Perhaps, we should start with the fact that the algorithm for the preparation of disinfecting solutions is not as complicated as it seems at first glance. During the training of middle and junior medical personnel, disinfection is given special attention. Because it is these people who support the sanitary and epidemic regime in medical institutions.
Types of disinfection
Disinfectant working solutions are prepared immediately before cleaning. And the characteristics of the solutions, such as concentration and volume, depend on its type. There are four types of disinfection:
- Prophylactic. It is regularly held in medical institutions to prevent the development of infectious diseases in both patients and staff.
- Focal. Be sure to be carried out by employees of the sanitary-epidemic station in the source of infection of infectious diseases. This is necessary to stop the spread of infection and prevent massive infection.
- Current. Disinfection that “accompanies” the patient. That is, it is carried out wherever there is sick: at home, in an ambulance carriage, in an infectious diseases hospital, in a ward.
- The final. It is carried out in the focus of infection by specially trained personnel after the patient recovers or dies.
The number and concentration of disinfectant solutions are taken into account when choosing a disinfection method. The mechanical method involves the removal of microorganisms from the human body, tools and surfaces by washing, washing, damp cleaning or ventilation. This is the easiest way to disinfect, and it is often used to pre-clean medical instruments.
The chemical method is based on the use of various groups of agents that affect microorganisms. They can create a film on the surface of the tool, can kill bacteria or stop their growth. The choice of drug depends on the desired final effect. The treatment may be in the form of irrigation, wiping or falling asleep.
The biological method is based on the confrontation of different types of microorganisms. This allows you to achieve a monoculture of bacteria, which can then be destroyed in any other way. In modern disinfection, this method is no longer used because of its complexity.
The thermal method is one of the most common. This is known to all mothers boiling, pasteurization, as well as roasting with dry heat and autoclaving. Specialized rooms, the so-called TSO (sterilization treatment center), are equipped in medical institutions, where the disinfection of materials and instruments takes place.
Radiation or physical method involves the use of ultraviolet rays to neutralize microorganisms (quartz).
Classification of disinfectant solutions
The algorithm for the preparation of disinfectant solutions depends on the basic substance, which is used for the elimination of microorganisms.
There are the following groups of drugs:
- Halogen compounds: chlorine, iodine, bromine. As a rule, it is alcohol solutions that are diluted with water. They clean the skin well and sterilize surfaces in operating rooms and wards.
- Chlorine-containing drugs, such as calcium hypochloride, Javelion, or Chloramil C, go separately.
- For the mechanical cleansing of the wound and the wiping of instruments, oxygen-containing agents are used: hydrogen peroxide, virone, saidex. Getting to the areas of contamination, they provide a rich foam, which not only kills microbial agents, but also “pushes” them out of the damaged areas.
- Aldehyde containing agents - lysoformin and bianol.
- Surface active substances. The most frequent representatives are Samara and Minstral.
- Alcohols include preparations based on ethanol, propanol and isopropanol. They form a film on the surface of the skin that prevents bacteria from colonizing. The same principle of action and on medical instruments.
The algorithm for the preparation of disinfectant solutions includes all available precautions against the ingestion of drugs on the mucous membranes, in the respiratory tract or in the stomach. The rules primarily relate to the age of staff and health.
- Only persons who have reached the age of majority are allowed to work with disinfectant solutions. They are required to undergo a medical examination, as well as receive instructions on how to properly work with disinfectants, and sign in a safety journal.
- Pregnant women, as well as young mothers who breastfeed their babies, are excluded from such work. This is due to the fact that in small doses the drugs still enter the body of the personnel, and therefore can harm the child.
- All medical professionals should use goggles, respirators and protective gloves to reduce the harmful effects on the body and prevent chemical burns.
- Personnel must undergo a medical examination in order to identify the beginning of an occupational disease in time.
Preparation of the solution
The algorithm for the preparation of disinfectant solutions is quite simple. To clean the surfaces in medical institutions using solutions of bleach. The steps to dilute the powder are as follows:
- Wear a robe, mask, goggles and protective gloves.
- Kilogram dry bleach pour in a ten-liter bucket. Then slowly pour water (10 l) into this container, stirring gently.
- Close the bucket with a lid and leave it for 24 hours.
- Strain the solution, pour it into a bottle of dark glass, seal it tightly and write a label indicating the date and time of preparation of the solution.
- The shelf life of such a disinfectant is a week.
First aid for accidental poisoning disinfectants
In case of violation of the mode of operation, non-observance of precautionary measures and in emergency situations, personnel may experience symptoms of general poisoning or local irritation of the skin, mucous membranes of the eyes, and respiratory tract disinfectants.
First aid in case of contact with unprotected skin - immediately wash this area with clean water. If formaldehyde is affected, treat the skin with a 5% solution of ammonia.
If irritation of the respiratory tract occurs, immediately remove the injured person from the room to fresh air or to a well-ventilated room. It is necessary to rinse the mouth and nasopharynx with water. In case of poisoning with formaldehyde, inhalation of water vapor with the addition of a few drops of ammonia is recommended, taking warm milk with sodium bicarbonate (baking soda) or Borjomi. According to the testimony - heart, sedative, antitussive, inhalation of oxygen. In severe cases, hospitalization.
If any drug gets into the eyes, they are immediately washed with a stream of water for several minutes. When eye irritation is instilled solution of albucide, with pain - 1-2% solution of novocaine.
In case of accidental ingestion of the chloro-active preparations in the stomach, it is washed with 2% sodium thiosulfate (hyposulfite) solution and 5-10-15 drops of ammonia with water, milk, baking soda, magnesia suspension (one or two tablespoons per glass of water) are given inside. In case of poisoning with formaldehyde, the stomach is washed with the addition of ammonia or 3% sodium carbonate (ammonium) solution to water. After washing, give raw eggs, protein water, milk.
Do I need to store and fit something in every pocket?
An iodine pen is a glass ampoule protected by a plastic case less than ten centimeters. So it is not a problem to take it with you. As the name suggests, it contains iodine, and therefore its use is the same as spray and ointment containing iodine.
Your choice: hand sanitizer gel. Disinfectant gels are made in the form of larger bottles with bottles or in small bottles of 50 ml or less. If necessary, they will also check at the airport. A small amount of the drug is applied to the hands, tilted and allow to dry freely. These products destroy the most common bacteria, fungi and viruses. However, skin may dry slightly.
Contraindications:Allergic reaction to chlorine-containing drugs
Safety nurses in the workplace:
2. Medical first aid kit.
Remember! Persons not younger than 18 years old are allowed to work with chlorine-containing drugs.
1. A hinge of dry powder chloramine 10 g
Do I need to disinfect large areas of skin?
Your choice: hypermanganes, iodine solutions. Hypermangan is available in the pharmacy as a deliberate powder. Used for disinfection baths. If you are preparing the solution of hypermans at home, it is important to dissolve only a few granules of the super-manganese powder. The resulting solution should be slightly pink. If you exceed the concentration of hypermanganate in the solution, it can cause skin burns.
The correct concentration depends on how it is used. As a rule, solutions are 1%, 5% or 10%. More concentrated iodine solutions are used in a hospital environment. Your choice: drops or ointment with septonex, a solution of boric acid and benzodedetsinom.
2. Capacity for water with marking to 1 l.
3. Capacity for des. solution.
4. Wooden spatula.
The sequence of actions m / s to ensure the safety of the environment:
1. Put on the second (surgical) gown, rubber apron, respirator or eight-layer mask, goggles, shoe covers, rubber gloves.
2. Check the operation of the supply and exhaust ventilation and alarm, turn on the ventilation.
Drops containing septonex can be applied one drop up to 5 times per day on the affected eye. After opening, the drops must be consumed within a month. If the symptoms of inflammation do not disappear within a few days, it is recommended not to continue with your doctor and consult a doctor. The fabric can be applied three times a day, but you can see it blurred for a while. The first centimeter of ointment is extruded and discarded before first use.
In addition to the solution, the solution is filled with a solution, the solution is applied to the eye, and eye movements are performed by the eye from 2 to 5 minutes, up to 5 times a day. Your choice: tea tree oil, sage. Tea tree oil is mainly used in traditional Oriental medicine for disinfection and treatment of various inflammatory conditions due to its antibacterial properties. Apply a few drops directly to the affected site.
3. Check for yourself (call the laboratory technician) chlorine activity and proper storage.
4. Hang a stencil on the door from the outside - “Do not enter! There is a preparation of des. solutions! ”, indicate the time when preparation is started.
5. Conveniently position the equipment you need, check the marking.
6. Pour a small amount of water into the container (preferably warm - to better dissolve the powder).
Sage is ideal for disinfecting the oral cavity. It is available in the pharmacy as saliva or alcohol tincture. You can make your infusion from home only by pouring hot water. Alcohol tincture must be diluted - half a teaspoon in 150 ml of warm water before use. Sage and drugs should not be used by pregnant and lactating women.
Your choice: disinfecting alcohol, disinfecting iodine. Even before removing the tick, it is recommended to abandon it by disinfecting alcohol, and then remove it with special ticks to remove ticks. Liquid disinfection is a multifunctional 60% alcohol used, for example, to disinfect newborn puppies. Before injection, it is also suitable for alcohol-impregnated dishwashers for single use.
7. Place a portion of dry chloramine powder (10g) in a container with water.
8. Add water to the 1l mark.
9. Stir the solution with a wooden spatula.
10. Close container tightly.
11. Attach a tag to the container - marking with the date, time of preparation and the name of the person who prepared it, his position.
12. Remove protective clothing.
13. Wash your hands, face with soap, dry off, rub into the skin of your hands silicone cream (any softening cream).
14. Close the lock room.
Evaluation of the results achieved
Prepared 1% solution of chloramine.
Chloramine solution is prepared immediately before use.
The solution is applied once.
Chloramine solution is valid for 15 days if chlorine activity is at least 25%.
Preparation of "working" solutions of chloramine:
1% - 10g of dry matter per 990 ml of water,
3% - 30 g of dry matter per 970 ml of water,
5% - 50 g dry matter per 550 ml of water.
0.5-1% solutions of chloramine, as a rule, are used where there can be no blood,
3% solution of chloramine - where there may be the presence of blood (orders №40 8, 128),
5% solution of chloramine - with tuberculosis (tbs) and microsporia, in CSO, oper blocks.
DISINFECTION. PREPARATION AND USE OF DISINFECTING SOLUTIONS
Medicine and Veterinary
As an independent work, it is recommended to create a thematic crossword, to prepare a reference message on the topics Disinfection: why it is needed Types of disinfection Disinfection methods Chemical disinfection. Equipment Demonstration material: tables Disinfection types, Disinfection methods, general cleaning log, bactericidal irradiation work log.
Ministry of Education and Science of the Russian Federation
I.Kant Baltic Federal University
on programs of secondary vocational education
Theme 3.2.1. “DISINFECTION. PREPARATION AND USE OF DISINFECTING SOLUTIONS
Laboratory lesson - 6 hours
for 1st year students
Full-time form of education
specialty (code) 060101.52 - Medical Business
060501.51 - Nursing
060102.51 - Obstetrics
Compiled by: teacher I.G.Manakova
Discussed and approved at the meeting
cyclic methodical commission
protocol number ___ dated __________ 20__
Head CMC ____________ / O.A. Butyrin /
- Motivation, goals.
- Interdisciplinary communication.
- Levels of learning. Competences.
- The structure of the lesson with a plan for the explanation of educational material and timing.
- Theoretical material laboratory work.
- Manipulations No. 6 “Preparation of disinfectant solutions”, No. 7 “Preparation of solutions of bleach bleach and bleach”, No. 8 “Cleaning of chambers”, No. 9 “Cleaning of the treatment room”.
- Control material.
- Situational tasks.
- List of used literature.
The knowledge and skills acquired during the lesson form the basis for studying the interdisciplinary course “Technology of providing medical services” and the subsequent classes of the interdisciplinary course “Safe environment for the patient and staff”.
The control of knowledge at the beginning of the lesson, in order to identify the level of preparation of students for laboratory work, should be conducted on 1-5 lecture questions - topic 3.2. "Disinfection". A frontal survey is recommended.
The presentation of the theoretical material of laboratory classes is accompanied by a demonstration of visual material, regulatory documents, instructions and techniques of manipulation.
Independent work of a laboratory lesson provides for acquaintance of students with instructions (methodical recommendations) on the use of disinfectants, regulatory documents, as well as working out the technique of manipulation and solving situational problems.
The final knowledge control is carried out in the form of a test control based on materials of lecture 3.1. "VBI" (7 question) lectures 3.2. "Disinfection" (1-5 question), theoretical material of laboratory classes and manipulations No. 6 "Preparation of disinfectant solutions", No. 7 "Preparation of solutions of chloramine and bleach", No. 8 "Cleaning of chambers", No. 9 "Cleaning of the treatment room" .
- tables "Types of disinfection", "Disinfection methods",
- general cleaning magazine
- logbook of bactericidal irradiators,
- disinfectants (powder, tablets, concentrate solution, aerosol, napkins, solution ready for use),
- containers for disinfectant solutions (pan, containers),
- sticks, shoulder blades,
- indicators of express control of the concentration of disinfectant working solutions.
Handout: regulatory documents:
- Instructions (methodical instructions) for disinfectants.
Workplace of students:
- bathrobe, cap, non-sterile gloves, mask, apron, glasses,
- disinfectants (powder, tablets, concentrate solution, aerosol, napkins, solution ready for use),
- measuring containers (cups, jars, cylinder), spoons,
- containers for disinfectants (pan, containers),
- sticks, shoulder blades,
- indicators of express control of the concentration of working solutions of disinfectants,
- buckets, rags, napkins, mop.
Грамотно организованное проведение дезинфекционных мероприятий (в том числе химическим методом) играют важнейшую роль в профилактике ИСМП.Дезинфекция предметов ухода, медицинского инструментария, оборудования, помещений занимают большую долю рабочего времени медицинского персонала. Не следует забывать, что применение дезинфицирующих средств - один из факторов, вредно влияющих на здоровье пациентов и, особенно, медперсонала. From the above it follows that medical personnel must carry out disinfection measures, strictly following the requirements of regulatory documents.
- Examine the role of the nurse in disinfection activities,
- To study safety precautions when working with disinfectants,
- To study the general requirements for the method of disinfection,
- Teach the preparation and use of disinfectant solutions,
- Teach disinfection of furnishings, sanitary equipment, cleaning equipment,
- Teach cleaning chambers and treatment room.
- Consider the ethical-deontological aspects of the topic
- To bring up responsibility towards their duties,
- To learn to use regulatory documents and instructions (guidelines),
- Develop speaking skills.
Biomedical ethics, hygiene and ecology, fundamentals of microbiology, virology and immunology, a healthy child and his environment, and all other clinical disciplines.
Levels of learning
- the concept of "disinfection"
- types and methods of disinfection,
- disinfectant characteristics
- the role of the nurse in the disinfection activities,
- general requirements for disinfection methods,
- sanitary-epidemiological regime of the somatic department.
- observe safety measures when working with disinfectants,
- prepare disinfectant solutions using the instructions
- carry out current and general cleaning of the premises using various disinfectants,
- provide a safe hospital environment for patients and medical staff.
General competencies (QA) for specialties 060101.52 - General Medicine, 060501.51 - Nursing, 060102.51 - Obstetrics:
- understand the nature and social significance of their future profession, show a steady interest in it (OK 1),
- to organize their own activities, based on the goals and methods of its achievement, defined by the head (OK 2)
- analyze the work situation, implement current and final control, assess and correct their own activities, be responsible for the results of their work (OK 3).
- search for information necessary to perform effective tasks (OK 4).
- use information and communication technology in their professional activities (OK 5).
- work in a team, communicate effectively with colleagues, management, consumers (OK 6).
- comply with the rules of labor protection, fire safety and safety (OK 8).
for the specialty 060101.52 - Medical business:
- observe the principles of professional ethics (PKS 7.2.).
- draw up medical records (PKS 7.5.).
- provide infectious safety (PKS 7.7.).
- provide a safe hospital environment for patients and staff (PKS 7.8.).
- provide industrial and personal hygiene in the workplace (PKS 7.11.).
Professional competence of a specialist (PKS): for the specialty 060501.51 - Nursing:
- observe the principles of professional ethics (PKS 4.2.).
- draw up medical records (PKS 4.5.).
- provide infectious safety (PKS 4.7.).
- provide a safe hospital environment for patients and staff (PKS 4.8.).
- provide industrial and personal hygiene in the workplace (PKS 4.11.).
Professional competence of a specialist (PKS): for the specialty 060102.51 - Obstetrics:
- observe the principles of professional ethics (PKS 5.2.).
- to issue medical documentation (PKS 5.5.).
- provide infectious safety (PKS 5.7.).
- provide a safe hospital environment for patients and staff (PKS 5.8.).
- provide industrial and personal hygiene in the workplace (PKS 5.11.).
The structure of the lesson With the PlanOM explanations of educational material AND TIME
- Organizational part: 5 minutes
- registration of those present
- check clothing, the presence of masks, gloves and documentation.
- Introduction: 10 minutes
- subject matter
- class objectives,
- lesson plan
- filling diaries.
- Input control knowledge: 40 minutes
- Explanation of theoretical material: 45 minutes
1. Question: Disinfection: types and methods.
2. Question: Preparation of disinfectant solutions.
3. Question: The use of disinfectant solutions.
- Independent work of students: 115 minutes
- working out the technique of manipulation
- work with regulatory documents and instructions
- solving situational problems.
- Total knowledge control: 30 minutes
- Lesson summary: 15 minutes
- filling diaries
- class analysis with answers to students' questions,
- rating with a comment.
- Homework with comment: 5 minutes
- repeat the lecture “Disinfection” (6-7 questions),
- learn glossary terms (exposure (exposure), disinfectants, disinfection),
- learn the manipulations № 6 "Preparation of disinfectant solutions", No. 7 "Preparation of solutions of chloramine and bleach", No. 8 "Cleaning of chambers", No. 9 "Cleaning of the treatment room",
- independent work (to make abstract messages on the topics: “Disinfection: why is it needed?”, “Types of disinfection”, “Disinfection methods”, “Chemical disinfection”),
- Cleaning office attendants: 5 minutes
Disinfection * - destruction of pathogens of infectious diseases and conditionally pathogenic microflora in the human environment.
Disinfectants * are chemicals that cause the death or suspension of microorganisms.
The mother liquor bleach * - 10% clarified solution of bleach.
Exposure (exposure exposure) * - the period of time necessary for the onset of disinfection (sterilization).
Note: Terms marked with (*) are written by students in their glossary.
Theoretical material laboratory work
- Question: Disinfection: types and methods.
Disinfection (disinfection) is the destruction of pathogenic and conditionally pathogenic microorganisms in the human environment.
V i d i d e z n i n f e c c i i
Current + gene. cleaning
Most often used in health care facilities:
- Mechanical method: wet cleaning, washing, washing hands, whitewashing and painting the premises.
- Physical method: ultraviolet irradiation, boiling, ultrasound, steam method.
- Chemical method: all methods are applied - rubbing, full immersion (soaking), irrigation, spraying, falling asleep.
- Combined method: washing hands with antiseptic soap, wet cleaning with disinfectants + UV.
- Question: Preparation of disinfectant solutions.
For the preparation of disinfectant solutions personnel is provided with disinfectants approved for use in the Russian Federation. When preparing disinfectant solutions, observe safety precautions when working with disinfectants in accordance with the instructions (guidelines) for the preparation. Solutions of disinfectants are prepared according to the instructions for use of the drug (guidelines) (see manipulation number 6). Tanks for the preparation of disinfectant solutions should be glass, enameled (without damage to the enamel), plastic. Tanks must be fitted with tightly fitting lids and labeled:
The expiration date
For disinfectants produced in the form of solutions of concentrates and in the form of powder, use appropriately sized measuring containers. For the preparation of disinfectant solutions using tap water. Some disinfectants require the preparation of a stock solution first, and then working solutions are prepared from it (for example, bleach) (see manipulation number 7).
Indicators are used for express control of working solution concentrations. The indicator should correspond to the tested solution. Firm "VINAR" produces indicator strips of the series "Dezikont". "Dezikont-NA" is used to control the neutral anolyte, "Dezikont-S" is used to control the "Septodor", etc.
- Question: The use of disinfectant solutions.
Disinfecting solutions are used to disinfect medical products, medical instruments, furnishings, premises, sanitary equipment, cleaning equipment, dishes, linens and care products.
Disinfection by wiping is carried out on objects that are not in contact with the patient or to which the immersion method cannot be applied. Wipe once or twice (according to the instructions) with a cloth moistened with disinfectant solution or a cloth soaked in disinfectants.
Dip disinfection is carried out:
- Option: the product is immediately immersed in a disinfecting solution.
- Option: visible impurities are removed from the product with the help of cloth napkins, then the product is immersed in disinfecting solution (the napkins are dumped into a separate container).
- Option: the product is pre-washed in a container with water (with a disinfecting solution), and then immersed in a disinfecting solution, the washings are also disinfected.
When disinfecting by immersion, detachable products are immersed disassembled. Tools with locking parts are immersed open, making several working movements in solution. Instruments having cavities and channels are immersed with the filling of their cavities. The height of the disinfecting solution above the tools is at least 1 cm.
Irrigation disinfection is carried out using disinfectants in the form of sprays or solutions are applied to the surface using special equipment.
After disinfection, items of care, medical devices and reusable instruments should be washed from the remains of the disinfectant in accordance with the recommendations of the manufacturer of the disinfectant.
Solutions of disinfectants are used for cleaning the wards and treatment room (see manipulation number 8, 9). There are washing-disinfectants of the new generation that do not require rinsing. Solutions of some disinfectants can be combined with a 0.5% detergent solution (Chlormix, Javel-Solid) according to the instructions. If the instructions do not indicate that solutions can be combined with detergent, then this cannot be done, as this may lead to a decrease in the activity of the disinfectant.
Calculation of disinfectant solution consumption is carried out according to the instructions for use.
"Preparation of disinfectant solutions (from powders, tablets and solutions of concentrates)"
Purpose: prevention of ISMP.
Equipment: protective clothing (gown, cap), personal protective equipment (mask (respirator), gloves, glasses) depending on the instructions for preparing the preparation solution, disinfectant (powder or tablets or concentrate solution), instructions (guidelines) for the preparation, measuring containers, labeled disinfecting container, tap water.
1. Preparation for the procedure
Ensuring the accuracy of the concentration of the solution and compliance with safety regulations.
1.2. Wear protective clothing and equipment.
1.3. Prepare a labeled container (container with a lid), disinfectant and, if necessary, measuring containers.
2. Execution of the procedure
2.1. Measure the required amount of disinfectant using a measuring container or count the required number of tablets.
Ensuring the accuracy of the concentration of the solution.
2.2. Pour some of the required amount of water into the container.
2.3. Place the disinfectant in a container.
2.4. Stir the solution using a perforated pan.
2.5. Add water to the mark of the desired volume in the container, using the graduation applied on the wall of the pan.
2.6. Stir the solution using a perforated pan.
2.7. Close container with lid.
Compliance with the requirements for storage and use of disinfecting solution.
2.8. Fill tag.
3. End of procedure
3.1. Remove personal protective equipment.
Compliance with safety when working with disinfectants.
3.2. Wash and dry hands.
Note: when preparing dezrastvorov in glass or enameled containers without calibration, water is added using measured water tanks or prepare a solution in a liter jar and pour it into a container, using a glass rod to stir the solutions.
"Preparation of solutions of chloramine and bleach"
Preparation of solutions of chloramine.
Chloramine is a white crystalline powder containing 25-29% active chlorine. Form release: packages of 100, 200, 300 grams. Chloramine is prepared by mixing the powder with tap water. The shelf life of the unused solution is not more than 15 days. The solution is used for disinfection once. Methods of disinfection: rubbing (single or double), immersion (soaking), irrigation (single or double).
The amount of chloramine in grams
Amount of water in ml
The surface of the room, dishes without food residues in the absence of infection.
For disinfection of care items not contaminated with blood and biological media. For disinfection with intestinal infections.
For disinfection of instruments, items of care contaminated with blood and other biological media. For disinfection of viral hepatitis and HIV infection.
- exposure exposure for disinfection tools - 60 minutes, the rest - according to the instructions,
- For the preparation of activated solutions of chloramine, a solution of ammonia is used.
Preparation of solutions of bleach.
Bleach is a white powder product. Available in 1 kg bags or in 30 kg bags. The product contains 26-32-35% of active chlorine, when dissolved in water, a suspension forms. First, a mother liquor of bleach is prepared from the powder, then, using a mother liquor (10% clarified bleach solution), working solutions of bleach are prepared.
Preparation of a 10% bleached bleach solution.
Before preparing a 10% bleached bleach solution, a health worker, in addition to a robe and cap, must wear a rubberized apron and rubber boots. Also, he must use protective equipment: rubber gloves, goggles, respirator (RU-60).
1 kg of dry bleach is placed in an enameled container and ground with the addition of a small amount of water to the state of a uniform slurry with a wooden spatula. Then add the remaining amount of water up to 10 liters, mix until a uniform suspension is formed and leave to settle in an enamel bowl with a lid for 24 hours (in the first 4 hours it is necessary to stir the suspension several times). After that, the clarified solution is carefully poured or filtered into a labeled enamel or glass container with a lid. Fill the oiling tag. The shelf life of a 10% bleached bleach solution is 7-10 days.
Preparation of working solutions of bleach.
Working solutions of bleach are prepared immediately before use. Used once. Exposure exposure - according to the instructions.
Methods of use - rubbing, immersion (soaking), irrigation.
Amount of 10% clarified mother liquor of bleach in liters
Amount of water in liters
Preventive disinfection in somatic units.
For disinfection with intestinal infections.
For disinfection of viral hepatitis and HIV infection.
For disinfection with tuberculosis.
- dry bleach is used in the method of falling asleep to disinfect secretions (urine, feces, vomit, etc.),
- For the preparation of activated solutions of bleach used a solution of ammonia.
Purpose: prevention of HSPI and creation of a safe environment for patients and medical personnel.
- implementation of the sanitary and hygienic regime in the wards of the somatic department of LPO.
- carried out at least twice a day,
- all cleaning equipment (carts, buckets, basins, mops, rags, mops, etc.) must be clearly labeled with the premises, types of harvesting or color coding,
- cleaning equipment must be used strictly for its intended purpose and stored in a separate room (there is a color-coding scheme located there),
- after wet cleaning, airing is necessary (air disinfection with bactericidal irradiators is carried out according to indications or in the wards of branches of the corresponding profile),
- LPO administration organizes preliminary and periodic (at least once a year) instructing the personnel engaged in cleaning the premises on issues of sanitary-hygienic regime and technology of cleaning.
Equipment: protective clothing (bathrobe, cap, oilcloth apron) and washable shoes with low heels, personal protective equipment (gloves), disinfectants and detergents allowed for use in the prescribed manner, labeled cleaning equipment.
1. Preparation for the procedure
1.1. Warn patients that the room will be cleaned.
Compliance with safety regulations.
1.2. Wear protective clothing and gloves.
1.3. Inspect the ward.
The effectiveness of the cleaning.
1.4. Prepare disinfectants of the required concentration according to the regime that ensures the death of bacterial microflora (it is advisable to use disinfectants with detergents).
2. Execution of the procedure
2.1. Clean the surfaces of window sills, furniture, equipment, appliances, doors with a clean cloth moistened with a decontamination solution.
2.2. Clean the sink.
Removal of dirt and microorganisms.
2.3. Вынести пакет с мусором и вставить в мусоросборник новый пакет.
Удаление медицинских отходов класса А.
Удаление пыли, органических веществ, микроорганизмов.
3. Окончание процедуры
3.1. Проветрить палату в течение 15 минут.
Удаление испарений моющих и дезинфицирующих средств и обеспечение нормируемых параметров воздушной среды.
3.2.Cleaning equipment to disinfect, rinse. Dry and store in a dedicated room.
The destruction of microorganisms on the surface of cleaning equipment.
- The schedule is held at least once a month. Outside the schedule, general cleaning is carried out in case of unsatisfactory results of microbial contamination of the environment and according to epidemiological indications.
- General cleaning of the wards is carried out according to the regimes causing the death of a bacterial infection.
- General cleaning is carried out with the windows open and in the absence of patients. Beds should be covered.
- Cleaning should begin with moving furniture away to ensure free access to the treated surfaces.
- During general cleaning, walls, equipment, inventory, lamps, batteries, window sills, safety shutters, doors, floors and baseboards are processed. The windows are washed as needed, but at least twice a year.
- When an NBI appears in the hospital, cleaning is carried out according to a regimen that is effective against the pathogen of the corresponding infection,
- When disinfecting objects contaminated with blood and other biological substrates, disinfectants should be used according to the antiviral regimen.
"Cleaning the treatment room"
- Current cleaning is carried out at least twice a day.
- All horizontal surfaces are treated with a solution of a disinfectant or detergent-disinfectant according to the instructions for use in antiviral mode (viral hepatitis B, C and HIV).
- The floors are cleaned with a solution of disinfectant or detergent disinfectant in the antiviral mode (viral hepatitis B, C and HIV).
- Air disinfection is carried out in accordance with the specific equipment instructions.
- Air treatment room at around the clock operation 4 times a day for 15-30 minutes.
B. General cleaning
- General cleaning is carried out once a week. Outside the schedule, general cleaning is carried out in case of unsatisfactory results of microbial contamination of the environment and according to epidemiological indications.
- General cleaning is carried out with disinfectants with a wide spectrum of antimicrobial action according to the regimes ensuring the death of bacteria, viruses and fungi.
- Personnel should have special clothes and personal protective equipment (bathrobe, hat, mask, rubber gloves, rubber apron, etc.), labeled cleaning equipment (floor and wall cleaning equipment should be separate), clean cloth napkins (if it is impossible to use disposable cloth napkins, reusable to be washed).
- Before cleaning, move the furniture away from the walls.
- During the general cleaning, they are applied to the wall washing and disinfecting solution with irrigation or wiping to a height of at least two meters, windows, window sills, doors, furniture, equipment and floors. At the end of the disinfection time (the staff must carry out the change of work clothes) all surfaces are washed with clean cloths moistened with tap (drinking) water, and then air disinfection of the room and airing are carried out (there are detergents and disinfectants that are not washed off).
- Make an entry in the journal of general cleaning of the treatment room.
Note: Used cleaning supplies are disinfected in a disinfectant solution, then rinsed in water and dried. Storage of cleaning equipment should be carried out in a specially designated room or closet outside the treatment room.
- Give the definition of "disinfection".
- What forms of microorganisms die during disinfection?
- Name the types of disinfection.
- In what case is prophylactic disinfection carried out, its purpose and multiplicity?
- In what case is the focal disinfection, its purpose?
- Name the goal, the frequency of the current focal disinfection.
- Name the goal, the multiplicity of the final focal disinfection.
- What are the methods of disinfection.
- Give examples of mechanical disinfection.
- Give examples of physical disinfection.
- Give examples of chemical disinfection.
- Give examples of combined disinfection.
- Give the definition of "disinfectant."
- What forms of disinfectants do you know?
- What are the toxicity classes of disrepairs?
- What groups are divided disinfectants depending on the objects of disinfection?
- List the disinfection modes.
- Name the groups of disinfectants by chemical composition and give examples.
- What is the disinfection boiling?
- Name the disinfection modes boiling.
- What material should there be for decontamination tanks?
- What information should contain marking of tanks for disinfecting solutions?
- What are the requirements for disinfection by immersion in a disinfecting solution?
- What options of disinfection products reusable immersion do you know?
- What items can be disinfected by wiping?
- Name the conditions necessary to ensure highly effective disinfection.
- How is the quality control of the preparation of disinfecting solution?
- What persons are allowed and not allowed to work with disinfectants, detergents and sterilizing agents?
- What remedies are used when working with disinfectants?
- What are the requirements for premises where disinfectants are prepared?
- What are the requirements for the storage of disinfectants?
- What actions should be taken in case of getting disinfectants on the skin, mucous eyes, nose and mouth, in the stomach?
- What levels of disinfection do you know?
- Describe low level disinfection?
- Describe the average level of disinfection?
- Describe high level disinfection?
Post-test: option number 1
1. The treatment room refers to the premises of the cleanliness class:
2. The little table (bedside table) for disinfection of the treatment room is located in the zone:
3. Washing the windows in the treatment room is carried out:
c) at least 2 times a year.
4. The current cleaning of the treatment room is carried out:
a) at least 2 times a day
5. General cleaning of the treatment room is carried out:
a) at least 2 times a day
6. The current cleaning of the chambers is carried out:
a) at least 3 times a day
b) at least 2 times a day,
7. General cleaning of chambers is carried out:
b) as pollution
c) once a month.
8. Airing of the chambers is carried out:
a) as necessary
c) at least 4 times a day for 20 minutes.
9. Bactericidal irradiator "Desar" refers to the type:
10. When changing the bed linen to the patient, the contaminated laundry is folded:
b) in a plastic bag,
11. Disinfection - a set of measures aimed at the destruction of:
12. Preventive disinfection is carried out:
a) around the patient
b) around the carrier
13. After the patient recovers or dies, they are disinfected:
14. Physical disinfection method:
15. Mechanical disinfection method:
16. Septodor solution is used for disinfection:
17. Disinfectant Zhavel Solid belongs to the group:
18. In the presence of patients apply toxicity disinfectants:
19. To prepare a 3% solution of chloramine - 1 liter, it is necessary to take chloramine powder:
20. To prepare a 0.5% bleach solution - 10 liters, it is necessary to take bleach bleach stock solution:
Post-test: option number 2
Task: choose one correct answer.
1. To prepare a 0.5% bleach solution - 10 liters, you must take bleach bleach:
2. To prepare a 3% solution of chloramine - 1 liter, it is necessary to take chloramine powder:
3. In the presence of patients apply toxicity disinfectants:
4. Disinfectant Zhavel Solid belongs to the group:
5. Septodor solution is used for disinfection:
6. Mechanical disinfection method:
7. Physical disinfection method:
8. After the patient recovers or dies, they are disinfected:
9. Preventive disinfection is carried out:
a) around the patient
b) around the carrier
c) after recovery of the patient
d) in the absence of the source of infectious diseases
10. Disinfection - a set of measures aimed at the destruction of:
11. When changing the bed linen to the patient, the contaminated laundry is folded:
b) in a plastic bag,
12. Bactericidal irradiator "Desar" refers to the type:
13. Airing of the chambers is carried out:
a) as necessary
b) at least 4 times a day for 15 minutes,
c) at least 4 times a day for 20 minutes
14. General cleaning of chambers is carried out:
b) as pollution
c) once a month.
15. The current cleaning of the chambers is carried out:
a) at least 3 times a day
b) at least 2 times a day,
16. General cleaning of the treatment room is carried out:
a) at least 2 times a day
17. The current cleaning of the treatment room is carried out:
a) at least 2 times a day
18. Washing the windows in the treatment room is carried out:
a) during the general cleaning,
b) according to pollution and at least 2 times a year,
c) at least 2 times a year.
19. The little table (bedside table) for disinfection of the treatment room is located in the zone:
20. The treatment room refers to the premises of the cleanliness class:
Standards of responses to post-tests with evaluation criteria:
Test items number 2
100-90% correct answers (20-18) - "5"
89-80% correct answers (17-16) - "4"
79-70% correct answers (15-14) - "3"
below 70% of correct answers - “2”
- During the summer holidays, a student who has completed the 10th grade of a school wants to get a job as a nurse. What is one reason for the failure?
- In one of the hospitals, a 3-year-old child was very thirsty at night. The nurse was absent from the post. The child got drunk in a washstand from a bucket standing there with a disinfecting solution, which the nurse prepared for the evening cleaning for the morning. Give an assessment of this situation.
- The nurse sees that the newly hired nurse washes the floors in the hallway using a bucket labeled "Procedural." Rate the situation. What needs to be done?
- A nurse on night duty did not do a wet cleaning. In the department, they do the cleaning during the day - a day nurse and in the evening a night nurse. Was the sanitary and antiepidemic regime violated?
- The nurse conducted a wet cleaning in the ward. A seriously ill patient complained to a nurse that after cleaning the ward, it smells strongly of disinfecting solution. What are the likely causes of this situation?
- When the employee of the controlling organization took a solution for analysis, it was found that the indicated concentration was exceeded 11 times. What is the likely cause of the incident?
- A nurse performs cleaning in the ward with the use of disinfecting solution without gloves. What can this lead to?
- When conducting disinfection measures, the solution of Zhavel Solid liquid dispensed into the eyes and on the skin of the nurse. What needs to be done?
- The student washed the floors in the treatment room and asked the nurse: "What to do with the cleaning equipment." Answer the student's question.
- The nurse was cleaning the ward. She was approached by the patient with a request to replace the soiled duvet cover. The nurse refused, arguing that bed linen was changed every 7 days. Are the nurse right?
- The nurse carried out disinfection measures with irrigation with the Zhavel Solid tool. She was wearing a robe, a cap. From protective equipment she used rubber gloves, an apron. At the end of the work she felt bad. Why did this happen and what should be done?
- The nurse needs to carry out an express control of the concentration of working solutions of the disinfectant "Septodor". It has a Desicont-NA indicator. Is it possible to use this indicator for the disinfectant "Septodor"?
Reference answer to situational problems
- Work as a nurse is always associated with the use of disinfectants. Persons under 18 are not allowed to do this work.
- Children in the department should be monitored, including at night, as well as ensure their drinking regime. Working solutions are prepared immediately before cleaning. Disinfectants and decontaminants should be stored in places not accessible to children. The child must call the doctor and act according to the instructions (methodological recommendations) for this disinfectant. As prescribed by the doctor, or flush the stomach, or give tablets of activated charcoal, depending on the instructions for this disinfectant.
- It is necessary to replace the bucket labeled “Procedural” with the bucket labeled “Corridor”. With the nurse it is necessary to conduct additional instructions on the use of inventory according to the label strictly for the intended purpose. Report to the head nurse about the situation. Treat bucket "procedural" with disinfecting solution.
- Yes, as the cleaning should be done at least twice a day. It is necessary to report in the morning to the head nurse and in 5 minutes.
- The nurse did not air the room after cleaning or prepared dezrastvor exceeding the required concentration. The nurse should arrange to air the ward and check with the nurse as she prepared the disinfectant solution.
- Excess concentration may be due to the erroneous use of instructions for the breeding of disinfectant, when using the measuring container is not consistent with this disinfectant.
- Allergic reaction, contact dermatitis.
- It is necessary to wash your eyes and skin with plenty of water (according to the instructions).
- It is necessary to disinfect, rinse, put for drying and subsequent storage in a specially designated place.
- No, not right. Linen when contaminated change immediately.
- She did not protect the respiratory system. According to the instructions for the preparation, respiratory protection should be carried out using universal respirators of the type RPG-67 or RU-60M with a patron of the brand Vis. It is also necessary to carry out eye protection with sealed glasses. The nurse, according to the instructions, you must bring to the fresh air, to ensure peace. Rinse your mouth, nose, throat with water, and then give warm milk with baking soda (one teaspoon per glass of milk). If necessary, consult a doctor.
- No you can not. Since the indicator “Dezikont-NA” is intended for express control of a neutral anolyte, and the indicator “Dezikont-S” is intended for “Septodor”.
- No. MU – 287–113 of 1998, “Guidelines for the disinfection of presterilizing cleaning and sterilization of medical devices”.
- Kuleshov L.I. Infectious safety in medical institutions / L.I. Kuleshov, E.V. Pustovetova. Ed. 2nd, add. and pererabat. - Rostov n / a: Phoenix, 2005. - 317 p.
- Kuleshov L.I. Basics of nursing: a course of lectures, nursing technology / L.I. Kuleshov, E.V. Pustovetova, ed. V.V. Morozov. - Rostov n / D: Phoenix, 2011. - 733 p.
- Mukhina S.A., Tarnovskaya I.I. A practical guide to the subject of "Basics of nursing": a textbook. - 2nd ed., Amended. and add. - M .: GEOTAR-Media, 2009. - 512 p.
- Obukhovets T.P. Basics of nursing / TP Obukhovets, OV Chernov, ed. B.V. Karabukhina - Ed. 14th, add. and pererabat. - Rostov n / D: Phoenix, 2009. - 792 p.
- Osipova V.L. Disinfection: study guide. - M .: GEOTAR-Media, 2009. - 139 p.
- Resolution of the Chief State Sanitary Doctor of the Region of 31.05.2005 No. 376 “On the conduct of disinfection measures at epidemiologically significant facilities of the Kaliningrad Region”
- SanPiN 126.96.36.19930-10 "Sanitary and epidemiological requirements for organizations engaged in medical activities"
- SP 3.5.1378-03 "Sanitary and epidemiological requirements for the organization and implementation of disinfection activities", 2005.