The health and safety professional working in health care today faces many challenges in not only meeting accreditation and regulatory requirements, but also in providing a safe environment for staff and physicians so that they can provide a healing environment for their patients. We present here just a few of those challenges that are of most concern to health and safety professionals today: maintaining a safe care and work environment, shipping materials appropriately, sustaining process improvements, providing environments that support effective infection control and prevention and that reduce exposure to toxins. Our main focus will be on maintaining continuous readiness in environment of care for Joint Commission accreditation, sustaining EH&S and clinical process improvements, shipping clinical specimens and infectious substances, emerging issues in disinfection and sterilization technology, and control of hazardous drugs in the pharmacy and chemicals in the pathology laboratory. Resource tools will be provided to attendees of this session of the 2007 PDC.

Disinfection and Sterilization

Due to changes in the design of delicate medical devices over the last 15 years, the health and safety professional has needed to work closely with their infection control, sterile processing and biomedical engineering colleagues to devise strategies that ensure medical devices are appropriately cleaned and disinfected or sterilized for reuse. At Kaiser Permanente we have developed policies for consolidation of these functions wherever practical, to take advantage of economies of scale in staffing these areas with dedicated, competent individuals. This has the added advantage of freeing up clinical staff to provide direct patient care and reduces the interoperator variability of having multiple people perform the cleaning and disinfection or sterilization tasks. Also, building spaces that adequately control hazardous chemical vapors from reprocessing technologies is expensive, so reducing the number of them throughout the medical facility makes good business sense.

Determining which disinfectant or sterilization process to use can be confusing, since substances that are good at killing bacteria, viruses and spores are also harmful to other complex living systems like humans. It is impossible to make an effective sterilant that is also not harmful to humans unless the design of the process reduces or eliminates contact. Each technology has its advantages and disadvantages. We will look first at the different low temperature sterilization technologies and then survey cold liquid sterilants that are available in the market today to reprocess semi-critical and critical medical devices that cannot be sterilized with high temperature steam.

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