Preparation of 10% basic clarified solution

bleach (10l).

Target: Use for the preparation of working solutions of various concentrations for the purpose of disinfecting rooms, utensils, toilets, patient secretions, etc.

Equipment:

Overalls - long dressing gown, hat, oilcloth apron, gloves

medical, respirator, goggles, removable shoes;

Dry bleach in standard packaging indicating the name, date of preparation, expiration date, activity by CL - (chlorine);

Containers for disinfectants (enamelled, plastic, dark glass) with appropriate markings;

Documentation: preparation log of 10% bleach solution, dry preparation control log for active chlorine;

Wooden spatula for stirring the solution;

Personal hygiene products: soap, individual towel.

Mandatory conditions:

Cooking should be carried out in a room with supply and exhaust ventilation, special equipment and equipment, in the absence of strangers.

	Rationale
Preparation for the procedure
1. Put on overalls.	Compliance with the safety of the sister in the workplace, prevention of exposure to toxic substances on the body of a nurse.
2. Prepare equipment.
3. Mark the start time of the procedure.	Compliance with the method of preparing the solution.
4. Pour a small amount of water into the container.	Prevention of spraying bleach powder.
5. Pour out 1 kg of dry bleach, stirring with a wooden spatula and kneading the lumps.	Compliance with the methodology for preparing solutions (order No. 916).
6. Top up with water up to 10 liters, mixing until smooth.
7. Close the container with a lid. Note: bleach in the light loses its bactericidal properties.
8. Make a mark on the tag about the cooking time, put your signature.	Maintaining continuity in work and ensuring personal responsibility.
9. Remove overalls.
10. Wash hands, face with soap, wipe dry.
11. Lock the room.	Compliance with the rules of labor protection when working with disinfectants. Compliance with the rules of storage of disinfectants.
12. Stir the solution several times during the day.	Ensuring complete dissolution of dry matter in water.
Completion of the procedure
1. Put on overalls.	Keeping sisters safe in the workplace.
2. After 24 hours, drain the settled solution into another container marked: 10% basic clarified bleach solution (mother), put the date of preparation, mark it in the log book, put your signature.	Compliance with the method of preparing the solution. Ensuring personal responsibility, continuity in work.
3. Remove overalls.
4. Wash your hands, wipe dry.	Compliance with personal hygiene.
5. Lock the room.	Compliance with labor protection rules. Compliance with the rules for the storage of chlorine-containing drugs.

Preparation of 1% working solution of bleach (10l)

Target: use for disinfection of premises, toilets, care items, utensils (according to orders for compliance with the sanitary and anti-epidemic regime).

Equipment:

Overalls: long gown, cap, oilcloth apron, medical gloves, removable shoes, respirator, goggles;

Containers for disinfectants with appropriate markings;

10% clarified solution of bleach (mother);

Measuring utensils with marking with a capacity of 1l and 10l (bucket);

Water, 9 liters;

Wooden spatula.

Mandatory conditions:

Stages	Rationale
Preparation for the procedure
1. Put on overalls.	Compliance with the safety of the sister in the workplace, prevention of exposure to toxic substances on the body.
2. Prepare equipment.	Ensuring clarity in work.
3. Check the marking of the mother solution, buckets for the working solution.	Personal responsibility.
Performing a procedure
1. Take a 1 liter measuring vessel, pour 10% basic clarified bleach solution (motherium) into a 1 liter container.
2. Pour into a container for a 1% working solution (bucket).
3. Top up with water up to 10l.
4. Stir the solution with a wooden spatula.
5. Close the lid, check the labeling, put the date of preparation of the solution and sign.	Personal responsibility. Ensuring continuity in work.
Completion of the procedure
1. Use for disinfection immediately after preparation. Note: the content of active chlorine decreases during long-term storage.	Compliance with orders No. 408, 916.
	Compliance with the personal hygiene of the nurse.

Preparation of a 1% solution of chloramine (1l)

Target: use for disinfection in accordance with the orders for compliance with the sanitary and anti-epidemic regime.

Equipment:

overalls;

Weighed dry powder of chloramine 10 g;

Water tanks labeled up to 1 liter;

Capacity for disinfectant solution;

Wooden spatula.

Mandatory conditions:

The solution is applied once.

Stages	Rationale
Preparation for the procedure
1. Put on overalls.	Ensuring safety in the workplace.
2. Prepare the equipment, check the markings.	Observance of clarity in work. Ensuring personal responsibility.
Performing a procedure
1. Pour a small amount of water into the container.	Powder spray warning.
2. Place a weighed portion of dry chloramine powder (10 g) into the container.	Compliance with the methodology for preparing solutions of percentage concentration.
3. Top up with water up to 10l.
4. Stir the solution with a wooden spatula.
5. Close the lid.
6. Check the marking of the container and tags.
7. Put the date of preparation of the solution, painting.	Ensuring continuity in work with disinfectants, personal responsibility.
Completion of the procedure
1. Use freshly prepared solution once.	Compliance with Order No. 408.
2. Remove overalls, wash hands, wipe dry.	Compliance with the personal hygiene of a medical worker.

Functional purpose - preventive

EQUIPMENT : oilcloth apron, rubber gloves, sealed goggles, four-layer gauze bandage or respirator, additional gown, scarf, containers for disinfection, disinfectants recommended for use, scales or measuring container, water, soap, dispenser with a disposable towel, hand cream.

SAFETY.

The preparation of concentrated disinfectants is carried out by a specially trained person - a disinfector. Preparation is carried out in a well-ventilated area using overalls, rubber gloves, hermetic goggles and a four-layer gauze bandage. Store disinfectants out of the reach of children and persons not engaged in disinfection. Containers with disinfectants should have tight-fitting lids and be labelled. Each container should have a label indicating the name, concentration, as well as the date of preparation, expiration date, painting of the person prepared this solution. The supply of disinfectants is stored in a dry, dark place, a cool room under lock and key. In case of contact with disinfectants in the eyes and on the mucous membrane, rinse with running water. After applying the solution, wash your hands with soap and grease with any cream.

RULES FOR THE PREPARATION OF DISINFECTANT SOLUTIONS.

EQUIPMENT: containers or enameled containers (glass) with tightly ground lids, measuring spoons, water, measuring cup, disinfectant recommended for use by regulatory documents.

Algorithm for preparing working solutions of disinfectants:

1. To prepare a disinfectant working solution of the required concentration, calculate the ratio of the disinfectant and water:

0.1% - 1 g (ml) disinfectant + 1000 ml water.

0.2% - 2 g (ml) disinfectant + 1000 ml water.

0.3% - 3g (ml) of disinfectant + 1000 ml of water.

0.5% - 5 g (ml) of disinfectant + 995 ml of water.

1% - 10 g (ml) disinfectant + 990 ml water

3% - 30 g (ml) disinfectant + 970 ml water

5% - 50 g (ml) disinfectant + 950 ml water

10% - 100 g (ml) disinfectant + 900 ml water

2.Pour the required amount of water into the measuring cup.

2. Pour water into the container (container) in the specified amount.

3. Pour the calculated amount of disinfectant in grams (pour in milliliters) or dip the required number of tablets into the water into the container:

4. Stir the solution.

5. Close the lid tightly.

6. Mark the container: on the tag indicate the name and percentage concentration of the disinfectant solution, the date of preparation, the expiration date, the signature of the person who prepared it.

7. Remove gloves, wash and dry hands.

8. Lubricate hands with protective cream.

Additional information about the implementation of the technique

The working solution is prepared immediately before use. The expiration date is indicated in the instructions for use of the disinfectant.

MEDICAL SERVICE No. 12

Disinfection of care items using modern disinfectants.

Functional purpose - preventive

Conditions of implementation - outpatient, inpatient, sanatorium-resort.

EQUIPMENT: honey products. appointments, patient care items, cleaning equipment, rags, dishes, linen, disinfectants, drinking water, containers, cloth napkins, watches, soap, dispenser with a disposable towel, hand cream.

Products made of metal and glass (instruments for examining the ear, nose, throat, medical thermometers, medical jars, scissors, hair clippers, metal vessels, glass urinals) are disinfected in a 2% solution of Lizaformin - 3000 for 15 minutes for tuberculosis and other bacterial infection;

In a 1.5% solution of "Lysoformin - 3000" for 15 minutes with a viral infection, including parenteral and viral hepatitis, HIV infection;

In a 1% solution of "Dezoform" for 60 minutes with a bacterial infection, including tuberculosis;

In a 3% solution of "Dezoform" for 30 minutes with a viral infection, including parenteral hepatitis and HIV infection.

Dry instruments are completely immersed in the solution (T at least 18 degrees) with the filling of channels and cavities.

Products made of glass and metals are washed sequentially in two waters "Lysoformin - 3000", in three waters ("Dezform") for 5 minutes, plastic and rubber products - in two waters ("Lysoformin - 3000"), in three waters (" Deform") for 10 minutes. The channels of the products are washed with a syringe or a water jet pump for 3-5 minutes in each container, preventing the flow of water from entering the container with the products to be washed.

Products are dried with tissue napkins and stored in a medical cabinet.

Rinsing water, used napkins and washing containers are disinfected.

For the disinfection of medical devices, the following agents are used: deoxon, dulbak, gibitan, lietol, gigasept (except for care items), deconex.

Uncontaminated linen is disinfected by soaking in a 0.5% solution of "Lizafina" for 60 minutes (for tuberculosis for 12 minutes) at a consumption rate of 5 liters per kg of dry linen.

Linen contaminated with secretions is soaked in a 1% solution of "Lizafina", including tuberculosis.

In a 2% solution for 120 minutes with viral infections, including parenteral hepatitis and HIV infection.

For disinfection of linen, it is possible to use the following agents: Ampholan, Alaminol, Clorsept, Peramin, Lidos, Purjavel according to the instructions for use.

Tableware and laboratory glassware. Fully immersed in des. solution at the rate of 2 liters per set of dishes. If there are food residues on the tableware, they are removed before disinfection.

Dishes without food residues are immersed in 0.1% solution of Lizafin for 90 minutes at bact. infections.

In 0.5% solution for 30 minutes with tuberculosis;

In 0.5% solution for 60 minutes with viral infections.

Dishes with leftover food are immersed in 0.5% solution for 180 minutes at bact. infections.

In 2% solution for 60 minutes with tuberculosis and viral infection.

At the end of disinfection, the dishes are washed for 3 minutes.

In addition to Lizafin, it is possible to use the following agents: calcium hypochlorite, hydrogen peroxide, ampholan, alaminol, gibitan.

Sanitary equipment (baths, sinks, toilet bowls) is disinfected by wiping with a rag soaked in 0.1% solution with a tank. infections, in 0.5% solution for viral infections, in 1% solution for tuberculosis of the drug "Lizafin", maintaining the disinfection time of 60 minutes.

Surfaces, furnishings, furniture are wiped with a rag soaked in 0.75% solution of "Lysoformin - Special" with a tank. infections, except for tuberculosis, in 1.5% solution for viral infections, maintaining the disinfection time - 1 hour. In 1% solution of "Lizafina" or in 3% solution of amocide - for tuberculosis, during exposure - 2 hours. The consumption rate of the drug is 150-200 ml / m 2.

Cleaning equipment and rags are disinfected by soaking in 2% solution "Lizafina" for 120 minutes.

At the end, cleaning equipment and rags are rinsed and dried.

It is possible to use funds: "Amocid", "Lysoformin - Special".

Disinfection of secretions is carried out by means of "Amocid".

The sputum of patients with tuberculosis is poured with 5% solution in the ratio of the volume of the drug to sputum 2/1 for 4 hours.

Urine is poured with 5% solution in a ratio of 1/1 for 1.5 hours (for tuberculosis for 2 hours.)

Fecal masses are poured with a 5% solution in the ratio of the drug to feces 2/1 for 5 hours (for tuberculosis for 6 hours).

Technology No. 13

Wet cleaning of LPO premises.

Functional purpose: prophylactic

Conditions of execution: outpatient, inpatient

GOAL:

1. Compliance with the sanitary and anti-epidemic regime of the department.

2. Prevention of nosocomial infections.

INDICATIONS. Daily at least 2 times a day.

CONTRAINDICATIONS. No.

EQUIPMENT: cleaning equipment, 2 rags, trays, containers with disinfectants, gloves, masks, aprons, skin antiseptic, napkins, paper towel.

Procedure algorithm

I. Room cleaning.

1. During cleaning, open the windows, ventilate the room. In winter, during cleaning, the sick should be well covered, tied with a scarf or towel, and tucked a blanket under their feet. Patients on semi-bed rest are asked to leave the room.

2. Cleaning of the wards and all other rooms is carried out in a wet way, because. dust contains a large number of microbes that cause various diseases. In the morning, wet cleaning is done after breakfast, so that by 9 o’clock the doctor’s round will be clean.

3. Re-wet cleaning is done before a quiet hour and before going to bed.

4. You need to start wet cleaning from bedside tables. They wipe the dust from them, remove unnecessary items, control the products in the bedside table (perishable ones should be stored in the refrigerator).

5. Then wipe the dust from the windowsill and other furniture.

6. During cleaning, the room should be quiet.

7. The floor must be washed from windows and walls to the door. Garbage is collected in the hallway.

8. The issue of ventilation is discussed with patients.

NOTE:

v For washing each ward, a working solution of disinfectant is prepared.

v In the Infectious Diseases Hospital, general cleaning of the wards is carried out once a week.

v The bucket and cloth marked as shown should only be used for its intended purpose.

v If there is a patient in the room who is allergic to the smell of chlorine, then the floor should be washed with a disinfectant of a different composition.

(from powders, tablets and solutions of concentrates)"

Target: prevention of HAIs.

Indications: carrying out disinfection.

Contraindications: individual intolerance to the disinfectant.

Equipment: overalls (robe, cap); personal protective equipment (mask (respirator), gloves, goggles), depending on the instructions for preparing the drug solution; disinfectant (powder or tablets or concentrate solution); instructions (guidelines) for the drug, measuring containers, labeled container for disinfectant solution, tap water.

Manipulation algorithm:

Stages	Rationale
1. Preparation for the procedure
1.1. Read the instructions for preparing the disinfectant solution (if necessary, calculate the amount of disinfectant and water).	Ensuring the accuracy of the concentration of the solution and compliance with safety regulations.
1.2. Wear overalls and protective equipment.
1.3. Prepare a labeled container (a container with a lid), a disinfectant and, if necessary, measuring containers.
2. Performing a procedure
2.1. Measure the required amount of disinfectant using a measuring container or count the required number of tablets.	Ensuring the accuracy of the concentration of the solution.
2.2. Pour some of the required amount of water into the container.
2.3. Place the disinfectant in a container.
2.4. Stir the solution using a perforated tray.
2.5. Add water to the mark of the required volume in the container, using the graduations printed on the wall of the pan.
2.6. Stir the solution using a perforated tray.
2.7. Close the container with a lid.	Compliance with the requirements for the conditions of storage and use of disinfectant solution.
2.8. Fill out the tag.
3. End of procedure
3.1. Remove personal protective equipment.	Compliance with safety precautions when working with disinfectants.
3.2. Wash and dry hands.
Note: when preparing disinfectants in glass or enameled containers without graduation, add water using measuring containers for water or prepare a solution in a liter jar and pour it into a container; a glass rod is used to stir the solutions.

Manipulation #7

"Preparation of solutions of chloramine and bleach"

Preparation of solutions of chloramine.

Chloramine is a white crystalline powder containing 25-29% active chlorine. Release form: packages of 100, 200, 300 grams. Chloramine is prepared by mixing the powder with tap water. The shelf life of the unused solution is not more than 15 days. The solution is used for disinfection once. Methods of disinfection: wiping (one or two times), immersion (soaking), irrigation (one or two times).

Note:

exposure exposure for disinfection of instruments - 60 minutes, the rest - according to the instructions;

for the preparation of activated solutions of chloramine, a solution of ammonia is used.

This is the destruction of vegetative forms of pathogenic and non-pathogenic microorganisms on various objects of equipment, inventory, utensils, in indoor air, on the hands of personnel.

EQUIPMENT: oilcloth apron, rubber gloves, sealed goggles, four-layer gauze bandage or respirator, additional dressing gown, scarf, containers for disinfection, dry bleach or chloramine, scales or measuring container, water, soap, towel, hand cream.

SAFETY

The preparation of disinfectants is carried out by a specially trained person - a disinfector. Preparation is carried out in a well-ventilated area using overalls, rubber gloves, hermetic goggles and a four-layer gauze bandage. Store disinfectants in places inaccessible to children and persons not engaged in disinfection. Containers with disinfectants should have tight-fitting lids and be labelled. Each container should have a label indicating the name, concentration, as well as the date of preparation, expiration date, painting of the person prepared this solution. The supply of disinfectants is stored in a dry, dark place, a cool room under lock and key. In case of contact with disinfectants in the eyes and on the mucous membrane, rinse with running water. After applying the solution, wash your hands with soap and grease with any cream.

RULES FOR THE PREPARATION OF DISINFECTANT CHLORINE-CONTAINING SOLUTIONS

EQUIPMENT: containers or enameled containers (glass) with tightly ground lids, wooden sticks, measuring spoons, water, measuring cup, disinfectant

SUBSEQUENCE preparation of a working disinfectant:

1. Pour the required amount of water into the measuring cup.

2. Pour 1/3 of water into the container (container) up to the specified amount.

3. Pour (pour) the required amount of disinfectant.

4. Stir the solution.

5. Add the rest of the water and mix the solution again. Close the lid tightly.

6. Mark the container, indicate on the tag: date of preparation, expiration date, name of the disinfectant, its%, signature of the person who prepared it.

1. Prepare the mother solution of bleach: dilute 1 kg of dry bleach in 9 liters of cold water (bucket), (grind bleach with a wooden spatula). Mark the dishes.

2. The mixture is settled for a day, stirred 2-3 times.

3. Pour the resulting solution into a dark bottle, closed with a stopper (this is a 10% clarified solution of bleach, which can be stored for 5-7 days in a dark place). The dishes are labeled accordingly.

4.If necessary, prepare a working solution of bleach of the desired concentration:

0.1% - 100 ml 10% bleach solution per 9.9 l H 2 O

0.2% - 200 ml 10% bleach solution per 9.8 l H 2 O

0.5% - 500 ml 10% bleach solution per 9.5 l H 2 O

1% - 1 liter of 10% bleach solution per 9.0 liters of H 2 O

2% - 2 l 10% bleach solution per 8 l H 2 O

Chloramine solutions:

The working solution is prepared immediately before use:

1% - 10 g chloramine + 990 ml water

3% - 30 g chloramine + 970 ml water

5% - 50 g chloramine + 950 ml water

0.5% - 5 g of chloramine + 995 ml of water.

Record the operation performed. Implement infection control measures.