Martin Li, MA, CRCST,
CER, CIS, CHL
Introduction
Sterile Processing Services (SPS) play a critical role in
ensuring patient safety in healthcare settings. The primary objective of SPS is
to provide critical and semi-critical reusable medical devices (RMDs) that have
been properly cleaned, decontaminated, inspected, packaged, and high-level
disinfected or sterilized according to the manufacturer’s instructions for use
(IFU). By controlling the number of microorganisms present on these devices,
SPS helps prevent the spread of infections within healthcare facilities. To
achieve this, Sterile Processing Technicians (SPTs) need to understand the history of infection prevention, key microbiological concepts,
the risks of infection and cross-contamination, and the measures needed to
control these threats.
The History and Background of Infection Prevention
Infection prevention has a long history that has evolved
significantly over the centuries. Early attempts at infection control were
largely based on trial and error. The ancient Greeks and Romans recognized the
importance of cleanliness, and basic antiseptic techniques were used, albeit
without a full understanding of the underlying principles. However, it was not
until the 19th century that significant advancements in infection control were
made. The work of Ignaz Semmelweis and Joseph Lister laid the foundation for
modern infection prevention practices. Semmelweis demonstrated that handwashing
could drastically reduce the incidence of puerperal fever in maternity wards,
while Lister pioneered the use of antiseptics in surgery, leading to a dramatic
reduction in postoperative infections [1].
The development of germ theory by Louis Pasteur and Robert
Koch further revolutionized infection prevention by establishing that
microorganisms were the cause of many diseases. This discovery led to the
development of sterilization techniques, the use of disinfectants, and the
implementation of more rigorous infection control protocols. In the 20th
century, the advent of antibiotics provided another powerful tool in the fight
against infections, though the emergence of antibiotic-resistant bacteria has renewed
the focus on traditional infection control measures such as sterilization and
disinfection [1].
Key Microbiological Terms and Concepts
To effectively control infections, SPTs must be familiar
with several key microbiological terms and concepts. Understanding these
concepts is crucial for comprehending how microorganisms cause disease and how
they can be controlled in a healthcare setting.
- Microorganisms:
These are tiny living organisms that can only be seen with a microscope.
They include bacteria, viruses, fungi, and protozoa. Some microorganisms
are pathogenic, meaning they can cause disease, while others are harmless
or even beneficial [2].
- Pathogen:
A pathogen is any microorganism that can cause disease. Pathogens can be
bacteria, viruses, fungi, or parasites. Understanding the different types
of pathogens and their modes of transmission is critical for infection
prevention [3].
- Sterilization:
This is the process of completely eliminating or destroying all forms of
microbial life, including spores. Sterilization is typically achieved
through methods such as steam under pressure (autoclaving), ethylene oxide
gas, or chemical sterilants [2].
- Disinfection:
Disinfection is the process of eliminating many or all pathogenic
microorganisms, except bacterial spores, on inanimate objects. High-level
disinfection is required for semi-critical devices that come into contact
with mucous membranes or non-intact skin [2].
- Cross-contamination:
This occurs when microorganisms are transferred from one person or object
to another, potentially causing infection. Cross-contamination is a
significant concern in healthcare settings and must be carefully managed
through proper sterilization, disinfection, and aseptic techniques [6].
The Threat of Infection and Cross-Contamination
In the medical center environment, the threat of infection
and cross-contamination is ever-present. Patients are often in a vulnerable
state, with weakened immune systems that make them more susceptible to
infections. The use of RMDs that have not been properly sterilized or
disinfected can introduce harmful microorganisms into the patient’s body,
leading to healthcare-associated infections (HAIs). HAIs are a major concern in
healthcare facilities, as they can result in prolonged hospital stays, increased
healthcare costs, and even death [4].
Cross-contamination is a particularly serious threat in
healthcare settings. It can occur in various ways, including direct contact
between patients and healthcare workers, contact with contaminated surfaces or
instruments, and through the air via droplets or aerosols. For example, if a
surgical instrument is not properly sterilized after use on one patient, it can
transfer pathogens to the next patient, leading to a new infection. Similarly,
improper hand hygiene by healthcare workers can facilitate the spread of
pathogens from one patient to another [6].
To mitigate the risk of infection and cross-contamination,
healthcare facilities must implement strict infection control measures. These
measures include proper hand hygiene, the use of personal protective equipment
(PPE), environmental cleaning, and the proper sterilization and disinfection of
RMDs. Sterile Processing Technicians play a vital role in this process by
ensuring that all RMDs are free from harmful microorganisms before they are
used in patient care [3].
Cross-Contamination Control Measures
Preventing cross-contamination is one of the primary goals
of SPS. Several control measures can be implemented to reduce the risk of
cross-contamination in healthcare settings.
- Hand
Hygiene: Proper hand hygiene is the single most important measure for
preventing the spread of infections. Healthcare workers should wash their
hands with soap and water or use an alcohol-based hand sanitizer before
and after patient contact, after contact with potentially contaminated
surfaces, and before performing any sterile procedures [5].
- Use
of Personal Protective Equipment (PPE): PPE, such as gloves, masks,
gowns, and eye protection, helps protect healthcare workers from exposure
to infectious agents and prevents the transfer of microorganisms from one
patient to another. PPE should be used appropriately and disposed of
safely after use [3].
- Environmental
Cleaning: Regular cleaning and disinfection of environmental surfaces
in healthcare facilities are essential to reduce the risk of
cross-contamination. High-touch surfaces, such as bedrails, doorknobs, and
light switches, should be cleaned frequently using appropriate
disinfectants [5].
- Proper
Sterilization and Disinfection of RMDs: Ensuring that all critical and
semi-critical RMDs are properly sterilized or disinfected before use is
crucial for preventing the spread of infections. SPTs must follow the
manufacturer’s instructions for use (IFU) for each device, including the
correct methods for cleaning, disinfecting, and sterilizing [2].
- Aseptic
Technique: Aseptic technique involves practices and procedures that
help prevent contamination by pathogens. This includes proper hand
hygiene, the use of sterile gloves and instruments, and the maintenance of
a sterile field during procedures. Aseptic technique is essential for
preventing cross-contamination during invasive procedures [5].
Conclusion
In conclusion, the primary objective of Sterile Processing
Services is to provide critical and semi-critical reusable medical devices that
have been properly cleaned, decontaminated, inspected, packaged, and high-level
disinfected or sterilized according to the manufacturer’s instructions for use.
To achieve this objective and prevent the spread of infection, Sterile Processing Technicians need to understand microorganisms and how they
live and grow. By understanding the history of infection prevention, key
microbiological concepts, the risks of infection and cross-contamination, and
the necessary control measures, SPTs can play a vital role in ensuring patient
safety in healthcare settings. Continuous education and adherence to infection
control protocols are critical for maintaining the highest standards of sterile
processing and protecting patients from harm.
References
- Torriani,F and Taplitz,R(2010). History
of infection prevention and control - PMC (nih.gov)
- Habboush,Y and el. (2023).Infecton
Control.https://www.ncbi.nlm.nih.gov/books/NBK519017/
- https://www.who.int/health-topics/infection-prevention-and-control#tab=tab_1
- https://www.physio-pedia.com/History_of_Infection_Control_Guidelines
- wikipedia.org - Infection prevention and control
- healthline.com
- Cross Infection
By understanding the history of infection prevention, key microbiological concepts, the risks of infection and cross-contamination, and the necessary control measures, SPTs can play a vital role in ensuring patient safety in healthcare settings. Continuous education and adherence to infection control protocols are critical for maintaining the highest standards of sterile processing and protecting patients from harm.
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