Infection Control and Instrument Disinfection

This week I will be giving a talk to the Podiatric Assistants at the APMA National Meeting in Boston on the topic of office infection control.  I believe that this is an area which does not receive enough attention since it is far from “sexy” or cutting edge but is still important.  Last year I sat in on discussions by the Clinical Practices Committee of The American Podiatric Medical Association in an attempt to come up with some Guidelines for disinfection and sterilization of instruments for the podiatric physician.  This document, available online for members of APMA by searching the term “disinfection” in the Members Section at www.apma.org , incorporates information from the CDC document “ Guidelines for Disinfection and Sterilization in Healthcare Facilities, 2008 ” also available online at http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf .  Much of the CDC document is not directly applicable to daily office practice, thus the need for the specialized Guidelines.  In the APMA document we approached podiatric instrumentation much the same way as the dentist classify their instruments.  They are broken down into 3 categories: Critical Instruments : These are any object that enters sterile tissue or the vascular system and therefore must be sterile because any contamination could transmit disease.  These would include any instrument used in a surgical procedure.  These instruments should be sterilized. Semi-critical Instruments : These instruments contact non intact skin.  Examples would include tissue nippers or curettes used in debridement of an ulceration or incision and drainage of an abscess.  These devices require high level disinfection. Noncritical Instruments : These come in contact with intact skin or nails.

This week I will be giving a talk to the Podiatric Assistants at the APMA National Meeting in Boston on the topic of office infection control.  I believe that this is an area which does not receive enough attention since it is far from “sexy” or cutting edge but is still important.  Last year I sat in on discussions by the Clinical Practices Committee of The American Podiatric Medical Association in an attempt to come up with some Guidelines for disinfection and sterilization of instruments for the podiatric physician.  This document, available online for members of APMA by searching the term “disinfection” in the Members Section at www.apma.org , incorporates information from the CDC document “ Guidelines for Disinfection and Sterilization in Healthcare Facilities, 2008 ” also available online at http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf .  Much of the CDC document is not directly applicable to daily office practice, thus the need for the specialized Guidelines.  In the APMA document we approached podiatric instrumentation much the same way as the dentist classify their instruments.  They are broken down into 3 categories: Critical Instruments : These are any object that enters sterile tissue or the vascular system and therefore must be sterile because any contamination could transmit disease.  These would include any instrument used in a surgical procedure.  These instruments should be sterilized. Semi-critical Instruments : These instruments contact non intact skin.  Examples would include tissue nippers or curettes used in debridement of an ulceration or incision and drainage of an abscess.  These devices require high level disinfection. Noncritical Instruments : These come in contact with intact skin or nails.

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Infection Control and Instrument Disinfection