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Dear Readers,
Good clinical outcomes forms the foundation for quality eye care service delivery. Good sterilization protocols form the critical cornerstone for this. As eye care providers, we have to choose the right sterilization methods, institute stringent monitoring systems and adopt recommended and updated guidelines for sterilization.

This issue of Site News explores the Methods and Principles of sterilization, what protocols are used for Disinfection and Sterilization, it reports the effect of Sterilization and Endophthalmitis. It also brings to you simple tips and guidelines for Cleaning and Sterilization, Ophthalmic Sterilization, Sterilization of Ophthalmic Surgical Instruments, Operation Theatre and Sterilization and several resources in the form of Guidelines and Manuals.



Your feedback will help us improve the newsletter. Please send in your feedback at eyesite@aravind.orgThank You. Have a happy reading.

Regards,
Library Team
The Issue Features...
Sterilization
Vol.10 No.2 March 2013
•  Introduction
•  Methods and Principles
•  Disinfection and Sterilization
•  Sterilization and Endophthalmitis
•  Cleaning and Sterilization
•  Ophthalmic Sterilization
•  Sterilization of Ophthalmic Surgical Instruments
•  Operating Theatre and Sterilization
•  Guidelines and Manuals

•   Past Issues


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  • Cataract surgeons must continue to perform surgeries in a sterile, efficient operating room with properaseptic techniques. However, many longstanding accepted aseptic recommendations, such as changinggowns and gloves and using the longest autoclave cycles, arose in surgical specialties outside ophthalmology. Although some practices add significantlyto the cost of providing surgery, their benefit to cataract patients has not been proven. Cataract isalready a major societal economic burden in developed and developing countries. Therefore, to keepcataract surgery safe, cost effective, and affordableon a global scale, it is important to measure outcomes and to periodically review and revise efficiency of operating protocols based on the best available evidence. On the other hand it is also essential to ensure safety with any of the protocols adopted. For this, it is essential to have stringent safety protocols and quality monitoring systems. This Site News issue brings to you exhaustive resources that explore thedifferent aspects of sterilization.

  • THE BASICS OF STERILIZATION

  • The proper sterilization of medical devices, surgical instruments, supplies and equipment utilized in direct patient care and surgery is a critical aspect of the modern health care delivery system and directly impacts patient safety. This article presents “the three key essentials” of sterilization.



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  • STERILIZATION METHODS AND PRINCIPLES

  • This article stresses on the pharmacological importance of sterilization.The success of the process depends upon the choice of the method adopted for sterilization. This article presents the principles to choose the right sterilization method.



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  • INCIDENCE OF POST-CATARACT ENDOPHTHALMITIS AT ARAVIND EYE HOSPITAL

  • A modified sterilization and asepsis protocol adopted at Aravind in order to facilitate high-volumecataract surgery appeared to be safe and effective in preventing postsurgicalendophthalmitis. Despite a 3:1 ratio of manual ECCE tophacoemulsification and the eliminationof certain traditional sterilization practices, the rate of endophthalmitis in this generally underservedpatient population with multiple risk factors for infection was comparable to that reported in othermodern settings.



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  • CLEANING, DISINFECTION, AND STERILISATION

  • Cleaning, disinfection, and sterilisation are the backbone for preventing the spread of infections. In spite of this, many health care facilities either lack these basic facilities for infection prevention and control (IPC) or their personnel receive insufficient training. The following is a critical overview of the fundamentals for cleaning, disinfection, and sterilisation with particular emphasis on reprocessing reusable medical devices. See references for more detailed advice.

  • OPERATION THEATRE CLEANING

  • Theatre cleaning can be divided into daily cleaning, weekly cleaning and monthly cleaning.



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  • STERILIZATION IN OPHTHALMIC PRACTICE



  • TASK FORCE ON OPHTHALMIC STERILIZATION: LOW RATES OF ENDOPHTHALMITIS, TASS SEEN IN SURVEY.

  • The Task Force on Ophthalmic Sterilization presents this report of a survey of an ambulatory surgery centre, reviewing five distinct areas of sterility management: Cleaning techniques, Preparation of instruments for sterilization and sterilization cycles, Sterilizer selections, Maintenance of sterilizer equipment and Outcomes.

  • CLARIFYING STEAM STERILIZATION

  • Eye hospitals should be aware of regulatory requirements and that there has been instances of lapses in infection control that has been reported. Here’s some background on when and why the spotlight on instrument sterilization began to shine, why regulators continue to talk about the issue, and what we need to do to stay current.



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  • EFFECTIVENESS OF THE GLASS-BEAD STERILIZER IN OPHTHALMIC INSTRUMENTS

  • This study evaluates the effectiveness of the glass-bead sterilizer compared to the autoclave in inhibiting the growth of common ocular bacterial pathogens.

  • TIME AND OPTIMAL CONDITIONS REQUIRED FOR STERILIZING SURGICAL INSTRUMENTS

  • This article delivers the sound advice given by Barbara Ann Harmer, RN, regarding the various methods available for sterilizing surgical instruments to protect patients from toxic anterior segment syndrome and other infections,

  • RECOMMENDED PRACTICES FOR CLEANING AND STERILIZING INTRAOCULAR SURGICAL INSTRUMENTS

  • This write-up focuses on general principles of cleaning and sterilizing intraocular surgical instruments and recommendations for cleaning and sterilizing intraocular surgical instruments etc.,

  • STERILIZATION OF OPHTHALMIC SURGICAL INSTRUMENTS AND EQUIPMENT

  • This is a comprehensive course that provides anoverview and then an in-depth listing of essential steps required to ensure a safe environment for ourpatient.

  • CARE OF OPHTHALMIC SURGICAL INSTRUMENTS

  • This article gives an overview of the principles of surgical instrument care.

  • STERILIZATION OF PHACOEMULSIFICATION HANDPIECES

  • In this letter, Dr Ravi Thomas explores the safety of common practices used for phaco hand pieces: “The sterilization of phacoemulsification handpieces between cases is not the norm in many operating rooms in our country. And while sterilization of the tips alone is probably better than no sterilization, it is neither safe, nor is a preferred practice…”

  • STERILIZATION AND DISINFECTION OF INSTRUMENTS

  • The appropriate sterilization method is determined according to how the item will be used, the material from which the item is made, and the sterilization methods available.

  • PROTOCOL FOR THE DECONTAMINATION OF RE-USABLE OPHTHALMIC DEVICES

  • The Ophthalmology outpatient clinic is an environment where the potential for transmitting infections via contaminated ophthalmic instruments is a cause for concern. Pathogens are regularly introduced into the clinic by patients suffering with systemic or ocular infections and instruments and devices that come into direct contact with the cornea represent a possible mode of infection transmission.

  • THE PREPARATION AND STERILIZATION OF OPHTHALMIC SOLUTIONS

  • The ideal ophthalmic solution should be sterile, non-irritating, stable, and active. The effect of individual drugs upon the eye is influenced by dilution by the tears, precipitation of the basic drug or a salt by tears and mucus, the reaction of the tissues and tears, the reaction of the drug, and by the concentration and frequency of use of the drug. The last two factors are considered as most important, since they are the qualities which can altered most easily.

  • OPHTHALMIC INSTRUMENT DECONTAMINATION

  • This article argues that decontamination should be maintained throughout the “life-cyle” of the instrument – beginning from acquisition, transportation, use, storage, sterilization, packaging, inspection upto disposal.



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  • GUIDELINE FOR DISINFECTION AND STERILIZATION IN HEALTHCARE FACILITIES, 2008

  • The Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, presents evidence-based recommendations on the preferred methods for cleaning, disinfection and sterilization of patient- care medical devices and for cleaning and disinfect ting the healthcare environment. This document super cedes the relevant sections contained in the 1985 Centers for Disease Control (CDC) Guideline for Handwashing and Environmental Control.

  • GUIDELINES FOR RE-STERILIZING SUTURES

  • In some countries the idea of re-sterilizingsutures is not acceptable; however, in other situations people re-sterilise suturesroutinely. If you do sterilise sutures, the guidelines presented here should be considered.

  • STANDARDIZATION MANUAL

  • This manual presents a simple guide for establishing sterilization standards for cataract surgery.



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