CONTINUING PROFESSIONAL DEVELOPMENT
THIS ARTICLE IS ONE OF A SERIES OF PULL-OUT EDUCATIONAL SECTIONS THAT CAN BE INSERTED INTO YOUR PORTFOLIO AND BE A CONTRIBUTION TOWARDS YOUR PERSONAL CPD LEARNING.
Review of cleaning and sterilisation used in practice Joanne Casey MInstChP, BSc
The following is a review of the cleaning and sterilisation techniques you use in your practice. As podiatrists, chiropodists and foot health practioners we work in a wide variety of locations ranging from our own clinics to temporary rooms and of course domiciliary. However by auditing and reviewing our infection control procedures regularly we can maintain eﬀective infection control. Following a literature review there is little speciﬁc to podiatry and infection control, therefore we must refer to the Minimum Standards of Clinical Practice which every member should have a copy of and which is available to download from the IOCP website www.iocp.org.uk. The standards speciﬁc to podiatry have been developed by the professional bodies and podiatry and foot health training agencies. Of course many procedures are common to many disciplines and are standard in health care settings. When conducting a practice audit with regard to cleaning and sterilisation the key questions are • • • •
What is my procedure? What is the function of the procedure? Does it achieve the outcome required? Does it comply with the required outcome? Put simply, what do I do? why do I do it?, and is it ﬁt for purpose? The prevention of all treatment-associated infection both in patients and ourselves is an integral part of the professional responsibility of podiatrists. It is impossible to dictate a single infection control regime suitable to all practitioners as working conditions vary widely, however we can select and implement measures most appropriate to our workplaces. (Lorimar et al 2006) The following is a brief recap on the deﬁnitions and requirements of infection control in your workplace.
Infection is typically described as the multiplication of microorganisms in or on the body. This is diﬀerent from contamination which is the presence of microorganisms which may or may not cause infection.
A process where all living organisms including spores are eliminated
Disinfectants are substances that are applied to non-living objects to help destroy the microorganisms that are living on them. Disinfection does not necessarily kill all microorganisms, especially non-resistant bacterial spores; it is therefore, less eﬀective than sterilisation. Chlorine based products are well known eﬀective disinfectants
Destroy microorganisms on living tissue.
This term is used to describe the spread of infection from patient to patient, practioner to patient or transfer of organisms via clinical instruments. There are three basic strategies of infection control 1. Elimination of sources and reservoirs of infection 2. Disruption of transmission routes of infection 3. Increasing or restoring host resistance to infection. A standard operating procedure for cleaning should be in place in every clinic and it should be as important as any other part of clinic operation. All medicaments and dressings should be in covered containers and not accessible to dust or debris. Disinfectants play an important role in infection control. Disinfectants are chemical compounds which need to be used correctly, as prescribed by the manufacturer, at the correct dilution, for a prescribed time. Therefore the disinfectant needs to be carefully chosen for the job it is required to do, in other words ﬁt for purpose. The following is a list of disinfectants and their uses
The Institute of Chiropodists and Podiatrists • 150 Lord Street • Southport • PR9 0NP • 01704 546141 • www.iocp.org.uk