Sterilisasi & Disinfeksi

Zahid Fikri, M.Kep.

 Indikator
• Mahasiswa mampu menjelaskan Pengertian
sterilisasi dan disinfeksi
• Mahasiswa mampu menjelaskan Klasifikasi dan
penggolongan sterilisasi dan disinfeksi
• Mahasiswa mampu menjelaskan Penggunaan
sterilisasi dan disinfeksi
• Mahasiswa mampu menyebutkan syarat-syarat
tindakan aseptis
• Mahasiswa mampu menjelaskan faktor yang
mempengaruhi keberhasian sterilisasi dan
disinfeksi
 Pre Test
• Apa itu sterilisasi?
• Apa itu disinfeksi?
• Apa saja klasifikasi sterilisasi?
• Apa saja klasifikasi disinfeksi?
• Kapan saja sterilisasi digunakan?
• Kapan saja disinfeksi digunakan?
• Apa saja syarat tindakan aseptis?
• Apa saja faktor yang mempengaruhi sterilisasi?
• Apa saja faktor yang mempengaruhi disinfeksi?
 What is disinfection??
• Disinfection describes a process that
eliminates many or all pathogenic
microorganisms, except bacterial spores, on
inanimate objects (CDC, 2017).
• In health-care settings, objects usually are
disinfected by liquid chemicals or wet
pasteurization.
 What is sterilization??
• Sterilization describes a process that destroys
or eliminates all forms of microbial life and is
carried out in health-care facilities by physical
or chemical methods (CDC, 2017).
• Steam under pressure, dry heat, EtO gas,
hydrogen peroxide gas plasma, and liquid
chemicals are the principal sterilizing agents
used in health-care facilities.
 CLASSIFICATION OF METHODS
• Physical Agents
– Heat
– Radiation
– Filtration
• Chemical Agents
– In practice, certain methods are placed under
sterilization which in fact do not fulfill the
definition of sterilization such as boiling for 1/2 hr
and pasteurization which will not kill spores.
 Uses of Sterilization and Disinfection
• Disinfectants should be used only on
inanimate objects.
• Sterilization for Surgical Procedures: Gloves,
aprons, surgical instruments, syringes etc. are
to be sterilized.
• Sterilization in Microbiological works like
preparation of culture media, reagents and
equipments where a sterile condition is to be
maintained.
 What are the requirements of aseptic action?
• Aseptic technique means using practices and
procedures to prevent contamination from pathogens.
• What is aseptic technique used for?
– handling surgery equipment
– helping with a baby’s birth by vaginal delivery
– handling dialysis catheters
– performing dialysis
– inserting a chest tube
– inserting a urinary catheter
– inserting central intravenous (IV) or arterial lines
– inserting other draining devices
– performing various surgical techniques
 Aseptic technique types
• According to The Joint Commission, there are
four chief aspects of the aseptic technique:
barriers, patient equipment and preparation,
environmental controls, and contact
guidelines.
 Barriers
• Barriers protect the patient from the transfer
of pathogens from a healthcare worker, from
the environment, or from both. Some barriers
used in aseptic technique include:
– sterile gloves
– sterile gowns
– masks for the patient and healthcare provider
– sterile drapes
 Patient and Equipment Preparation
• Healthcare providers also use sterile
equipment and sterile instruments.
• To further protect the patient, they apply
cleansing and bacteria-killing preparations to
the patient’s skin before a procedure.
 Environmental controls
• Maintaining a sterile environment requires
keeping doors closed during an operation.
• Only necessary health personnel should be at
the procedure.
• The more people present, the more
opportunities for harmful bacteria to cause
contamination.
 Contact guidelines
• Once healthcare providers have on sterile
barriers, they should only touch other sterile
items.
• They should avoid touching nonsterile items at
all costs.
Factors Affecting the Efficacy of Disinfection and Sterilization

• Number and Location of Microorganisms

• Innate Resistance of Microorganisms
• Concentration and Potency of Disinfectants
• Physical and Chemical Factors
• Organic and Inorganic Matter
• Duration of Exposure
• Biofilms
 Number and Location of Microorganisms
• All other conditions remaining constant, the
larger the number of microbes, the more time
a germicide needs to destroy all of them.
• Spaulding illustrated this relation when he
employed identical test conditions and
demonstrated that it took 30 minutes to kill 10
B. atrophaeus (formerly Bacillus subtilis)
spores but 3 hours to kill 100,000 Bacillus
atrophaeus spores.
 Innate Resistance of Microorganisms
• Microorganisms vary greatly in their resistance
to chemical germicides and sterilization
processes.
• For example, spores are resistant to
disinfectants because the spore coat and
cortex act as a barrier, mycobacteria have a
waxy cell wall that prevents disinfectant entry,
and gram-negative bacteria possess an outer
membrane that acts as a barrier to the uptake
of disinfectants.
 Concentration and Potency of Disinfectants
• With other variables constant, and with one
exception (iodophors), the more concentrated
the disinfectant, the greater its efficacy and the
shorter the time necessary to achieve microbial
kill.
• This was illustrated by Spaulding who
demonstrated using the mucin-loop test that
70% isopropyl alcohol destroyed 104 M.
tuberculosis in 5 minutes, whereas a
simultaneous test with 3% phenolic required 2–3
hours to achieve the same level of microbial kill.
 Physical and Chemical Factors
• Several physical and chemical factors also
influence disinfectant procedures:
temperature, pH, relative humidity, and water
hardness.
 Organic and Inorganic Matter
• Organic matter in the form of serum, blood,
pus, or fecal or lubricant material can interfere
with the antimicrobial activity of disinfectants
in at least two ways.
 Duration of Exposure
• Items must be exposed to the germicide for
the appropriate minimum contact time.
– Multiple investigators have demonstrated the
effectiveness of low-level disinfectants against
vegetative bacteria (e.g., Listeria, E. coli,
Salmonella, VRE, MRSA), yeasts (e.g., Candida),
mycobacteria (e.g., M. tuberculosis), and viruses
(e.g., poliovirus) at exposure times of 30–60
seconds.
 Biofilms
• Microorganisms may be protected from
disinfectants by production of thick masses of
cells and extracellular materials, or biofilms.
• Biofilms are microbial communities that are
tightly attached to surfaces and cannot be
easily removed.
 Home Work
• Find or make the procedure for desinfection
and sterilization..
SEMANGAT BELAJAR

ALHAMDULILLAH