CDC - Guideline Decontamination ...

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//-->Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008Guideline for Disinfection and Sterilizationin Healthcare Facilities, 2008William A. Rutala, Ph.D., M.P.H.1,2, David J. Weber, M.D., M.P.H.1,2, and the HealthcareInfection Control Practices Advisory Committee (HICPAC)31Hospital EpidemiologyUniversity of North Carolina Health Care SystemChapel Hill, NC 27514Division of Infectious DiseasesUniversity of North Carolina School of MedicineChapel Hill, NC 27599-703021Guideline for Disinfection and Sterilization in Healthcare Facilities, 20083HICPACMembersRobert A. Weinstein, MD (Chair)Cook County HospitalChicago, ILJane D. Siegel, MD (Co-Chair)University of Texas Southwestern Medical CenterDallas, TXMichele L. Pearson, MD(Executive Secretary)Centers for Disease Control and PreventionAtlanta, GARaymond Y.W. Chinn, MDSharp Memorial HospitalSan Diego, CAAlfred DeMaria, Jr, MDMassachusetts Department of Public HealthJamaica Plain, MAJames T. Lee, MD, PhDUniversity of MinnesotaMinneapolis, MNWilliam A. Rutala, PhD, MPHUniversity of North Carolina Health Care SystemChapel Hill, NCWilliam E. Scheckler, MDUniversity of WisconsinMadison, WIBeth H. Stover, RNKosair Children’s HospitalLouisville, KYMarjorie A. Underwood, RN, BSN CICMt. Diablo Medical CenterConcord, CAThis guideline discusses use of products by healthcare personnel in healthcare settings such ashospitals, ambulatory care and home care; the recommendations are not intended for consumer use ofthe products discussed.2Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008Disinfection and Sterilization in Healthcare FacilitiesExecutive SummaryIntroductionMethodsDefinition of TermsApproach to Disinfection and SterilizationCritical ItemsSemicritical ItemsNoncritical ItemsChanges in Disinfection and Sterilization Since 1981Disinfection of Healthcare EquipmentConcerns with Implementing the Spaulding SchemeReprocessing of EndoscopesLaparoscopes and ArthroscopesTonometers, Cervical Diaphragm Fitting Rings, Cryosurgical Instruments, Endocavitary ProbesDental InstrumentsDisinfection of HBV, HCV, HIV or Tuberculosis-Contaminated DevicesDisinfection in the Hemodialysis UnitInactivation ofClostridium difficileOSHA Bloodborne Pathogen StandardEmerging Pathogens (Cryptosporidium,Helicobacter pylori, E. coliO157:H7, Rotavirus, HumanPapilloma Virus, Norovirus, Severe Acute Respiratory Syndrome Coronavirus)Inactivation of Bioterrorist AgentsToxicological, Environmental, and Occupational ConcernsDisinfection in Ambulatory Care, Home Care, and the HomeSusceptibility of Antibiotic-Resistant Bacteria to DisinfectantsSurface Disinfection: Should We Do It?Contact Time for Surface DisinfectantsAir DisinfectionMicrobial Contamination of DisinfectantsFactors Affecting the Efficacy of Disinfection and SterilizationNumber and Location of MicroorganismsInnate Resistance of MicroorganismsConcentration and Potency of DisinfectantsPhysical and Chemical FactorsOrganic and Inorganic MatterDuration of ExposureBiofilmsCleaningDisinfectionChemical DisinfectantsAlcoholOverviewMode of ActionMicrobicidal ActivityUsesChlorine and Chlorine CompoundsOverviewMode of ActionMicrobicidal Activity3Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008UsesFormaldehydeOverviewMode of ActionMicrobicidal ActivityUsesGlutaraldehydeOverviewMode of ActionMicrobicidal ActivityUsesHydrogen PeroxideOverviewMode of ActionMicrobicidal ActivityUsesIodophorsOverviewMode of ActionMicrobicidal ActivityUsesOrtho-phthalaldehydeOverviewMode of ActionMicrobicidal ActivityUsesPeracetic AcidOverviewMode of ActionMicrobicidal ActivityUsesPeracetic Acid and Hydrogen PeroxideOverviewMode of ActionMicrobicidal ActivityUsesPhenolicsOverviewMode of ActionMicrobicidal ActivityUsesQuaternary Ammonium CompoundsOverviewMode of ActionMicrobicidal ActivityUsesMiscellaneous Inactivating AgentsOther GermicidesUltraviolet RadiationPasteurizationFlushing- and Washer-DisinfectorsRegulatory Framework for Disinfectants and SterilantsNeutralization of Germicides4Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008SterilizationSteam SterilizationOverviewMode of ActionMicrobicidal ActivityUsesFlash SterilizationOverviewUsesLow-Temperature Sterilization TechnologiesEthylene Oxide “Gas” SterilizationOverviewMode of ActionMicrobicidal ActivityUsesHydrogen Peroxide Gas PlasmaOverviewMode of ActionMicrobicidal ActivityUsesPeracetic Acid SterilizationOverviewMode of ActionMicrobicidal ActivityUsesMicrobicidal Activity of Low-Temperature Sterilization TechnologyBioburden of Surgical DevicesEffect of Cleaning on Sterilization EfficacyOther Sterilization MethodsIonizing RadiationDry-Heat SterilizersLiquid ChemicalsPerformic AcidFiltrationMicrowaveGlass Bead “Sterilizer”Vaporized Hydrogen PeroxideOzoneFormaldehyde SteamGaseous Chlorine DioxideVaporized Peracetic AcidInfrared radiationSterilizing PracticesOverviewSterilization Cycle ValidationPhysical FacilitiesCleaningPackagingLoadingStorageMonitoring (Mechanical, Chemical, Biological Indicators)Reuse of Single-Use Medical DevicesConclusion5 [ Pobierz całość w formacie PDF ]