Minnesota Association For Aesthetic Safety

This association has chosen Infection Control Standards based on the Standard Precautions for infection control as recommended by the CDC, the Center for disease Control. Standard Precautions utilize Universal Precautions for bloodborne pathogens, which have been designed to reduce risk of transmission of pathogens from blood and body fluids, secretions and excretions, non intact skin and mucous membranes. Also, they were designed to reduce the risk of transmission of recognized and unrecognized sources of infection.

The Standards have been developed for use by all personnel in the med-spa setting, considering the potential that all patients/clients may be infectious. Adhering to Infection Control precautions minimizes the risk of exposure to blood and/or body fluids of all clientele. This will also reduce the risk of transmission of infection and disease from client to client, practitioner to client and client to practitioner.

Voluntary compliance with these standards in the absence of state regulations is a reasonable goal and will assist med-spa personnel in the appropriate development of an Infection Control Protocol and hazard reduction in the work setting. The Minnesota Association for Aesthetic Safety would like to promote awareness for these guidelines.

With the development of training and licensing programs, which serve to elevate professional standards of excellence in delivery of care, both practitioner and public are served.. Voluntary compliance with the proposed standards as well as a developed knowledge base on infection control is both reasonable and necessary as we look forward to regulation of service and providers.

NEED FOR STANDARDS OF INFECTION CONTROL FOR MED-SPA INDUSTRY

 The Minnesota Association for Aesthetic Safety will assist in promoting Infection Control Standards: 

*As a base of client safety and practical aseptic awareness necessary to minimize the transmission of microorganisms.

*Demonstration of expert skills in sanitation and sterilization techniques as well as management of hazardous waste and disposal.

*Sound and professional judgement and decisions for high quality of patient/client care are fostered by standards of care, and by participation in continuing education

OVERVIEW OF STANDARDS

The med-spa industry should be viewed as an environment where clinically control measures need to be in place for Standard Precautions.

1. Hand Hygiene and Use of Gloves: Hand hygiene is considered one of the most important procedures for preventing the transmission of infection. Hands are cleansed by washing with plain liquid soap and water or degermed by hand antisepsis with alcohol based hand rub, only if hands are not visibly soiled. This is completed before and after treatment of each client. Before gloving and immediately after gloves are removed.
2. Hands are washed thoroughly with soap and water when visibly soiled and immediately if bare handed contact with blood or bodily fluids or secretions or contaminated equipment occurs.
3. Handwashing techniques with soap and water includes wetting hands with water and liquid soap per manufacturers recommendations; vigorously rubbing hands together for 30 seconds, covering all hand surfaces, between fingers and fingernail areas. Rinse hands thoroughly under running water; drying hands thoroughly with a clean disposable towel; turn faucets off with paper towel and dispose of towel in appropriate covered receptacle in treatment room.
4. Hand antisepsis achieved by using alcohol based antiseptic hand rubs includes applying the product label recommended amount of gel to the palm of one hand; vigorously rubbing hands together, covering all surfaces, especially between fingers and continue rubbing hands for 30 seconds or until gel dries.

USE OF GLOVES

1. Gloves are worn during hand contaminating activities. A fresh pair of non sterile medical grade latex, nitrile or vinyl disposable examination gloves are worn during the treatment of each client or when contact or other potentially infectious materials, mucous membranes and non intact skin could occur. Exam or utility gloves are worn during the procedures of cleaning, rinsing, drying and packaging of contaminated instruments.
2. Decontaminate hands in accordance with Hand Hygiene standards before putting on gloves and immediately after removal.
3. If treatment is interrupted: use a protective, disposable barrier or remove and discard gloves and decontaminate hands, surfaces touched.
4. Decontaminate hands before re-gloving with a fresh pair of gloves before resuming care.
5. Torn or perforated gloves are removed immediately; hands are decontaminated  then re-gloved with fresh gloves.
6. After each treatment, gloves are removed and disposed of in the appropriate receptacle located in the treatment room and hands are immediately decontaminated.

CONTROL MEASURES FOR HAND HYGIENE

Hand transfer can be a significant mode of transmission of bacteria and viruses from person to person, from person to surface or vice-versa. Hand-washing uses plain or non anti-microbial soap This will accomplish a physical removal of soil and microorganisms by mechanical action. Hand antisepsis uses anti-microbial soap or alcohol based hand rubs, containing ingredients with activity against skin surface microorganisms. This results in the reduction of microbial flora on the hands.

The cleansing activity of plain soap can be attributed to the detergent properties, resulting in the removal of surface contaminants from the skin. Hand-washing with plain soap can remove loosely adherent flora. Follow the manufacturers‘ recommendations regarding the volume of product to use. Wash hands with warm water, not hot as repeated exposure to hot water increases the risk of dermatitis. Residual moisture on hands after hand-washing has been found to play an important role in the transfer of bacteria and viruses .Hand-washing products can become contaminated and support the growth of micro-organisms so adding soap to a partially empty soap dispenser can lead to bacterial contamination of soap, therefore liquid products are to be stored in closed containers and dispensed from disposable washed, dried and clean containers. 

 According to the CDC Guidelines for Hand Hygiene in the Health Care Settings, alcohol based products are more effective for standard hand hygiene by Health care workers than soaps. The anti-microbial activityof alcohol rinses or gels can be attributed to their abilityto denature proteins. Alcohol solutions containing 60 to 90% alcohol are most effective, and higher concentrations are less potent. The ideal volume of product to apply to their hands is not known and may vary for different formulations. However, if hands feel dry after rubbing hands together for 10-15 seconds, it means an insufficient volume of product likely was applied. Follow the manufacturers recommendations regarding the volume of product to use. Alcohols are not appropriate for use when hands are visibly dirty or contaminated with blood or bodily fluids or visible blood products.

After 5-10 uses of alcohol based products, handwshing with soap and water is needed to remove a build-up of emollients. Since alcohols are flammable, it is important to rub hands together after application of alcohol based products until all of the alcohol has evaporated. Use containers which will minimize evaporation.

 When selecting products for hand hygiene, information gathered regarding any known interactions between products used to clean hands and the type of gloves used. 

CONTROL MEASURES FOR USE OF GLOVES

 The CDC has recommended that Health care workers wear gloves to reduce the risk of personnel acquiring infection from patients; to prevent health care worker flora from being transmitted to patients; and to reduce transient contamination of the hands of personnel by flora that can be contaminated from one patient to another. The Occupational Safety and Health Administration (OSHA) mandate that gloves be worn during all patient care activities that may involve exposure to blood or body fluids.

 Gloves are worn in addition to and not as a substitute for hand hygiene practices. When gloves are worn, hand hygiene practices are also recommended because gloves  will decrease the risk of potential exposure.

 OSHA prohibits washing or decontaminating disposable or single use exam gloves for re-use. In addition, the use of hand creams or petroleum based lotions will adversely affect the longevity of latex gloves. The consistant wearing of gloves will decrease the risk of potential exposure to the microbial flora of the provider, including blood borne organisms should there be cuts, or scrapes or micro lesions on the hands. Torn or perforated gloves should be removed immediately and hands washed after removal because pathogens can gain access to the provider’s hands via small defects in gloves or by contaminants of the hands during glove removal.

 Determine if there are any sensitivities or allergies before wearing latex gloves. Several factors have been linked to latex sensitization, including the presence of of allergic conditions( asthma allergies) and frequency of and duration of use/exposure. The FDA has approved several powdered and powder free latex gloves with reduced protein content, as well as synthetic gloves that cn be made available for use by sensitive individuals.

STANDARDS FOR CLEANING AND STERILIIZATION –OTHER SAFETY PRECAUTIONS

Coordinate necessary sterilized instruments and needed supplies for each treatment room in a manner adhering to aseptic technique. Wear gloves when handling soiled instuments.

NEEDLES are single use and disposable; stored in a manner that will maintain sterility; not recapped, bent or manipulated to avoid accidental puncture injury. Place in a puncture resistant sharps container immediately after use or when contaminated.

INSTRUMENTS used are accumulated in a covered holding container by submersion in a protein dissolving detergent and water, following manufacturers dilution recommedations. Instruments are placed in an ultrasonic solution and run for recommended time. Then rinsed, air dried on a clean disposable cloth. Items are packaged individually in wraps, paper or film pouches for sterilization. Packaged items are placed into an autoclave or dry heat sterilizer with chemical indicator and run to manufacturers instructions.

 After processing instruments are stored in a clean, dry, covered container drawer or closed cabinet.

STERILIZATION Methods of sterilization include dry heat either 340 degrees F (170degreesC) for one hour or 320degrees (160degrees C( for two hours)

Autoclave (steam under pressure) The following time temperature pressure relationship is recommended 15-20 minutes at 121degrees C (250degrees F) and 15 psi for packaged instruments and items. Follow the sterilizer manufacturer’s instructions for the unit you have.

 USE OF STERILIZERS The temperature and exposure time for using dry heat sterilizers and autoclaves relates only to the time of exposure after attainment of the specific temperature and does not include a penetration or heat up lag time. Exposure time does not include drying and cool down time. Sterilizers should have visible thermometers. Load, operate and maintain according according to manufacturees recommendations. Use those regulated by industry/  Indicators should be used. Biological monitors should be used no less than once per month.

Packaging materials for sterilization. Choose size, shape and number of instruments to be sterilized. Follow manufacturers recommendations for spacing of packaged items.