HOSPITAL ENGINEERING

CHAPTER -2

Equipment for maintaining patient health and comfort

Shimelis N.(Ass.Lecturer)
April, 2018
 EQUIPMENT-RELATED INFECTION CONTROL

‘What is infection control’ ?

a wide range of practices, processes and procedures in the clinical work of the
health facility as a whole.
 Proper infection control (relating to equipment) can be achieved by making

decisions about a number of different issues:

 Decontamination, through appropriate use of cleaning, disinfection, and

sterilization methods, as well as monitoring sterility

 What is Decontamination ?

processes which remove, inactivate, or destroy contaminating infectious agents

from items or surfaces, and make items safe for handling, disposal, or reuse(if
this is possible and advisable)
 What is Needed?
 In order to decontaminate equipment effectively, it will be necessary to
make decisions about and address the following issues:
 The appropriate decontamination methods to follow.
 Who will be responsible for decontamination of which type of item.
 Daily procedures
 The three decontamination processes commonly used are:
 cleaning,
 disinfection, and
 sterilization.
 Cleaning
It is a process which removes visible contamination but does not
necessarily destroy micro organisms. It is necessary prerequisite for
effective disinfection or sterilization.
Cleaning is the first step in the decontamination process.

Proper pre-cleaning can substantially reduce the pathogen load

while removing organic and inorganic residues to facilitate

reprocessing.
Thorough pre-cleaning is vital for successful disinfection and

sterilisation.
 Disinfection
 A process that eliminates many or all pathogenic
microorganisms on inanimate objects, with the exception of
bacterial spores.
Disinfectants are substances that are applied to non-living

objects (e.g., instruments) to destroy microorganisms that are

living on the objects.
Reducing the number of pathogenic microorganisms to the

point where they no longer cause diseases.

 Sterilisation
 The process of freeing an article from microorganisms
including their spores. ZERO -PATHOGES
 In practice sterility is achieved by exposure of the object to be
sterilized to chemical or physical agent for a specified time
To achieve sterilization of any instrument three definite stages are to be
completed-

 Pre sterilization cleaning

 Sterilization process
 Aseptic storage
 Pre sterilization cleaning
 Objective-
Removal of the organic matters, blood and saliva which provide
protective barrier for microorganisms and prevents its
destruction.
 There are three methods for cleaning
-Manual
-Ultrasonic
-Mechanical washing
 MANUAL CLEANING

 Simplest and the cheapest method, but time consuming and

difficult to achieve.
 heavy duty gloves and glasses must be worn to protect needle
stick injury and to protect eye.
 Material used for manual cleaning
-Soaps
-Detergents
ULTRASONIC CLEANING

Principle- conversion of electrical energy into

vibratory sound waves which pass through a
soap solution containing the instrument.

Used mainly for burs, bone files, bone

cutter, artery forceps, saw etc.
MECHANICAL WASHING

Principle- High-pressure jets of water

with or without a detergent which
removes debris from instrument.
Small instrument like burs, blade are
not suitable for this type of cleaning.
 Methods of Sterilization
1. Steam Sterilization
2.Chemical (Gas) Sterilization
3.Plasma Sterilization
4.Ionizing Radiation
5.Cold Chemical Sterilizations
1. Steam Sterilization

 The use of steam under pressure is most commonly used by veterinary hospitals
to sterilize items.
 The three factors that dictate the success of steam sterilization are
temperature, pressure and exposure time.

 Increasing pressure of steam in a closed container causes the temperature of the

steam to rise.
 When microbes are exposed to the correct temperature and pressure for the right
amount of time, they are destroyed and the items they were on become sterile.
 The device used for steam sterilization is called an autoclave.
Contd…
2.Chemical (Gas) Sterilization
 Exposure to the gas at under
appropriate conditions results in
sterility
 Ethylene oxide is a gas that can
be used to sterilize this types of
method
 items include plastics, power
cables and endoscopes.
3.Plasma Sterilization
 safer method of sterilizing
heat-sensitive items is plasma
sterilization
 uses reactive ions, electrons
and neutrons to sterilize items
in about 45 minutes
temperatures as low as 122 ºF
Contd…
4.Ionizinig Radiation
 Most prepackaged sterile items
like surgical gloves and suture
packets have been sterilized with
ionizing radiation
 Exposure of these items to a
radioactive source, such as cobalt
60, destroys microorganisms.
 This process is expensive and
limited to commercial use
5.Cold Chemical Sterilizations
 common and inexpensive
method of sterilizing items
 The most common chemical
used is glutaraldehyde.
 Immersion times in the
solution vary depending on the
item
Important Terms
 Sanitize a term used in connection with catering and food equipment
that means to reduce the number of micro-organisms to an acceptable
level on these items.
 Antisepsis a term used in connection with living tissues and wounds
that means the destruction of micro-organisms on these areas in order
to prevent sepsis (rot) or decay.
 Asepsis: Absence of significant contamination
Bacteriostatic Agent: An agent that inhibits the growth of bacteria,
but does not necessarily kill them.
Bactericide: An agent that kills bacteria. Most do not kill Endospores.

Sporicide: An agent that kills spores.

Strategies for Ensuring Sterility
 Choose methods that ensure sterility
 Choose the right equipment in the right place, in order to establish

a ‘sterile-pack’ supply service

 Reorganize the packing system to provide smaller sets and packets

of items
 Ensure there is a ‘sterile chain’
 Technology Solutions

 There is consequently a clear need for sterilization equipment that is

robust, affordable, reliable, simple to use, and able to tolerate
fluctuations in power or operate on alternate power sources.
 Below is a list of promising technologies for facilities with erratic,

limited, or no electric power supply.

1)Nonelectric “Pressure Cookers”
These autoclave devices are designed for placement over an external
thermal source such as a coal or wood fire or over a more controlled
source such as a propane flame or hotplate.
Contd…
 The materials of construction are typically aluminum and/or
stainless steel.
 Controls are manual and cycle times are determined and
controlled by the end-use.
 but tend to focus on immediate use of the instruments after the
sterilizing cycle is complete.
 The likelihood of misuse is high and, therefore, these devices
are not recommended
2) Solar-Powered Autoclaves

 Solar energy can be used to directly heat matter.

 Solar concentrators are reflecting shields, usually in the shape of a parabola,
which take solar energy from a larger area and concentrate it into a smaller
area. The concentrated radiated energy is converted to thermal energy.
 The following is a list of the academic projects, a brief description of their
technology,
 Solarclave
 The latest design uses 90 pocket mirrors to concentrate the solar rays onto a
pressure vessel that produces steam at a sufficient temperature to sterilize
instruments in the vessel.
 The device can be manufactured in country with locally sourced materials
Contd…

 Capteur Soleil
 The design includes an array of curved mirrors that focus sunlight

on a steel tube filled with water.

 The tube produces steam that in turn heats a custom-designed

hotplate.
 The hotplate is made available to heat a standard non-electric

“pressure cooker” or any other items requiring a thermal source.

 Promethus

autoclave made from a set of long copper tubes encased in evacuated

solar collector tubes.
Contd…
 The solar collector tubes have an optically sensitive surface that
allows visible and UV radiation to pass into but not out of the tubes.
The radiation is absorbed as heat.
 Solar Brucke
 In 2004, a team from Aillingen, Germany, and Solar Alternatives
(India) installed a Scheffler reflector-based autoclave at Holy Family
Hospital in Mandar, India.
 The 10-m2 reflector heats a 230-kg iron block which functions as a
once-through steam generator.
Contd…

 The solar-powered steam generator is connected to a traditional

electric boiler providing a hybrid design suitable for sunny and
non-sunny days.
 The one advantage the solar concentrator autoclaves have over
pressure cooker autoclaves is the ability to harness the sun as a
reliable power source.
 The complexity of setting up and operating an autoclave varies
with the type of autoclave and the quality control specifications.
Contd…
 While most autoclaves are fairly simple to operate and maintain,
providers will need some level of training in their use to ensure that
items are being sterilized correctly.
 Facility staff will also need to be trained to correctly maintain the
autoclave to ensure that the machine is being used in a way that can
increase its lifespan.
 Where possible, mechanical, chemical, or biological indicators should
be used to provide evidence that the sterilization cycle was successful.
 Refrigeration in hospitals
 Refrigeration: - is the process of cooling, or lowering the temperature
of a space or substance below the temperature around it.
 The basic components of a refrigerator are

b. Condenser
c. Refrigerant control
d. Evaporator
e. Connecting tube and
f. Refrigerant
Working Principle
 Refrigeration is a cooling process

 A compressor is found at the base of the fridge

 This compressor contains refrigerant –

 Freon 12 or liquid ammonia
 A refrigerant is a substance that turns from liquid to gas or gas to liquid very
quickly

 The motor activates the compressor which forces the refrigerant into the
condenser

Motor ----- Compressor---- Refrigerant----Condenser

 Evaporator

Tray

Condensor

Compressor

Motor
 The condenser causes the gaseous refrigerant to cool, changing it into a
liquid

 The refrigerant moves to the evaporator where it turns back into a gas
 The liquid evaporates as heat is taken from the fridge cabinet

 This cools the fridge

 The refrigerant returns to the compressor and it starts again

 Evaporator
Tray

Condensor
Compressor
Motor
Motor: to power the compressor
Compressor: forces liquid into the condenser
Condenser: cools the gas and changes it into a liquid
Evaporator: evaporates liquid by drawing heat away from interior of
the refrigerator. Gas returns to the compressor
Tray: collects liquid during defrosting
Principles of Operation

High Temp High Temp

High Pressure High Pressure
Vapor Liquid

Low Temp Low Temp

Low Pressure Low Pressure
Vapor Liquid
 Diagrams
Hot line (outlet) (compressor
Electrical Wire discharge line)
Expansion Valve Housing Compressor

Drying
Assembly

Liquid Line Overload

Power Cord Cold Line (inlet) Grounding Plate
(Suction line) Protector
Many Thanks
The End….
But We Have Additional Tasks!!