Transcript Infection Control - Respiratory Therapy Files

Infection Control
Definition of Terms
• Asepsis
– Absence of disease-producing microorganisms
• Sterility
– Complete absence of all microorganisms
Definition of Terms
• Pathogen
– Microorganism capable of causing disease in humans
• Hospital acquired infections (nosocomial infections)
– Infection acquired during the course of hospitalization.
– Accounts for 2 million infections, 4.5 billion dollars and
90,000 deaths annually in the U.S.
Definition of Terms
• Cross contamination
– Transmission of microorganisms between places or persons
• Contamination
– Presence of a microorganism in an otherwise sterile
environment
Definition of Terms
• Virulence
– Heightened ability of an organism to produce infection in its
host
• Exotoxin
– Poisonous substance produced primarily by gram positive
bacteria and secreted into surrounding media; some are
extremely lethal
Definition of Terms
• Endotoxin
– Poisonous substance produced by gram negative bacteria
and released when the bacterial cell is destroyed
• Vector
– Insect, animal, or other carrier that transfers an infecting
agent from one host to another
Etiology
• Primary source of HAI’s are humans (visitors,
personnel, other patients)
• There are 3 major routes for transmission of human
sources of infection in the hospital:
– Direct and indirect contact
• Direct contact - Person to person (infection from the host
to another)
• Indirect contact – Transfer of organism thru a
contaminated object or intermediate person (unwashed
hands passing a pathogen picked up from one patient
and passing it on to another patient)
• The most frequent route of pathogen transmission in the
hospital setting is via indirect contact
Etiology
• There are 3 major routes for transmission of human
sources of infection in the hospital (cont):
– Respiratory droplets
• Coughing, sneezing, talking
• Use mask within 6 feet of patient or when entering room
– Airborne droplet nuclei (respirable particles < 5
micrometers)
• Remains suspended in air for long periods
• TB, Varicella, Variola, Rubeola, SARS
• Requires negative pressure room
• Requires N-95 fit tested mask
Infection Prophylaxis
• The techniques used by most hospitals to reduce host
susceptibility to infection focus mainly on the employee.
These include:
– Immunizations and chemoprophylaxis
– OSHA mandates that employers provide Hepatitis B
vaccinations
– Postexposure chemoprophylaxis is recommended after
exposure to B. pertussis, N. meningitides, B. anthracis,
Influenza virus, HIV, and group A streptococci
– Hand washing for at least 15 seconds is still the single most
important procedure for reducing hospital acquired
infections
Infection Prophylaxis
– Multi-dose vials of saline, water, and medications should be
time/dated when opened and discarded if contaminated
and/or not used within 24 hrs.
– Most disposable respiratory equipment should be discarded
and replaced every 48 hrs., This includes ventilator circuits
large and small volume nebulizers and humidifiers.
– Once a piece of equipment has been used and becomes
contaminated, that piece of equipment must be thrown out if
disposable, cleaned or sterilized
– Gloves are not 100% pathogen proof.
– Hand washing between patients is not the same hand
washing you would use going into a NICU or OR
Biohazardous Waste
• Defined as:
– Laboratory waste including specimen cultures, live and
attenuated vaccines, surgery specimens and blood
– Waste containing discarded materials/equipment
contaminated with exudate or secretions from patients
required to be isolated
– Contaminated sharps including needles, blades, broken
glass, or any items capable of cutting or piercing
– Any disposable item such as dressings, gloves, gowns etc.,
visibly soiled with recognizable human blood or body fluids
Biohazardous Waste
• What it is not:
– Unless it contains fluid blood, the following are NOT
considered biohazardous waste pursuant to the California
Department of Health
• Urine
• Feces
• Saliva/sputum
• Nasal secretions
• Sweat
• Tears
• Vomit
• Always refer to your clinical sites policy and procedures
Infection Prophylaxis
• Disposal of biohazardous medical waste
– All glass, sharps, guide wires, stylets must be placed in an
approved sharps container.
– Dry wound dressings, dry gloves, diapers and other forms
of contaminated equipment not saturated or dripping with
blood or other body fluids may be placed in regular trash
– Wet, dripping or fully saturated dressings, IV tubing and
their empty bags, ventilator circuits, HME’s, and other
pieces of equipment with blood, liquid secretions, liquid
mucous, must be placed in a red biohazard bag.
– Any equipment coming out of an isolation room including
PPE must be placed in a red biohazard bag or sharps
container
Infection Prophylaxis
Biohazard bag
Yellow sharps
containers and bags
are for chemotherapy waste
Sharps container
Infection Prophylaxis
• The 5 key recommended components of an infection
control program in the hospital setting are:
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Surveillance
Investigation
Prevention
Control
Reporting
Classification of Organisms
• Eukaryotic
– Types
• Protozoa
• Fungi
• Slime molds
• Algae (except blue-green)
Classification of Organisms
• Prokaryotic
– Types
• Bacteria
• Rickettsiae
• Mycoplasmas
• Blue-green algae
Classification of Organisms
• Viruses
– Simple nucleic acid chain
(DNA or RNA)
– Has a protein coat
– Some debate as to whether
they can be classified as
living organisms
Bacterial Environments
Bacterial Environments
• Bacterial requirements:
– Growth medium
– Atmospheric gas
– Temperature
– pH range
– Moisture
– Light
Requirements For Bacterial
Growth
• Growth medium
– Varies by bacteria from simple to complex nutrients
– Simple nutrients
• Water, carbon, nitrogen, oxygen, calcium, potassium,
etc.
– Complex nutrients
• Sugars, amino acids, blood products
Requirements For Bacterial
Growth
• Atmospheric gas requirements
– Obligate aerobes
• Require oxygen for reproduction
– Obligate anaerobes
• Only reproduce in an oxygen free environment
– Aero tolerant anaerobes
• Unaffected by exposure to oxygen
Requirements For Bacterial
Growth
• Atmospheric gas requirements (cont)
– Facultative anaerobes
• Reproduce under aerobic or anaerobic conditions
– Microaerophilic anaerobes
• Reproduce best at low oxygen levels; high oxygen
levels are inhibitory
Requirements For Bacterial
Growth
• Atmospheric gas requirements (cont)
– Chemolithotrophic and photolithotrophic bacteria use
carbon dioxide as principal source of carbon
Requirements For Bacterial
Growth
• Temperature requirements
– Psychrophilic
• —5° C to 30° C (optimum range 10° C - 20° C)
– Mesophilic (pathogenic)
• 10° C to 45° C (optimum range 20° C - 40° C)
– Thermophilic
• 25° C to 80° C (optimum range 50° C to 60° C)
Requirements For Bacterial
Growth
•Hydrogen ion (pH) requirements
o Pathogens
o Acidophiles
7.2 to 7.6 (optimum range)
6.5 to 7.0
o Neutrophiles 7.5 to 8.0
o Alkalophiles
8.4 to 9.0
Requirements For Bacterial
Growth
• Moisture
– Essential for all bacterial growth
• Light
– Most bacteria prefer darkness
– Ultraviolet and blue light are destructive to bacteria
Bacterial Shapes
• Spherical – coccus
• Rod – bacillus
• Spiral – spirillum, spirochete
• Comma-shaped – vibrio
• Spindle-shaped – fusiform
Staining
• Gram staining of bacteria
• Purpose:
– To separate bacteria into two general categories: gram
positive and gram negative bacteria
– The technique is based on the fact that the Gram positive
cell wall has a stronger attraction for crystal violet when
Gram's iodine is applied than does the Gram negative cell
wall
Staining
• Gram's iodine is able to form a complex with the crystal
violet that is attached more tightly to the Gram-positive
cell wall than to the Gram-negative cell wall. This
complex can easily be washed away from the Gramnegative cell wall with ethyl alcohol. Gram-positive
bacteria, however, are able to retain the crystal violet
and therefore will remain purple after DECOLORIZING
with alcohol.
Gram Stain Bacteria
• Gram positive
organisms stain
blue or violet
• Gram negative
organisms stain
red or pink
Acid-Fast Stain
Acid-fastness is a physical property of some bacteria referring to
their resistance to decolorization by acids during staining procedures
• Used to identify
bacteria of the genus
Mycobacterium
• Acid-fast bacteria
appear red against a
blue background
Acid-Fast Stain
• The primary stain used in acid-fast staining,
carbolfuchsin, is lipid-soluble and contains phenol,
which helps the stain penetrate the cell wall. This
is further assisted by the addition of heat. The
smear is then rinsed with a very strong decolorizer,
which strips the stain from all non-acid-fast cells
but does not permeate the cell wall of acid-fast
organisms. The decolorized non-acid-fast cells
then take up the counterstain.
Common Gram Positive Bacteria
• Bacillus anthracis
– Rod-shaped, arranged in chains, spore forming
– Secretes endotoxin
– Causes skin infections, septicemia, enteritis, meningitis,
anthrax, and pneumonia (wool-sorter’s disease)
Common Gram Positive Bacteria
• Clostridium botulinum
– Rod-shaped pairs, spore forming
– Causes botulism
Common Gram Positive Bacteria
• Clostridium perfringens
– Rod-shaped in pairs, spore forming
– Causes gas gangrene
Common Gram Positive Bacteria
• Clostridium tetani
– Rod-shaped in pairs, spore forming
– Causes tetanus
Common Gram Positive Bacteria
• Streptococcus pneumoniae
– Coccus, arranged in chains, may produce capsules
– Aerobic
– Causes lobar pneumonia; may cause empyema,
septicemia, meningitis, and peritonitis
Common Gram Positive Bacteria
• Staphylococcus aureus
– Coccus arranged in irregular, grapelike clusters
– Aerobic, facultative anaerobe
– Produces exotoxin and endotoxin
– Causes pneumonia, empyema, and wound infection
Common Gram Negative Bacteria
• Pseudomonas aeruginosa
– Rod-shaped, found as a single organism
– Aerobic, facultative anaerobe
– Responsible for up to 10% of all hospital acquired infections
– Causes pneumonia with characteristic green odoriferous
sputum; also causes wound infection, urinary tract infection,
empyema, meningitis, and septicemia
Common Gram Negative Bacteria
• Serratia marcescens
– Rod-shaped
– Aerobic
– Causes empyema, septicemia, wound infections;
responsible for some hospital epidemic
Common Gram Negative Bacteria
• Escherichia coli
– Rod-shaped, found as a single organism
– Aerobic
– Responsible for 45% of all nosocomial infections
– Causes necrotizing pneumonia, septicemia, endocarditis,
meningitis, wound infections, and urinary tract infections
Common Gram Negative Bacteria
• Klebsiella pneumoniae
– Short rod found as a single organism, produces capsules
– Aerobic, facultative anaerobe
– Causes necrotizing pneumonia with characteristic “red
currant jelly” sputum; also causes lung abscesses,
endocarditis, and septicemia
Common Gram Negative Bacteria
• Hemophilus influenzae
– Minute rod found as a single organism
– Aerobic, facultative anaerobe
– Common cause of epiglottitis in children; also causes
meningitis, laryngitis, croup, and sub acute bacterial
endocarditis
Common Gram Negative Bacteria
• Salmonella typhi
– Rod-shaped, found as a single organism
– Aerobic, facultative anaerobe
– Produces exotoxin
– Resistant to freezing
– Transmitted through contaminated water and, less
frequently, food
Common Gram Negative Bacteria
• Salmonella enteritidis
– Rod-shaped
– Aerobic, facultative anaerobe
– Found in animals, particularly shellfish, swine, and fowl
Common Gram Negative Bacteria
• Salmonella enteritidis
– Transmitted orally via contaminated milk, turtles, eggs,
undercooked chicken, fish, clams, and pork
– Causes enteritis that may progress to meningitis,
encephalitis, or nephritis
Common Gram Negative Bacteria
• Bordetella pertussis
– Minute, non-motile coccobacillus
– Causes whooping cough
Common Gram Negative Bacteria
• Neisseria meningitides
– Coccus found as diplococci
– Aerobic
– Causes meningococcal meningitis, bacteremia, and
pneumonia
Common Gram Negative Bacteria
• Proteus mirabilis and Proteus vulgaris
– Rod-shaped, found as a single organism
– Aerobic, facultative anaerobe
– Causes chronic urinary tract infections, pneumonia,
gastroenteritis, and bacteremia
Common Mycobacterium
• General characteristics
– Acid-fast, gram positive, aerobic rods
– Virulent strains found in cords – two chains in
side-by-side parallel arrangement
Common Mycobacterium
• Mycobacterium tuberculosis
– Very slow growing; requires three to six weeks for culture
– Causes pulmonary tuberculosis, spinal tuberculosis, and
miliary tuberculosis
– Transmitted through inhalation of droplet nuclei
– Causes necrotizing lesion with caseating center
Common Mycobacterium
• Mycobacterium leprae
– Transmission is intimate contact
– Causes leprosy
Common Mycobacterium
• Mycobacterium avium complex (MAC) and
Mycobacterium avium intracellulare (MAI)
– Non-tuberculous forming mycobacterium
– Does not require same level of precautions
– Causes chronic pulmonary infections
Common Fungi
• Characteristics
– Primarily work to decompose dead and decaying matter
(saprophytes)
– Some parasitic types derive food from living plants or animals
– May cause pulmonary infection or pneumonia through
inhalation
– Yeast: single cell forms
Common Fungi
• Pneumocystis carinii
– Normally not pathogenic
– Dormant in most individuals
– Mode of transmission is inhalation
Common Fungi
• Pneumocystis Carinii
– Common infection in immunosuppressed hosts; common
in HIV patients
– Causes diffuse panlobular pneumonia with abrupt onset,
fever, tachypnea, hypoxia, cyanosis, and possible
asphyxia in the acute stage
Isolation Procedures
Types of PPE Used in Healthcare
Settings
• Gloves – protect hands
• Gowns/aprons – protect skin and/or clothing
• Masks and respirators– protect mouth/nose
– Respirators – protect respiratory tract
from airborne infectious agents
• Goggles – protect eyes
• Face shields – protect face, mouth, nose, and eyes
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Isolation Procedures
• Handwashing
– The single most important act to prevent spread of infection
– Wash hands after touching blood, body fluids, secretions,
excretions, or contaminated items, even if wearing gloves
– Wash hands between patient contacts or between
procedures on the same patient
Isolation Procedures
• Standard precautions
– Hand washing
– Gloves: clean, non-sterile gloves when touching blood,
body fluids, secretions, mucus membranes, and
contaminated equipment
Isolation Procedures
• Standard precautions
– Gowns: clean, non-sterile gowns to protect against
activities that may generate splashes or spray of blood,
body fluids, secretions, or excretions
– Mask and eye protection: if danger of splashes or spray
Isolation Procedures
• Contact precautions
– Standard precautions apply
– Required in treatment of patients where transmission of
pathogens occurs from body-to-body contact
– Gloves required
– Gowns for direct contact with patient
– Private room
– Equipment dedicated to only one patient
Isolation Procedures
• Droplet precautions
– Surgical mask when within six feet of patient
– Private room
– Door may remain open
– Standard precautions apply
Isolation Procedures
• Airborne precautions
– N95 mask is required unless isolation is for measles or
chicken pox and the caregiver is immune
– Negative-pressure room required
– Standard precautions apply
Isolation Procedures
• Reverse Isolation
– Protects immunocompromised patients from visitors and
healthcare workers
– Standard precautions apply
– Gowns, gloves, surgical masks required
How to Don a Gown
Select appropriate type and size
Opening is in the back
Secure at neck and waist
If gown is too small, use two gowns
– Gown #1 ties in front
– Gown #2 ties in back
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How to Don a Mask
Place over nose, mouth and chin
Fit flexible nose piece over nose bridge
Secure on head with ties or elastic
Adjust to fit
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How to Don a Particulate Respirator
Select a fit tested respirator
Place over nose, mouth and chin
Fit flexible nose piece over nose bridge
Secure on head with elastic
Adjust to fit
Perform a fit check –
– Inhale – respirator should collapse
– Exhale – check for leakage around face
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How to Don Eye and Face Protection
Position goggles over eyes
and secure to the head
using the ear pieces or
headband
Position face shield over
face and secure on brow
with headband
Adjust to fit comfortably
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How to Don Gloves
Don gloves last
Select correct type and size
Insert hands into gloves
Extend gloves over isolation gown cuffs
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How to Safely Use PPE
Keep gloved hands away from face
Avoid touching or adjusting other PPE
Remove gloves if they become torn;
perform hand hygiene before donning
new gloves
Limit surfaces and items touched
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Where to Remove PPE
At doorway, before leaving patient room
or in anteroom*
Remove respirator outside room, after
door has been closed*
* Ensure that hand hygiene facilities are available at
the point needed, e.g., sink or alcohol-based hand
rub
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How to Remove Gloves (1)
Grasp outside edge near
wrist
Peel away from hand,
turning glove inside-out
Hold in opposite gloved
hand
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How to Remove Gloves (2)
Slide ungloved finger
under the wrist of the
remaining glove
Peel off from inside,
creating a bag for
both gloves
Discard
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Remove Goggles or Face Shield
Grasp ear or head
pieces with ungloved
hands
Lift away from face
Place in designated
receptacle for
reprocessing or
disposal
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Removing Isolation Gown
Unfasten ties
Peel gown away from
neck and shoulder
Turn contaminated
outside toward the
inside
Fold or roll into a
bundle
Discard
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Hand Hygiene
Perform hand hygiene immediately after
removing PPE.
– If hands become visibly contaminated during PPE
removal, wash hands before continuing to remove
PPE
Wash hands with soap and water or use
an alcohol-based hand rub
* Ensure that hand hygiene facilities are available at
the point needed, e.g., sink or alcohol-based hand
rub
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PPE Use in Healthcare Settings:
When to Use PPE
• Thus far we have discussed the various types of PPE,
considered various factors that go into selecting
appropriate PPE, and described how to don, use, and
remove PPE safely. This last segment of this
presentation will discuss WHEN to use which PPE.
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Standard and Expanded Isolation
Precautions
• Decisions regarding when and which type of PPE
should be worn are determined by CDC
recommendations for Standard Precautions and
Expanded Isolation Precautions.
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Standard Precautions
Previously called Universal Precautions
Assumes blood and body fluid of ANY
patient could be infectious
Recommends PPE and other infection
control practices to prevent
transmission in any healthcare setting
Decisions about PPE use determined by
type of clinical interaction with patient
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PPE for Standard Precautions (1)
Gloves – Use when touching blood, body
fluids, secretions, excretions,
contaminated items; for touching mucus
membranes and nonintact skin
Gowns – Use during procedures and
patient care activities when contact of
clothing/ exposed skin with blood/body
fluids, secretions, or excretions is
anticipated
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PPE for Standard Precautions (2)
Mask and goggles or a face shield –
Use during patient care activities likely
to generate splashes or sprays of blood,
body fluids, secretions, or excretions
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What Type of PPE Would You Wear?
Giving a bed bath?
Suctioning oral
secretions?
Transporting a patient in
a wheel chair?
Responding to an
emergency where
blood is spurting?
Drawing blood from a
vein?
Cleaning an incontinent
patient with diarrhea?
Irrigating a wound?
Taking vital signs?
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What Type of PPE Would You
Wear?
Giving a bed bath?
Gown, gloves
Suctioning oral secretions?
Gloves and mask/goggles or a
face shield – sometimes
gown
Transporting a patient in a
wheel chair?
Generally none required
Responding to an emergency
where blood is spurting?
Drawing blood from a vein?
Gloves
Cleaning an incontinent
patient with diarrhea?
Gloves with or without gown
Irrigating a wound?
Gloves, gown, mask/goggles
or a face shield
Taking vital signs?
– Gloves
Gloves, fluid-resistant gown,
mask/goggles or a face
shield
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Disinfection and Sterilization
Disinfection and Sterilization
• Definitions
– Cleaning: the removal of all foreign matter such as
sputum, blood, dirt, or organic matter that may provide
an environment for bacterial growth
– Disinfection: a process to eliminate vegetative, pathogenic
microorganisms on inanimate objects; differs from
sterilization by lack of sporicidal activity
– Sterilization: complete destruction or inactivation of all
forms of microorganisms
Disinfection and Sterilization
• Cleaning
– Must be done in an area with separate “dirty” and “clean”
sections
– Equipment to be cleaned must be completely disassembled
Disinfection and Sterilization
• Cleaning
– Soap, detergent, or enzymatic cleaners must be used
– If the object, such as electrical equipment, cannot get wet,
then the surface of the device should be cleaned with
70% isopropyl alcohol
Disinfection
• Disinfection describes a process that destroys the
vegetative form of all pathogenic organisms on an
inanimate object except for spores
Disinfection
• Alcohol
– Ethyl alcohol and isopropyl alcohol used in healthcare
setting
– Recommended concentration: 70%
– Inactivated by protein
– Can damage rubber, plastic, and the shellac mounting of
instruments with lenses
Disinfection
• Quaternary ammonium compounds
– Surface acting agents containing ammonium ion that
leads to
lysis of the cell walls
– Best with an alkaline pH
– Gram positive bacteria are most susceptible
– Ineffective against tuberculosis bacilli, spores, viruses, Hepatitis
B, and some fungi
– Can be stored and reused for up to two weeks if undiluted
Disinfection
• Acetic acid (vinegar solution)
– Inhibits growth of bacteria and fungi
– 1.25% solution appears to have sufficient effectiveness
(1 part vinegar to three parts water)
– Effectiveness reduced when reused
– Used extensively in the home care setting by caregivers
Disinfection
• Phenols (Lysol)
– Bactericidal, fungicidal, and tuberculocidal
– Retain activity in the presence of organic matter and are
active for a significant time after application
– Easily absorbed by porous material and may irritate skin
through contact
Disinfection
• Iodophors (iodine solution, betadine)
– Bactericidal, virucidal, and tuberculocidal
– Can be used on skin
– Water soluble, non-staining
Sterilization
• Glutaraldehydes
– Widely used in disinfection/sterilization of non-critical items
– All surfaces must be in contact with solution for it to be
effective
– Generally bactericidal, tuberculocidal, fungicidal, and
virucidal when object is in contact with the solution for ten
to thirty minutes; sporicidal if immersed for ten hours
– Must be rinsed thoroughly after use to avoid skin irritation
Sterilization
• Sodium hypochlorite (household bleach)
– Exposure to 1:50 dilution for ten minutes sufficient to kill
vegetative bacteria, bacterial spores, and tuberculosis
organisms
– CDC recommends 1:10 solution for disinfecting blood spills
– Do not allow mixing with any acid solution; toxic fumes
result
Sterilization
• Autoclaving
– Use of steam under pressure for a given duration of time –
most common settings are 121° C at 15 lb/sq. inch for 15
minutes
– Equipment is cleaned and packaged prior to sterilization
– Most common, efficient, and easiest sterilization method
Sterilization
• Autoclaving
– Variables for effectiveness
• Temperature
• Pressure
• Concentration of steam
• Holding time – minimum time necessary to kill spores at
a specific pressure
Sterilization
• Autoclaving
– Heat sensitive indicators demonstrate equipment has been
exposed to conditions necessary for sterilization – they do
not indicate sterility
Before
After
Sterilization
• Ethylene Oxide ((CH2)2O)
– Gas at room temperature, but liquefies readily under
pressure
– Has distinct, almost sweet odor
– Causes irritation to tissue, especially mucus membranes
– Flammable and explosive
Sterilization
• Ethylene Oxide ((CH2)2O)
– Variables for effectiveness
• Gas concentration
• Humidity
• Temperature
• Time of exposure
Sterilization
• Ethylene Oxide ((CH2)2O)
– Packaging material must be permeable to humidity and ETO
– Biological indicator necessary to ensure sterilization
– Aeration time required – 24 hours in a well ventilated area
– Toxicity to humans includes mutagenicity and carcinogenicity
EO Burn
EO
Explosion
Respiratory Therapy Equipment
• Large volume nebulizers
– Most common source of equipment related patient
infections
– Always use distilled water
– When refilling, empty remaining fluid
and then refill
– Drain tubing away from the patient
– Change and sterilize large volume
nebulizers every twenty-four hours
Depends on facility, once a week
Respiratory Therapy Equipment
• Small volume nebulizers
– Daily between treatments on the same
patient, rinse with sterile water, and air dry
– Replace every 72 hrs
– Use disposable or sterilized units between
patients
– Use single use medication vials whenever
possible
Respiratory Therapy Equipment
• Ventilator circuits
– Infections uncommon due to use of high efficiency
particulate air/aerosol filters
– Change every 30 days
– Sterilize circuits, if non-disposable
Respiratory Therapy Equipment
• Ventilator circuits
– Place bacterial filters
proximally to the humidifier
– Use sterile water to fill
humidifiers
– Change heat-moisture
exchangers (HMEs)
according to manufacturer’s
specifications
Respiratory Therapy Equipment
• Bag-valve-mask devices
– Must be sterilized between patients if non disposable, BUT
most are disposible
– Should be cleaned and exterior disinfected daily when in
use with one patient
Respiratory Therapy Equipment
• Suction systems
– Use a fresh, sterile single-use catheter on each patient
– Canister and tubing must be changed between patients
Respiratory Therapy Equipment
• Oxygen therapy equipment
– Minimal risk associated with oxygen therapy equipment
– If using humidifier, it must be changed between patients
Respiratory Therapy Equipment
• Pulmonary function equipment
– External tubing must be exchanged and sterilized between
patients
– Inner parts of equipment pose little risk of crosscontamination
• Use disposable equipment whenever possible