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What is wrong with our Practices
 Disinfectants used indiscrimately,
 Used unnecessarily
 Not used when needed.
 Concentration not adequate
 Economic consideration,
 Business promotions.
 Laboratory testing X Hospital conditions.
Economical loss
 Money wasted on unnecessary use.
 People concentrate on
Floors, Inanimate objects,
Basic Principles
 Cleaning more Important
 Disinfection and Sterilization ?
 Cleaning
Removes contaminants,
Dust, organic matter,
Disinfection
Reduces number of microbes
Disinfection x Sterilization
 Sterilization is absolute, removes microbes and spores
too.
 To achieve Sterilization is Expensive, not sustainable,
many times not needed.
Basic care of Operation Theatres.
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Reduction of Microbial counts is important.
Very rarely the Microbes reach the operation site,
Paying attention to Floors
Using unnecessary, too many chemical not necessary
Keep Clean Dry - Bacteria are reduced,
Most Important component of Bacteria is water, dry areas
causes natural death.
Walls and Roof of
Operation Theatre
 Frequent cleaning has little effect.
 Do not disturb these areas unnecessarily,
 Floors get contaminated quickly, depend on
Number of persons present in the
Theatre / Movements they make,
On many people make unnecessary movements than
needed
Care of and Floors
 Do remember only 1 % are pathogenic.
 On many occasion S.aureus.
 Floor should be decontaminated with
Use Vacuum cleaner.
Wet cleaning techniques
Wet Mop / Keep the mops dry
Care of Roof
 Do not disturb unnecessarily,
 Do not use ceiling fans they cause aerosol spread
 Clean only when remodeling or accumulated ,good
amount of dust.
How you care for Floors
 Use only vacuum cleaners
 Don't broom
 Use a Mop keep it dry,
Roof, Artificial ceilings, Walls
 Do not disturb every day
 Routine disinfection not necessary
Caring for Floors
 Only 1 % are pathogenic
 The counts depend on the number of persons,
 Only people needed for procedures should enter the
theatres.
 Unnecessary movements disturbs the bacterial flora
Cleaning the Floor
 A simple detergent reduces flora by 80 %
 Addition of disinfectant reduces to 95 %
 In busy Hospitals counts raise in 2 hours
Environmental Cleaning of
Operation Theatres
 Do not waste chemicals.
 Only remove the dust with cloth wetted with clean
water,
 Don't use chemicals/Disinfectants as a habit,
 Use only when contaminated with blood or body
fluids.
Handling of Air in Operation
theatre.
 Negative Air pressure vented to the operation theatre.
 Environmental cleaning should be twice daily
Environmental cleaning of Hospital.
 Disinfectant
Purpose
Sodium hypochlorite Contaminated with
Blood and body
fluids
Bleaching powder
Toilets, bathrooms
9 grams/lit
Environmental cleaning of OT
Contd
 Disinfectant
Alcohol 70%
Purpose
Metal surfaces
trolleys
Safety of Air conditioning and
Water cooling system
 Legionnaires disease is associated with Air Condition
system
 Chlorination / Heating of water may prove better
alternatives.
Between procedures in the
Operation Theatres.
 Clean operation tables, theatre equipment with
disinfectant solution with detergent,
 In case of spillage of blood / body fluids decontaminate
with bleaching powder/chlorine solution ( 1 % available
chlorine ).
 Always discard wastes in prescribed plastic bags – Don’t
accumulate biohazard waste in the operation theatres.
 Don’t discard discarded soiled gowns in the operation
theatre.
At the End of the Day
in Operation theatre.
 Clean all the table tops sinks, door handles with detergent /
low level of disinfectant.
 Clean the floors with detergents mixed with warm water,
 Finally mop with disinfectant like Phenol in the
concentration of 1 : 10
 Low concentration of Phenol serve as perfume and not as
disinfectant.
Infection control programmes
1 Monitoring of Hospital associated infections.
2 Training of Health care workers.
3 Investigations of outbreaks.
4 Any technical lapses.
5 Monitoring of staff health
6 Education on Universal Precautions
7 Advise on isolation of Infectious patients.
8 Waste disposal
9 Safe use of Antibiotics / Antibiotic policy.
Role of Microbiology
Department
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Identifies the pathogens
Monitoring of Antibiotic therapy,
Education on specimen collection and transportation,
Information on common Antibiogram patterns
Data on Hospital Infection
Surveillance of the Hospital environment
Counseling of the Infected Hospital Staff.
Surveillance of Operation theatre
Examination of Air
 Estimations are done for detection of bacteria carrying
particles in Air.
 Factors influence
Number of persons present.
Body movements,
Disturbances of clothing.
Do we need surveillance regularly
 Bacteriological surveillance testing at regular
internals is not warranted,
 But warranted when modification of operation
theaters are done,
 In any unforeseen increase of incidence of
infection form any particular operation
theatre.