Sterilisation unit

Curso REA-AICLE Mª José García García-Saavedra

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Template to design a CLIL didactic unit

Subject: HOSPITAL HYGIENE

Title of the Unit: CENTRAL STERILIZATION SERVICE DEPARTMENT (CSSD)

Course / Level: First course of Vocational Education and Training

Degree: Nursing Assistant (Health and care professional degree). Upper compulsory secondary Education

A2 L2 level Unit Plan: Lessons: 4 4 x 1 hour 50 minutes Teacher: Mª José García García-Saavedra


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1. Learning outcomes / Evaluation criteria

To know how Nursing Assistants work at the Central Sterilization Service Department in tasks related to that service within the hospital in which medical/surgical supplies and equipment, both sterile and no sterile, are cleaned, prepared, processed, stored, and issued for patient care. To identify the four major areas in the Sterile Processing Departments and their functions of decontamination, assembly and sterile processing, sterile storage, and distribution. To ensure that instruments and supplies are sterile when used, monitoring of the sterilization process through Sterilization Quality Assurance procedures To promote the multiple benefits of learning in a second language (L2) provides healthcare students to increase marketable skills To encourage healthcare students to learn through videos, texts, presentations, posters, role plays, critical thinking activities to enjoy learning content and foreign language in a very fun and cooperative atmosphere To raise awareness of culture, humanization of health process and develop soft skills with patients and relatives

2. Subject Content Central Sterilization Service Department: (CSSD) Major areas in which Sterile Processing Departments are typically divided into to accomplish the functions of decontamination, assembly and sterile processing, sterile storage, and distribution. Materials (reusable and disposal), trays and equipment at CSSD CSSD: Policies and procedures pertain to: Decontaminating, terminally sterilizing, and cleaning all reusable items;

disposing of disposable items. Packaging and labeling of items. Loading and unloading the sterilizer. Operating the sterilizer. Monitoring and maintaining records of each cycle. Adhering to safety precautions and preventive maintenance protocol. Storing of sterile items. Handling sterile items ready for use. Making sterile transfer to a sterile field.

Sterilization Quality Assurance: mechanical, chemical and biological indicators Nursing Assistant protective clothing attire and task in CSSD


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3. Language Content / Communication

Vocabulary

Nouns: Antiseptic, Asepsis, Autoclave, Bacillus Stereathermophillus, Bacillus Subtilis, Biological Indicator, Bowie-Dick Test, Chemical Indicators, Decontamination, Ethylene Oxide (EO), Glutaraldehyde, Lumen, Microorganisms, Spores, Steam, Expiration date, Packaging materials, Attire, Detergent, Washer/decontaminator, Ultrasonic washer, Tunnel washers, Carts and other transportation vehicles and containers, Instruments with cutting edges such as scissors, Chisels, Curettes, etc., Box locks, Serrations, Bacterial spore, Resistance, Protective package, Disinfectant, Vegetative forms of microorganisms, Sanitation, Expiration Dating, Pouch packaging Procedures: Aeration, Disinfection, Infection, Sterilization, decontamination, High Level Disinfection (HLD), Packing, cleaning, sorting, soaking, inspection, handling, storing, drying, controlling, delivering, transport, assembling, Administrative Monitoring, Quality Assurance Adjectives: Contaminated, Pathogenic, Disinfected, Sterile, non-sterile, Sporicidal Bactericidal, Bactereostatic, Disinfectant, Usable, Reusable, Disposable

Structures

Comparative, Imperative and descriptive expressions. Passive voice in procedures instructions Giving advises and instructions language: you may.., be careful not pricking the skin Oral presentation language: first, second, finally Conclusion explanation language Effective use of grammatical structures: present tenses and modal verbs: Pricking with, remove ....from, insert….into, choose a location around.., apply pressure to, prevent from.., to be contaminated with.., …may be contaminated with


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Structures Structures

harmful microbial life… Used supplies and equipment should be collected and taken to the Decontamination Area… Used supplies and equipment should be collected and taken to the Decontamination Area Personnel working in the decontamination area should wear protective clothing, which includes a… ….should be critically inspected for cleanliness Giving advice: Under no circumstances may you use… Giving instructions: first, second, after.. Making a joint decision with a partner Introducing to a patient or colleague in shift changes Expressing points of view and making suggestions Talking about actions a process involve: washing hands, wearing gloves, explaining to patients, processing biological waste Agreeing and disagreeing expressions Expressing with synonyms Similarities and differences between clean, disinfected and sterile Classroom management expressions: Introducing a Topic: What we are going to cover today is ... First of all, I would like to talk about ... Today, I am going to talk about … What I want to do today is ... The important point I want to make today is ...


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Structures

Making Transitions Between Ideas: Now, let's see what happens. The second point I want to make is... If that's clear, we will go on to the next point. Let's get back to the idea of... Now, let's approach the problem in a different way. I'd like to finish talking about ... before we move on ... Summarizing and Concluding In summary ... To conclude ... In conclusion ... The conclusions we can draw from this are ... What we have been talking about … Okay, we have discussed... So far (up until now), I have been trying to show you ... The important points to remember are ... Inviting Participation or Discussion Who would like to say something? Do you agree ...? Could you say a little more about that? Can you elaborate on that? What do you think ? How do you feel ? What comparison can you make between ? What is the point made by the author of this article? Clarifying Student Comments In other words ... If I understand you correctly, you mean ... What you said is ... What this means is that ... I think I understand what you mean. Let me put it another way. Would you like to elaborate on this point? This brings us to our major question ... Could you restate your point? I'm not sure I understand. Giving Examples For example ... Take ..., for example. To be more specific ...


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Structures

Let me give you an example … For instance … Grades & Test Performance Final Examination = Mid-Term = Test = Quiz =Pop Quiz = Learning Check G.P.A. = Grade Point Average I want to know what you know, not know what you don’t know. Class Rules/Regulations Please raise your hand if you have something to say. No sleeping in class. (“You snooze, you lose.”) Please put your cell-phones on silent mode. Please don’t talk when I’m talking. Let’s chat about this after class together. Did you bring enough (food) for the rest of us, too? *I’m talking at you not talking to you.

Discourse type Routines: Introduction, function, methods, steps, materials (images) and processes Basics on Processing & Sterilization The Decontamination Process The Assembly & Packaging Process Quality Assurance In the decontamination area: Reusable equipment, instruments, and supplies are cleaned and decontaminated by means of manual or mechanical cleaning processes and chemical disinfection. In the assembly and packaging area: Clean items are received from the decontamination area and are then assembled and prepared for issue, storage, or further processing (like sterilization). In the sterile storage area After assembly or sterilization, items are transferred into this area until their time for them to be issued. In the distribution area: Several major functions are carried out: cards preparation and delivery; exchange card inventory, replenishment and delivery; telephone-order and requisition-order filling…


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Language skills Listening and reading (receptive skills): Listen to videos and identify specific terminology and cognates Understand the global sense of a video, a presentation or a text Read information written on packages Interpret instructions of washers machines and autoclaves Understand and do short orders related to the work of Nursing assistant in

CSSD Writing and speaking (productive skills)

Explain the global sense of a video, a presentation or a text Make graphic organizers of Major areas in which Sterile Processing

Departments are divided and procedures realized in each one. Make suggestion about ways of working in CSSD Make mind-maps of each area in the CSSD and procedures there are

done in each area

4.Contextual (cultural) element

Find friends or relatives who work in Hospitals to talk about the different procedures with usable, reusable an disposable material before and after their stay in CSSD Express advise in a way to be understood by future patients in order to manipulate sterilized material Open minded behaviour Demonstrate and apply basic active listening skills Compare procedures, manipulation and decontamination products used in different countries Compare sterilization methods used in different hospitals in the same city Teamwork with colleagues from other shifts changing the most important information related to material and procedures

5.Cognitive (thinking) processes

Select the ideal sterilization method for each material according to its resistance to the heat Interpret in a very effective way the quality assurance outcomes Classify materials depending on its nature and functions to sterilize in the best way Solve problems, verbalize strategies and keep calm if patient gets nervous or scared with handling with sterilized material Find different answers to a question, different synonym words in explanation Order clinical procedure and material according to different criterion Design written instructions for colleagues when equipments or machines are fail


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6. (a) Task(s) WARM-TASK: Treasure Hunt: A day in the life of... a Central Sterile Services Department http://poster.4teachers.org/ Class Code238800

FINAL TASK: Simulation CSSD in the classroom Students will be able in simulated processes in the classroom: To pack, sterile, store and deliver different type of surgical materials To use the autoclave To check the containers content To prepare and identify chemical indicators To measure sterilization effectiveness with biological indicators To fill in documentation sheets information about procedures and results

6. (b) Activities 1.Treasure Hunt activity: Answer the following questions after doing warm-up task What does “sterilization” means in clinical terminology? What does “decontamination” means in clinical terminology? What does “disinfection” means in clinical terminology? Where does sterilization process take place in hospitals? What is the meaning of the acronym C.S.S.D.? What are the responsibilities of the CSSD staff? 2. Vocabulary activity: VOCABULARY WORKSHEET. Glossary learning with definitions and word cards to make them easy to learn Traffic light activity Self or pair assessment worksheets to grade themselves or in pairs Grade worksheet with assessment criteria 3. Meaningful situations activity simulation in the classroom To work in the classroom as if students were in the real work environment in the CSSD in hospitals.

http://poster.4teachers.org/


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7. Methodology

Organization and class distribution / timing

1.Treasure Hunt activity: 20minutes 2. Vocabulary activity: 60 minutes (Activities 1,2: 1 session, 1hour and 50 minutes) 3. Meaningful situations activity simulation in the classroom: - Classroom adaptation (1 hour) - Procedures development: (3 sessions of 1hour and 50 minutes)

Resources / Materials

Webpages to Treasure hunt: http://www.urmc.rochester.edu/sterile/basics.cfm http://www.infectioncontroltoday.com/articles/2011/05/infection-control-and-the-central-sterile-supply-department.aspx http://www.uhmb.nhs.uk/work-with-us/a-day-in-the-life-of/a-day-in-the-life-of-a-central-sterile-services-department/ Video to Treasure hunt: http://www.youtube.com/watch?v=GAOCDMbDvRQ Traffic light worksheets for vocabulary activity Assessment worksheets for vocabulary activity Personal Computer with internet connection and big screen in the classroom Attire, tables, autoclave, different kinds of packaging

Textiles , Nonwovens

Pouch packaging

Rigid container systems

Autoclave

http://www.urmc.rochester.edu/sterile/basics.cfm

http://www.infectioncontroltoday.com/articles/2011/05/infection-control-and-the-central-sterile-supply-department.aspx

http://www.infectioncontroltoday.com/articles/2011/05/infection-control-and-the-central-sterile-supply-department.aspx

http://www.uhmb.nhs.uk/work-with-us/a-day-in-the-life-of/a-day-in-the-life-of-a-central-sterile-services-department/

http://www.uhmb.nhs.uk/work-with-us/a-day-in-the-life-of/a-day-in-the-life-of-a-central-sterile-services-department/

http://www.youtube.com/watch?v=GAOCDMbDvRQ

http://www.urmc.rochester.edu/sterile/images/woven.jpg

http://www.urmc.rochester.edu/sterile/images/nonwow.jpg

http://www.urmc.rochester.edu/sterile/images/pouch.jpg

http://www.urmc.rochester.edu/sterile/images/aesculap.jpg


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Key Competences Ability to deal with people beyond giving and receiving instruction as a member of the health team demonstrating ethical and professional behaviour (social competence, citizenship and cultural competences are included) Learning to learn with autonomy and personal initiative taking into account when talking to qualified nurses is required Digital competence and clinical data processing

8. Evaluation (criteria and instruments)

Know and correctly use of autoclave in the classroom Explain procedure and interpret results as if students were Nurse Assistant in real meaningful situations (CSSD is simulated in the classroom) Use in a very correct way the attire to work in each zone of the simulated CSSD Package and label of different type of material Load and unload the sterilizer. Operate the sterilizer. Monitor and maintain records of each cycle. Explain and take safety precautions and preventive maintenance protocol. Store sterilized materials Handle sterile items ready for use. Make sterile transfer to a sterile field. Use correctly and interpret sterilization quality assurance devices: mechanical, chemical and biological indicators Use and process Nursing Assistant protective clothing attire and task in CSSD Use properly infinitive and imperative sentences through written and spoken activities taking into account verbs and their prepositions and familiarize with expressions like “under no circumstances may you + infinitive “ (to pre-vent from infection diseases in biological samples analytical procedures) and “I want you to


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Evaluation (criteria and instruments)

+ infinitive to explain to colleagues who begin to work in the following shift Demonstrate effective communication and social skills (their ability to cooperate in groups) and use of strategies to look for different types of information selecting scientific resources and producing mind maps Submit tasks which have been asked as preliminary and final task before dead line on VET school Moodle Know and use mathematical language to interpret quality assurance systems data and key words of this unit and previous ones Assessment Criteria: PASS/NEED TO IMPROVE PASS WITH MERIT

Information about procedures made: Detailed, accurate, relevant; key points highlighted.

Procedure development: Rigorously, technical, aseptic, easy to follow. Attire: Appropriate and well used Procedural Skills: Correct in time and way Academic Referencing: Exemplary use NEED TO IMPROVE: Information about procedures made: No-Detailed, inaccurate, irrelevant;

key points not highlighted. Procedure development: No-rigorously, technically inappropriate, no-

hygienic, difficult to follow. Attire: inappropriate or bad used Procedural Skills: incorrect in time or way Academic Referencing: Not used or commented


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EXPLAIN WHAT HAPPEN IN THESE IMAGES TAKEN IN OUR CLASSROOM SIMULATION ASSAYS


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1. TREASURE HUNT ACTIVITY

Insert Class Code 238800

Click on the ID number


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Treasure Hunt Assessment

Treasure Hunt Assessment

What does “sterilization” means in clinical terminology?

What does “decontamination” means in clinical terminology?

What does “disinfection” means in clinical terminology?

Where does sterilization process take place in hospitals?

What is the meaning of the acronym C.S.S.D.?

What are the responsibilities of the CSSD staff?

To pass with merit this activity you need a mark of more than 3 point up on 6

/6


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2. VOCABULARY ACTIVITY

WORD DEFINITION Aeration

To expose ethylene oxide gas-sterilized item to warm, circulating air to remove trace ethylene oxide (EO).

Antiseptic

A mild disinfectant used on the skin and membranes to lower the count and inhibit the growth of bacteria.

Asepsis

Absence of microorganisms that cause disease; freedom of infection; exclusion of microorganisms

Autoclave A steam-pressure vessel that sterilizes by steam under pressure at temperature above 1000 C

Bacillus Stereathermophillus

A highly heat-resistant, spore-forming microorganism used in form on commercially prepared spore strips for checking sterilization effectiveness in steam sterilizers.

Bacillus Subtilis A spore-forming microorganism used in spore form on commercially prepared spore strips for checking sterilization effectiveness in ethylene oxide sterilizers.

Bactericidal Having the characteristic of destroying bacteria Bactereostatic Inhibiting or retarding bacterial growth Biological Indicator A device intended for use by a health care provider to accompany products

being sterilized through a sterilization procedure and to monitor adequacy of sterilization

Bowie-Dick Test A test designed to challenge the vacuum pump in a high vacuum steam sterilizer Chemical Indicators A physical/chemical device employed to monitor one or more process

parameters of the sterilization cycle in order to detect failures in packaging, loading, and/or sterilizer function.

Decontamination To make safe by removing or reducing contamination by infectious organisms or other harmful substances.

Disinfectant An agent that kills all growing or vegetative forms of microorganisms, thus completely eliminating them from inanimate objects

Disinfection Process capable of destroying pathogenic microorganisms but, as ordinarily used, not bacterial spores

Ethylene Oxide (EO) Colorless, flammable gas to sterilize materials with no resistance to high temperatures

Glutaraldehyde A compound used in a aqueous solution as a disinfectant and a sterilant agent Pathogenic Producing or capable of producing disease. Sanitation Process capable of reducing the number of microbial contaminants to a

relatively safe level. It provides the lowest safety margin because it does not require or necessarily produce the complete destruction of any particular microorganisms.

Spores

Bacteria in a dormant state

Sporicidal Any agent with the ability to kill spores.


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Sterile Free of all living microorganisms. Sterilization Process capable of destroying all forms of microbial life on inanimate surfaces VOCABULARY ASSESSMENT:

WORD

DEFINITION

1 Aeration 2 Antiseptic 3 Asepsis 4 Autoclave 5 Bacillus Stereathermophillus 6 Bacillus Subtilis 7 Bactericidal 8 Bactereostatic 9 Biological Indicator

10 Bowie-Dick Test 11 Chemical Indicators 12 Decontamination 13 Disinfectant 14 Disinfection 15 Ethylene Oxide (EO) 16 Glutaraldehyde 17 Pathogenic 18 Sanitation 19 Spores 20 Sporicidal 21 Sterile 22 Sterilization

To pass with merit this activity you need a mark of more than 10 point up on 22


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VOCABULARY UNDERSTANDING PROCESS

To pass with merit this activity you need to locate in the green place more than 16 WORDS written in the squares

GREEN: I understand the meaning of these words and can explain them to my schoolmates AMBER: I understand but i cannot explain, need more time


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RED: I need help to understand the meaning of the words


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SCAFFOLDING ACTIVITIES

Central Sterile Service Department (CSSD): FUNCTIONS

Sterile Processing Departments are typically divided into four major areas to accomplish the functions of decontamination, assembly and sterile processing, sterile storage, and distribution. In the____________________________(1), reusable equipment, instruments, and supplies are cleaned and decontaminated by means of manual or mechanical cleaning processes and chemical disinfection. Clean items are received in the_________________________(2) from the decontamination area and are then assembled and prepared for issue, storage, or further processing (like sterilization). After assembly or sterilization, items are transferred to the ______________________(3) until its time for them to be issued. Several major functions are carried out in the ____________________________(4): case cart preparation and delivery; exchange cart inventory, replenishment and delivery; telephone-order and requisition-order filling; and, sometimes, patient care equipment delivery.

(1) decontamination area (2) assembly and packaging area (3) sterile storage area (4) distribution area


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3. Reconocer verbos y nombres de materiales y/o equipamiento de cada zona (andamiaje de

lenguaje)

decontamination areA

assembly and packaging area

sterile storage area

distribution area

Scrub uniform Covered Shoe covers Rubber gloves Plastic gloves Hair covering Safety goggles Face mask Cleaning Sorting Soaking Washing

Sets Trays Recipe cards Autoclave Pouch packaging Rigid container systems Steam Hydrogen Peroxide Plasma Assembling Packaging Sterilize Decontaminating

Gloves Shelf Wardrobe Inventory Management Storekeeper Storeroom Storing Processing

Case cart preparation Cars delivery Information sheet Communication Giving Delivering Documenting


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4. VOCABULARY ACTIVITY

WORD DEFINITION To expose ethylene oxide gas-sterilized item to warm, circulating air to remove

trace ethylene oxide (EO). Antiseptic

Asepsis

Absence of _________________________that cause disease; freedom of infection; exclusion of microorganisms

A steam-pressure vessel that sterilizes by steam under pressure at temperature above 1000 C

Bactericidal Bactereostatic Inhibiting or retarding _____________________ Bowie-Dick Test A test designed to challenge______________________________ Chemical Indicators A physical/chemical device employed ______________________-one or more

process parameters of ____________________in order to detect failures in packaging, loading, and/or sterilizer function.

To make safe by removing or reducing contamination by infectious organisms or other harmful substances.

Disinfectant An agent that kills ______________________________of microorganisms, thus completely eliminating them from inanimate objects

Disinfection Process capable of destroying _________________________but, as ordinarily used, not bacterial spores

Glutaraldehyde A compound used in a aqueous solution as a _________________________________ agent

Pathogenic Producing or capable of producing ____________________


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5. COMPARE STERILIZATION PROCESSES INDICATORS

Mechanical Chemical Biological Gauges Thermometers Timers Recorders Other devices that monitor their functions. Most sterilizers have automatic controls and locking devices. Some have alarm systems that are activated if the sterilizer fails to operate correctly. Records are maintained and review for each cycle.

Test packs (Bowie-Dick test) Tape, labels, and paper strips Verifies exposure to a sterilization process. An indicator should be clearly visible on the outside of every on-site sterilized package. An indicator may be placed inside a package.

Preparation of living spores resistant to the sterilizing agent. Positive assurance that sterilization conditions have been achieved can be obtained only through a biologic control test. The sterilized units and the control are incubated for 24 hours or 48 hours A biologic indicator must conform with USP testing standards.

http://www.urmc.rochester.edu/sterile/glossary.cfm#bowie


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6. NURSING ASSISTANT FUNCTIONS IN THE CENTRAL STERILIZATION SERVICE DEPARTAMENT

(CSSD)

(1) Effectively communicate, both verbally and in writing, utilizing accurate and appropriate terminology with classmates, simulated patients, and members of the healthcare team.

(2) Effectively communicate with classmates, simulated patients and simulated members of the surgical team.

(3) Access information from books, reference manuals, computers, and paper and electronic medical documents to accurately perform duties and safely use equipment.

(4) Safely access, prepare, and operate equipment and supplies in a variety of settings. (5) Assist with transport and transfer of patient and equipment. (6) Detect and respond appropriately to odors in order to maintain environmental safety and patient

needs. (7) Perform or assist with and/or transfer, lift, move, position, and manipulate the client who is

unconscious. (8) Demonstrate positive interpersonal skills during interactions with patients, staff, faculty and

health care team members. (9) Recognize potentially hazardous materials, equipment, and situations and proceed safely in

order to minimize risk of injury to patients, self, and nearby individuals. (10) Do all the task related to sterilization in the CSSD

Feel free to use this template. Thanks for attributing the source. A first sample of this template has been published at: Pérez Torres, I. 2009. "Apuntes sobre los principios y características de la metodología AICLE" en V. Pavón, J. Ávila (eds.), Aplicaciones didácticas para la enseñanza integrada de lengua y contenidos. Sevilla: Consejería de Educación de la Junta de Andalucía-Universidad de Córdoba.171-180. It is mainly based on the hands-on experience at designing units and on conversations with experts and peers. The theory of the 4Cs by Do Coyle has also been taken into account. This theory has been shown in various publications, such as: Coyle, D., Hood, P. and Marsh, D., 2010. Content and Language Integrated Learning. Cambridge University Press.


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Sterilisation unit

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