Choosing a Sterilization Wrap for Surgical Packs By William A. Rutala PhD, MPH and David J. Weber, MD, MPH
AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infections Control
Practices Advisory Committee. Guideline for prevention of surgical site
infection, 1999. Infect Control Hosp Epidemiol. 1999;20:247-278.
M. Breakthrough still needed for sterilization wraps. Infect Control Today.
PG, Mackel DC, Mallison GF. Microbial penetration of muslin- and paper-wrapped
sterile packs stored on open shelves and in closed cabinets. Appl Microbiol.
D. Sterile shelf life and expiration dating. J Hosp Supply.
NA, Greene VW, Langholz AC, Hunstiger C. Effect of long-term storage on sterile
status of devices in surgical packs. Infect Control. 1987;8:289-293.
AF, Houston A, Bollinger E, Wenzel RP. A new standard for sterility testing for
autoclaved surgical trays. J Hosp Infect. 1992;21:253-260.
WA, Weber DJ. Use of gowns and drapes (single use and reusable) in healthcare:
Review and meta-analysis. Submitted for publication.
of Operating Room Nurses. Recommended practices: Selection and use of packaging
systems. AORN J. 1992;56:1096-1100.
Training New Employees By Julie Stoller, CRCST
Central Service Management Manual. IAHCSM.
Supervision Principles: Leadership Strategies for Healthcare Facilities.
Double the Protection? By Carolyn Twomey, RN, BSN
1. Hancock A, Wilson T. Impact of changes to OSHAs bloodborne pathogens directive outlined by attorney. OSHA Guide for Health Care Facilities. January 2000;6(6).
2. Blood safety survey shows room for improvement. OR Manager. 15;(11):9-11.
3. Kim LE, et.al. Compliance with Universal Precautions among emergency department personnel; implications for prevention programs. AJIC. October 1999;27(5).
4. OSHA seeks plan to curb needle sticks. The American College of Orthopaedic Surgeons Bulletin. October 1998;46(5).
5. Korniewicz DM. Barrier protection of latex. Immunol Allergy Clin North Am. February 1995;15(1).
6. Church J, Sanderson P. Surgical glove puncture. J Hosp Infect. 1980;1(84).
7. Cole R, Gault DT. Glove perforation during plastic surgery. Br J Plast Surg. 1989;42:481-483.
8. Giercksky KE. Non-antibiotic perioperative infection prophylaxis. Infection in Surgery: International Congress and Symposium Series 234. March 1998.
9. Koch F. Whats new in personal protective devices. Infect Control Today. July 1999:22-28.
10. Dodds RD, Gay PJ, Peacock AM, et. al. Surgical glove perforation. Br J Surg. 1988;75:966-968.
11. Dodds RD, Barker SG, Morgan NH, et.al. Self protection in surgery: the use of double gloves. Br J Surg. 1990;77:219-220.
12. Main-Bertolin S, Gonzalez-Martinez R, et. al. Does double gloving protect surgical staff from skin contamination during plastic surgery? Plast Reconstr Surg. April 1997;99(40):956-960.
13. Munksgaard EC. Permeability of protective gloves to (di)methacrylates in resinous dental materials. Scand J Dent Res. 1992;100:189-192.
14. Preventing disease in the operating room. Panel discussion, American College of Surgeons Spring Meeting. April 29, 1998.
15. AORN. Recommended practices for maintaining a sterile field. Standards, Recommended Practices and Guidelines. Association of peri-Operative Registered Nurses, 1999.
16. Quebbeman EJ, Telford GL, et. al. Double gloving. Protecting surgeons from blood contamination in the operating room. Arch Surg. 1992;127(2):213-216.
17. Albin A, et. al. Anatomy of a defective barrier: sequential glove leak detection in a surgical and dental environment. Crit Care Med. 1992;20:170-183.
18. Chapman S, Duff P. Frequency of glove perforations and subsequent blood contact in association with selected obstetric surgical procedures. Am J Obstet Gynecol. May 1993;168(5):1354-1357.
19. Tokars JI, Culver DH, et. al. Skin and mucous membrane contacts with blood during surgical procedures: risk and prevention. Infect Control Hosp Epidemiol. December 1995;16(112):703-711.
20. Greco RJ, Garza JR. Use of double gloves to protect the surgeon from blood contact during aesthetic procedures. Aesthetic Plast Surg. May-June 1995;19(3):265-267.
21. Hollaus PH, Lax F, Janakiev D, Wurnig PN, Pridun NS. Glove perforation rate in open lung surgery. Eur J Cardiothoracic Surg. April 1999;15(4):461-464.
22. Internal study conducted by SSL International, plc Research and Development Division, Cambridge, UK. September 1999.
23. Novak CB, Patterson JMM, Mackinnon SE. Evaluation of hand sensibility with single and double latex gloves. Plast Reconstr Surg. January 1999;103:128-131.
24. Webb JM, Pentlow BD. Double gloving and surgical technique. Ann Royal Coll Surg. July 1993;75(4):291-292.
25. Jackson EM, Neal JG, et. al.. Biochemical performance of orthopaedic gloves. J Biochem Material. 1999;48(2):193-198.
26. Beck WC. Barrier breach of surgical gloves. J Long Term Effects Med Implants. 1994;4(2-3):127-132.
27. Rabussay DP, Korniewicz DM. Improving glove barrier effectiveness. AORN J. December 1997;66(6):1043-1046, 1049-1054, 1057-1060.
28. Duron JJ, Keilani K, Wilan NG. Efficacy of double gloving with a coloured inner pair for immediate detection of operative glove perforations. Eur J Surg.1996;162:941-944.
29. Nicoali P, Aldam CH, Allen PW. Increased awareness of glove perforation in major joint replacement. J Bone Joint Surg.1997;79-B:371-373.
30. Avery CME, Taylor J, Johnson PA. Double gloving and a system for identifying glove perforations in maxillofacial trauma surgery. Br J Oral Maxillofac Surg. 1999;37:316-319.
Handwashing Problems and
Solutions: Part II By David Dyer
States Center for Disease Control. 1999.
Preventing Emerging Infectious Diseases:
A strategy for the 21st Century.
States Center for Disease Control. 1994.
Addressing emerging infectious disease threats:
A prevention strategy for the United States.
AC, Mallison GF. Handwashing practices for the prevention of nosocomial
infections. Ann Intern Med. 1975;83(5):683-90.
Favero MS. Guidelines for handwashing and hospital environmental control, 1985. Infection
BS, Medley GF, Scott GM. Preliminary analysis of the transmission dynamics of
nosocomial infections: stochastic and management effects. J Hosp Infect.
EL. Skin hygiene and infection prevention:
more of the same, or different approaches? Clin Infect Dis.
Handwashing tames E. coli outbreak. Family Practitioner.
Interruption of shigellosis by hand washing. Trans R Soc Trop Med Hyg.
Reducing hospital respiratory infections. Nurs Times. 1991;87(29):36
Dickson H, O'Callaghan C, Sheaves R, Winter A, Moxon ER. Handwashing and
cohorting in prevention of hospital acquired infections with respiratory
syncytial virus. Arch Dis Child. 1991;66(2):227-31.
and 1992, 1993, and 1994 APIC Guidelines committee. APIC Guidelines for
handwashing and hand antisepsis in healthcare settings. AJIC.
final monograph for healthcare antiseptic drug products; proposed rule.
Federal Register. 1994;59:31402-31542.
Jones RD. Bacterial resistance and topical antimicrobial wash
products. AJIC. 1999;27(4):351-63.
Roujeinikova A, Levy CW, Rowsell S, Sedelnikova S, Baker PJ,
Minshull CA, Mistry A, Colls JG, Camble R, Stuitje AR, Slabas AR, Rafferty JB,
Pauptit RA, Viner R, Rice DW. Crystallographic analysis of triclosan bound to
enoyl reductase. J Mol Biol. 1999;294(2):527-35.
Roujeinikova A, Sedelnikova S, de Boer GJ, Stuitje AR, Slabas AR,
Rafferty JB, Rice DW. Inhibitor binding studies on enoyl reductase reveal conformational
changes related to substrate recognition. J Biol
Levy CW, Roujeinikova A, Sedelnikova S, Baker PJ, Stuitje AR,
Slabas AR, Rice DW, Rafferty JB. Molecular basis of triclosan activity. Nature.
Chodosh D. 1998. United States Patent 5661107.
Gerenraich KB, Wadhams PS. Testing a new alcohol-free hand sanitizer to combat
infection. AORN J.
Sheet. Antimicrobial Hand Sanitizers Position in Continuum Model Challenged.
July 27, 1998.
DS, Fendler EJ, Dolan MJ, Williams MS. A close look at alcohol gel as an
antimicrobial sanitizing agent. AJIC. 1999;27: 332-338.
test method for evaluation of health care professional handwash formulation.
Method E 1174-94. 1994. American Society for Testing and Materials.
DS. Comparative evaluation of five surgical hand scrub preparations.
AORN J. 1994;246-256.
Widmer AF. No time for handwashing!? Handwashing versus alcoholic rub: can we
afford 100% compliance? Infect Control Hosp Epidemiol. 1997;18(3):205-8.
A, Rupley K, Wadhams P. Effectiveness of an alcohol free instant hand sanitizer.
J Am Pod Med Assoc. Submitted 2000.
ML, James-Davis LA, Milanesi L. A field study evaluating the effectiveness of
different hand soaps and sanitizers. Dairy, Food Env Sanitation.
Yao GA. Shedding of bacteria and skin squames after handwashing. J Hygiene (Camb).
RR, Noble WC. Dispersal of bacteria on desquamated skin. Lancet.
EL, McGinley KJ, et. al. 1986. Physiologic
and microbiologic changes in skin related to frequent handwashing. Infect
Norton-Hughes CA, Pyrek JD, Sparks SM, Cagatay EU, Bartkus JM.
Changes in bacterial flora associated with skin damage on hands of
healthcare personnel. AJIC. 1998;26:513-521.
EL. Persistent carriage of gram-negative bacteria on hands. AJIC.
EL. Effects of handwashing frequency, agent used and clinical unit on bacterial
colonization of the hands. AJIC. 1984;12:76-82.
Pitcher DG. Microbial ecology of the human skin. Advances in Microbiol Ecol.
K, Nakagama S, Seki T, Hosoya K. Mechanism of skin penetration-enhancing effect
by laurocapram. Pharm Sci. 1992;81(1):58-64.
KA. Percutaneous absorption and transdermal therapy. Pharm Tech.
Percutaneous absorption enhancers. Durg Cosmet Ind. 1985;137:30.
Percutaneous absorption. J Pharm Sci. 1972;64:901-924.
Banga AK. Methods of enhancement of transdermal drug delivery Part II B:
Chemical permeation enhancers. Pharm Tech. 1993;17:68-76.
T.K. and Banga, A.K. 1993.
Methods of enhancement of transdermal drug delivery Part II A:
Chemical permeation enhancers. Pharm
Chemical methods of enhancing transdermal drug delivery. Pharm Tech.
C, Wang C, Hazy J. An observational study of handwashing and infection control
practices by healthcare workers. Infect Control Hosp Epidemiol.
J. Teaching hospital medical staff to handwash. Med J Aust.
IR, Rees BI. Handwashing: simple but effective. Ann J R Coll Surg Engl.
EL, Talbot GH. An approach for selection of healthcare personnel handwashing
agents. Infect Control. 1986;7: 419-424.
S, Sattar S. Handwashing: what can we learn from research? Infect Control
1990. United States Patent 4967935.
Foslein M.1999. United States Patent 5897031.
T. 1999. United States Patent 5960991.
KB. 1999. Personal communication. Woodward Laboratories, Inc.
EL, Bryan JL, Adler LM, Blane C. A multifaceted approach to changing handwashing
behavior. AJIC. 1997;25:3-10.
Burdorf A, Coenrads PJ. Prevalence of hand dermatitis in different occupations. Int
Arch Occup Environ Health. 1994;64:541-544.
EL, Friedman C, Cohran J, trestan-Aurand J, Green S. Prevalence and correlates
of skin damage on the hands of nurses. Heart Lung. 1997;26:404-412.
Mahmoud GS, Sudami OH. An outbreak of hand dermatitis among workers using sodium
lauryl sulfate for skin cleaning. Contact Dermatitis. 1996;34:366-367.
Y, Kwan D, Sakamoto K, Maibach HI. Electron resonance for skin cleansing. Dermatology.
DW, Agner T. Effect of glove occlusion on human skin I: short term experimental
exposure. Contact Dermatitis. 1996;34:1-5.
DW, Agner T. Effect of glove occlusion on human skin II:
long term experimental exposure. Contact Dermatitis.
Urea-containing moisturizers influence barrier properties of normal skin.
Arch Deratol Res. 1996;288:103-107.
333 and 369: Topical antimicrobial
drug products for over the counter human use; tentative final monograph for
first aid antiseptic drug products; proposed rule: Federal Register 56(140), July 22, 1991:
IL. Is the use of benzalkonium chloride as a preservative for nasal formulations
a safety concern? A cautionary note
based on compromised mucociliary transport. J Allergy Clin Imunol.
Wolf W, Matteus A, Neise H. Use of XXT assay to assess the cytotoxicity of
different surfactants and metal salts in human keratinocytes. A feasible method
for in vitro testing of kin irritants. Acta Derm Venereol.
Effectiveness of an alcohol-free instant hand sanitizer at reducing illness
absenteeism. J Nurse Pract. Publication pending.
ST, Cydulka RK, Emerman GL. Is handwashing teachable?: failure to improve
handwashing behavior in an urban emergency department. Acad Emerg Med.
JA, Dubbert PM, Miller M, Burkett PA, Chapman SW. Increasing handwashing in an
intensive care unit. Infection Control. 1986;7(5):259-262.
Hill S, Ross J, Lertzman J, Louie TJ. Handwashing practices in an intensive care
unite: the effect of an educational program and its relationship to handwashing.
PM, Dolce J, Richter W, Miller M, Chapman SW. Increasing ICU staff handwashing:
effects of education and group feedback. Infect Control Hosp. Epidemiol.
L.S. Handwashing education can decrease illness absenteeism. J Sch Nursing.
McGuckin-Guinan M, Sevareid A. Who washes their hands after using the bathroom? AJIC.
M, Waterman R, Porten L, Bello S, Caruso M, Juzartis B, Krug E, Mayer S,
Ostrawski S. Patient education model for increasing handwashing compliance. AJIC.
ZA, McGuckin M, Blais FX. Duration of handwashing in intensive care units: a
descriptive study. AJIC. 1984;12(2):83-87.
communication. (Ton D).
Water Quality and
Reprocessing Instruments By Herber Kaiser, PhD; Gerald E. McDonnell, PhD;
Jason F. Tirey, MA; and Daniel Klein, BS
Doyle JE, Ernst RE. Resistance of B. subtilis var. niger spores occluded
in water-insoluble crystals to three sterilization agents. Appl Microbiol.
Mullican CC, Hoffman RK. Dry heat or gaseous chemical resistance of Bacillus
subtilis var. niger spores included within water-soluble crystals. Appl
Muller HE. The effect of different water-insoluble anorganic salts on the
resistance and storage time of B. stearothermophilus Spores used for biological
indicators. Zentralblatt fur Hygiene and Umweltmedizin. 1994;196:360-366.
Hazardous Materials Emergencies in
Surgery By Jack Donaldson, RN, CNOR, CSPDM
F. Notes On Nursing: What It Is, And What It Is Not, (Commemorative Edition).
Philadelphia: J.B. Lippincott Company; 1859.
H, Siegelson H. Hazardous materials: disaster medical planning and response. Emerg
Med Clin North Am. 1996;14(2):327-348
Institute for Occupational Safety and Health, (1998) Guidelines for Protecting
the Safety and health of Health Care Workers, "Chemicals Encountered in
Selected Hospital Occupations, (Appendix 4)" Online Article, http://www.cdc.gov/niosh/hcwapp4.html
and Guidelines for Protecting the Safety and health of Health Care Workers,
"Occupational Hazards by Location in the Hospital (Appendix 3),"
Online Article, http://www.cdc.gov/niosh/hcwapp3.html.
P. Complying with the hazard communication standard. J Am Veterinary Med
Decontamination and management of hazardous materials exposure victims in the
emergency department. Ann Em Med. 1994;23(4):761-770.
for Toxic Substances and Disease Registry ATSDR (undated). Managing Hazardous
Materials Incidents Volume II: Hospital Emergency Departments: A planning Guide
for the Management of Contaminated Patients. US Department of Health and
Human Services. Managing Hazardous Materials Incidents Volume III: Medical
Management Guidelines for Acute Chemical Exposures. US Department of Health
and Human Services.
Emergency department planning for hazardous materials victims: getting started. J
Em Nurs. 1994;20(1):41-44.
J. Mad Cow Disease: An overview of the nursing concerns regarding the Spongiform
Encephalopathies. 1998. Online Article http://www.nurseceu.com/cpu2.htm.
Surgical Site Infections By
Vickie VanDeventer, RN, BSN, CIC
HICPAC, Centers for Disease Control & Prevention. Guideline for prevention of surgical site infection, 1999. AJIC 1999;27:97-134.
- Kluytmans J. Surgical infections including burns. In: Wenzel R, ed. Prevention and Control of Nosocomial Infections. 3rd ed. Baltimore: Williams & Wilkins; 1998:841-865.