Infection Control, Disinfection and Sterilization
What the exam tests
This domain assesses standard precautions, transmission-based precautions, cleaning, disinfection, and sterilization in Kazakhstani healthcare facilities, including how to choose the correct reprocessing method and verify it.
Core rules
- Break the chain of infection: hand hygiene, PPE, safe sharps, clean environment, and separation of clean from dirty flows.
- Perform hand hygiene at WHO moments: before patient contact, before aseptic task, after body-fluid exposure risk, after patient contact, and after touching surroundings.
- Use Spaulding classification: critical items enter sterile tissue (sterilize); semicritical items touch mucous membranes (high-level disinfection or sterilization); noncritical items touch intact skin (low-level disinfection).
- Clean first. Organic material protects microbes and inactivates disinfectants; cleaning must precede disinfection and sterilization.
- Monitor sterilization by physical parameters, chemical indicators, and biological indicators; load release depends on policy and biological results.
- Store sterile packs in closed cabinets, away from moisture; check integrity, date, and indicator before use.
Worked example
A blood-soaked dressing falls on the floor. The nurse puts on gloves, removes visible blood with absorbent material, cleans the area with detergent and water, then applies the facility’s approved chlorine-based disinfectant at the specified concentration and contact time. Reasoning: visible organic matter must be removed first; alcohol alone is not a floor disinfectant and evaporates too quickly. The nurse discards waste in the correct clinical-waste stream and performs hand hygiene.
Traps
Placing a bloody instrument directly into a sterilizer; topping up disinfectant instead of preparing fresh solution; using gloves as a substitute for hand hygiene; recapping needles; and releasing an autoclave load without the required indicators. Also check exposure time and dilution-not just the product name.