Aseptic cleaning typically refers to cleaning and creating sterile environments in a hospital or other medical setting. Because so many patients develop infections in hospitals, proper cleaning techniques are essential toward preventing unnecessary patient death. Improper cleaning procedures for even very simple procedures, such as inserting an IV, can have serious consequences.
Sepsis is a state in which a person develops severe blood and tissue infection. In a hospital setting, in which a patient is likely to have other complications at the same time as sepsis, this can result in a very high mortality rate. In times past, the role of microorganisms in infection was not well understood, but today, great emphasis is placed on maintaining aseptic conditions in clinical settings, or conditions in which microorganisms are removed, to lower the rate of patient death due to sepsis.
Washing one's hands is a key part of maintaining a state of asepsis. It is important to prevent germs from transferring from one person to another, and hands are a primary method of germ transfer. Although specific protocols vary from one facility to another, it is recommended that clinical personnel wash when their hands are visibly soiled, before and after touching a patient, before any invasive procedure, and after removing gloves. Basic handwashing involves washing with warm water and antibacterial soap for at least 15 seconds, as well as removing jewellery which may trap microorganisms. Surgeons have more intense handwashing procedures and must use a more powerful antibacterial soap and scrub under the fingernails. Patients are also encouraged to wash their hands often to help maintain asepsis.
Creating an aseptic environment inside a surgical room is extremely important, not only to prevent transferring germs, but also because people may have many harmless bacteria while on the skin, which can cause sepsis if it enters the body. Many chemicals are used to prepare a surgical site on a patient's body to help prevent this type of infection. Chlorhexidine, hexachlorophene, iodine and iodophor solutions are all chemicals used to clean an area for surgery, although some chemicals are more suited to others for certain areas of the body due to skin sensitivity.
Some medical tools are designed not to be touched at vital points, and are thus naturally aseptic. Most tools, however, require cleaning. Alcohol-based cleaning products and antibacterial swabs are suitable for many surfaces, such as cleaning trays. There are a variety of ways to clean tools and equipment, such as chemicals, gas, heat or radiation. Some techniques are more suitable than others for a particular type of equipment due to size, intricacy of parts, or type of material.
Problems with Aseptic Practice
Although the importance of cleanliness, the need for sterile medical instruments and the role of microorganisms in infection are much better understood today than in the past, there remain many problems and poor understanding of how to protect patients. Two studies in 1983 and 1996 showed a great variance in hospital practices. For instance; staff may not wash their hands often enough or perform procedures which, while seemingly harmless, do not follow aseptic practice, such as reinserting an IV needle after it touched bed linens. Staff may also rely too heavily on items such as sterile gloves, which, although helpful, are not a completely reliable method of preventing transfer. In addition, there are many situations in which aseptic procedures are not required but a hospital may have a protocol, which indicates the general understanding of aseptic technique is not well understood in practice.
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