract infections, surgical wound infections, pneumonia, and primary bloodstream infection. Each of these is associated with an invasive medical device or invasive procedure. Specific policies and practices to minimize these infections must be established, reviewed and updated regularly, and compliance monitored (Table 1). TABLE 1. 1 Urinary tract infections (UTI) Urinary tract infections are the most frequent nosocomial infections (1); 80% of these infections are associated with an indwelling urethral catheter (Figure 1).
Hair must be worn short or pinned up. Beard and moustaches must be kept trimmed short and clean. The working outfit must be made of a material easy to wash and decontaminate. If possible, a clean outfit should be worn each day. An outfit must be changed after exposure to blood or if it becomes wet through excessive sweating or other fluid exposure. 3 Clothing Working clothes Shoes Staff can normally wear a personal uniform or street clothes covered by a white coat. In special areas such as burn or intensive care units, uniform trousers and a short-sleeved gown are required for men and In aseptic units and in operating rooms, staff must wear dedicated shoes, which must be easy to clean.