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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 autoclavecycles, 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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  1. March 2013 2013 -Sterilization
  2. January & February 2013 2013 -Instruments and Maintenance
  3. May & June 2012 2012 -Research in Eye Care
  4. November & December 2012 2012 -IT Applications in Eye Care
  5. August 2012 2012 -Primary Eye Care
  6. July 2012 2012 -Refractive Error
  7. Jan & Feb 2012 - Human Resoure in Eye Care
  8. Oct 2011-SUSTAINABILITY IN EYE CARE
  9. Sep 2011-REACHING THE UNREACHED EYE CARE SERVICES
  10. Feb 2011-HEALTH INSURANCE
  11. Jan 2011-PATIENT SAFETY
  12. Oct 2010-COMMUNITY OPHTHALMOLOGY
  13. Aug 2010-DIABETIC RETINOPATHY
  14. Jul 2010-GLAUCOMA SCREENING
  15. Jun 2010-TYPES OF CATARACT
  16. May 2010-STRABISMUS
  17. Apr 2010-EYECARE FOR BABIES
  18. Mar 2010-CONGENITAL CATARACT
  19. Feb 2010-EYE CARE STATUS – WHO REGIONS
  20. Jan 2010-EYE CARE STATUS – WHO REGIONS
  21. Dec 2009-ENHANCING COMPLIANCE TO TREATMENT
  22. Nov 2009-DIABETES AND EYE
  23. Oct 2009-COST OF EYE CARE
  24. Sep 2009-GENDER and EYE HEALTH
  25. Aug 2009-Vision Rehabilitation
  26. Jul 2009-Patient Empowerment
  27. Jun 2009-Service Marketing
  28. May 2009-Medical Tourism
  29. Apr 2009-Pharmacy Management
  30. Mar 2009-Hospital accreditation
  31. Feb 2009-Hospital accreditation
  32. Jan 2009-Monitoring In Eye Care
  33. Dec 2008-Monitoring In Eye Care
  34. Nov 2008-Inpatient Management In Eye Care
  35. Oct 2008-Advocacy in Eye Care
  36. Sep 2008-Macular Degeneration
  37. Aug 2008-Amblyopia
  38. Jul 2008-Computer Vision Syndrome
  39. Jun 2008-Creating Awareness about Eye Care
  40. May 2008-Resource Utilization
  41. Apr 2008-Eye Care Barriers
  42. Mar 2008-Global Eye Care Programme
  43. Feb 2008-Standardization through Clinical Protocols
  44. Jan 2008-Materials Management in Hospitals
  45. Dec 2007-Glaucoma Management
  46. Nov 2007-Outpatient Management
  47. Oct 2007-Demand Generation
  48. Sep 2007-Trachoma
  49. Aug 2007-Eye Banking
  50. Jul 2007-Diabetic Retinopathy
  51. Jun 2007-Paediatric Eye Care Services
  52. May 2007-Managing People
  53. Apr 2007-Ophthalmic Emergencies in Eye Care
  54. Mar 2007-Eye Care Information Resource Center
  55. Feb 2007-Patient Education Resources
  56. Jan 2007-Financial Planning for Eye Hospital
  57. Dec 2006-Patient Satisfaction
  58. Nov 2006-MLOP for Effective Delivery of Eye Care
  59. Oct 2006-Low Vision & Refractive Error
  60. Sep 2006-Tele Ophthalmology
  61. Aug 2006-Medical Records in Hospitals
  62. Jul 2006-Housekeeping in Hospitals
  63. Jun 2006-Quality Assurance in Eye Care
  64. May 2006-Refractive Correction
  65. Apr 2006-Evidence for Action - Cataract Control
  66. Mar 2006-Leadership
  67. Feb 2006-Community Outreach - Cataract
  68. Jan 2006-Counselling
  69. Dec 2005-Vision Centre
  70. Nov 2005-Human Resources in Eye Care
  71. Oct 2005-Ophthalmic Equipment and Instruments
  72. Sep 2005-IEC
  73. Aug 2005-Start up eye Hospital
  74. Jul 2005-Refractive Error
  75. Jun 2005-Low Vision
  76. May 2005-Cataract
  77. Apr 2005-Paediatric Eye Care Service Delivery
  78. Mar 2005-Strategic Planning Tools
  79. Feb 2005-Frequently Asked Questions on Eye Glasses!
  80. Jan 2005-Refractive Error Service Resources
  81. Dec 2004-Highlighting Starting a New Eye Hospital Tool
  82. Nov 2004-Diabetic Retinopathy Knowledge, Attitude and Practice Study
  83. Oct 2004-Strategy worksheet for continually improving quality of services and checklist
  84. Sep 2004-Quality Cataract Series - Paramedical Contributions Module
  85. Aug 2004-Sterilization Protocol
  86. Jul 2004-Medical Records Protocol
  87. Jun 2004-Magnitude of Cataract Blindness Estimation Tool
  88. May 2004-Cataract Frequently Asked Questions
  89. Apr 2004-Introduction to SiteNews
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