Page 162 - Assurance of Sterility for Sensitive Combination Products and Materials

144 Assurance of sterility for sensitive combination products and materials

• Control of direct person-to-person spread of bacteria
• MRSA and vancomycin-resistant enterobacter (VRE) are spread
primarily by person-to-person contact.
• Diligent hand washing is needed to prevent spreading bacteria from
one place to another. Hands can act as a vehicle for moving bacteria
from one location to another and from one person to another.
• Control of indirect person to person spread of microbes
• Effective cleaning of floors, sinks and other surfaces is needed to
minimize the spread of microbes.
• Effective cleaning of patient care equipment will help to prevent
patient to patient transmission of microbes.
• Surgical instruments and medical devices must be effectively cleaned,
disinfected, and/or sterilized. It is important to disinfect surgical in-
strumentation to prevent transmission to health-care personnel as
well as to prevent transmission from one patient to another. A re-
minder of the importance of cleaning is seen in the recent problems
in the United States that resulted in infections from the use of con-
taminated duodenoscopes.
• Reducing hospital stays will reduce the potential for exposure to
microorganisms that are present on other people.
• Utilizing outpatient procedures whenever possible will also mini-
mize the potential for patient-to-patient exposure to and transmis-
sion of infectious agents.
• Risk-based personal protective equipment is used to provide pro-
tection from infections without raising health-care costs to a point
where the cost is prohibitive. For example, AAMI Level 4 protection
surgical gowns are only used for procedures where there is expected
to be a high volume of blood and other body fluids, e.g., total joint
surgery. This level of protection is not needed for surgical procedures
where small volumes of blood and body fluid are expected to be
present, e.g., eye surgery.

6.4.1.3 Means of transmission
There are many methods by which microorganisms can move from one
place to another. Microorganisms can move by direct or indirect contact.
Respiratory droplets can occur from coughing, sneezing, talking, suctioning,
and during bronchoscopy procedures. The droplets can land on a mucosal
surface such as the nose, mouth, or eyes or compromised skin. Transmission
can also occur when droplets land on a surface of an inanimate or animate
object and then are transferred to a mucosal surface.