Infection Prevention and PPE in Sterile Services

Task 1: Breaking The Chain Of Infection During Manual Cleaning

The department’s washer-disinfector is temporarily unavailable, so staff are cleaning instruments manually. You notice a co-worker wearing gloves but no eye protection while manually scrubbing contaminated forceps. Another team member removes their gloves to answer a mobile phone call, then puts the same gloves back on to continue cleaning.

1. Describe correct hand hygiene steps before and after handling contaminated items and explain why timing of hand hygiene is critical. (15 marks)
2. Explain why correct PPE selection and the sequence of donning and doffing are important when cleaning contaminated devices. (15 marks)
3. Identify all breaches in infection prevention and control in this scenario. For each breach, describe how it increases the risk of exposure to blood-borne infections and contributes to the potential spread of infection within the sterile services environment. (10 marks)
4. Identify one relevant section or clause from AS/NZS 5369:2023 and state how this supports your answer in 1.3. (10 marks)

(Word count guideline 400 words; Task 1 total: 50 marks)

Task 2: PPE Use To Break The Chain Of Infection

You are rostered to work in the decontamination area. The washer-disinfector has just finished a load, and your colleague asks you to help reload it. You notice:

• some staff are wearing gloves and gowns but not face shields;
• one staff member has their mobile phone in their pocket while working;
• one person is wearing a gown but hasn’t tied it up at the back.

Write a structured reflection that addresses the following.

1. For each unsafe PPE practice above, describe how each relates to the chain of infection and creates control risks for staff and instruments, including how these practices could contribute to the spread of infection in the sterile services environment. (10 marks)
2. Explain what you would do in the moment to address each issue, while remaining professional with your colleagues. (20 marks)
3. Describe a time (in your experience working in sterilising technology) where you felt uncertain about PPE. What did you do, and what did you learn that will guide your practice in the future? (20 marks)

(Word count guideline 600 words; Task 2 total: 50 marks)

Experts Answer on Above Questions on Infection Prevention

Breaking the chain of infection during manual cleaning

Correct hand hygiene steps – the important steps to follow are to remove any kind of jewellery and keep fingernail short, apply soap and rub palms, rinse thoroughly and dry with a single use towel, utilise alcohol based hand rub, perform hand hygiene before putting on gloves, and repeat hand hygiene after handling contaminated instruments.

Correct PPE selection and donning and doffing

PPE required for manual cleaning – the gloves should be heavy duty one that can protect against contaminated instruments, fluid resistance apron to protect clothing and skin, face shield to prevent splashes entering the eyes, surgical mask and closed protective footwear.
Donning sequence – the process to follow includes performing hand hygiene, putting on a gown or apron, wearing a mask and eye protection, and putting on protective gloves.
Doffing sequence – the steps include removing gloves carefully, removing gown or apron without touching contaminated surfaces, removing eye protection using the straps, removing the mask, and performing hand hygiene immediately.
The use of correct PPE prevents exposure to blood, body fluids and cleaning chemicals. It also prevents transfer of microorganisms from contaminated PPE to clean surfaces.

Infection prevention and control breaches

Missing eye protection – Scrubbing forceps can result in splashes of blood-borne pathogens, exposing to infections such as hepatitis B, C and HIV.
Removing gloves to answer a phone – there are possibilities that a phone may be contaminated through contact with hands.
Reusing the same gloves – microorganisms can be transmitted from instruments to hands or other equipment using contaminated gloves.
Incorrect hand hygiene – after removing the gloves, it is important to clean hands, as failing to do so would allow microorganism to spread.

Relevant AS/NZS 5369:2023 clause

As per the clause 5.6.13 – personal protective equipment, it is essential that the PPE should be appropriate to the exposure risk and easily accessible in each work area. This is highly compliant with the given scenario because staff should wear suitable protective equipment like gloves, protective clothing and face protection, as they are required to manually clean contaminated forceps. There is increased risk of contamination and exposure from missing eye protection and unsafe glove reuse.

PPE use to break the chain of infection

Unsafe PPE practices and infection risk

From missing face shields, there is a possibility of splashes when handling, as it exposes staff to blood and microorganism through the eyes. From a mobile phone in your pocket, there is a possibility that the phone may be contaminated through dirty hands and transfer microorganisms to clean areas and instruments. Finally untied gown exposes clothing and skin to contamination, thereby allowing microorganism to spread through contact with other surfaces.

Actions to address unsafe practices professionally

The important steps I would consider are to remind colleagues to wear appropriate face protection, remove the phone from the work area and perform hand hygiene, remind the colleague to secure the gown properly, and report repeated PPE breaches to the supervisor and refer to workplace infection control procedure.

Personal reflection on PPE uncertainty

At the time of my sterilising technology training, I was not sure about the standard gloves and gown effectiveness in providing sufficient protection when handling contaminated instruments. After consultation with my supervisor, I have reviewed the workplace PPE guidelines before continuing the task. I have also understood that the selection of PPE depends on the exposure risk.

Eye protection, appropriate gloves and protective clothing are crucial when handling contaminated instruments. In the future, I will definitely perform a check of the PPE before starting the task, clarify with my supervisor in case of uncertainty, follow correct procedures related to donning and doffing, perform hand hygiene and report unsafe practices immediately.

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