Glossary
A
Antimicrobialagents: Substances or processes that inhibit the growth or tend to destroy or inhibit the pathogenic action of microorganisms including bacteria, viruses and fungi
Autoclave: Common term for small steam steriliser
B
Biofilm: A layer of material on the surface of an instrument or device which contains biological material and in which microorganisms may be embedded
Biological indicator: A carrier on which a defined number of test microorganisms have been deposited, contained within its primary pack and ready for use, that provides a defined resistance to the specified sterilisation process (colloquially known as a ‘spore test’)
Body substance: Replaces former term ‘body fluids’
C
Chemical indicator: A system that reveals a change in one or more predefined process variables based on a chemical or physical change resulting from exposure to a process
Cleaning: The process of removing all visible dust, soils and other material from a surface. Manual cleaning is usually performed by using detergents and a physical action such as rubbing or brushing. Meticulous cleaning of instruments and other reusable equipment is required before disinfection or sterilisation
Contamination: The introduction of microorganisms or foreign matter (or both) to sterile or nonsterile materials or living tissue
D
Decontamination: The removal of microorganisms and foreign matter from materials or living tissue
Disinfectants, levels of: Disinfectants are classed as low, intermediate or high level:1
Low-level disinfectants are defined as those that rapidly kills most vegetative bacteria as well as medium-sized lipid-containing viruses when used according to the manufacturer’s instructions. It cannot be relied upon to kill bacterial endospores, mycobacteria, fungi or all small nonlipid viruses.
Intermediate-level disinfectants kill all microbial pathogens except bacterial endospores, when used as recommended by the manufacturer. They kill bacteria (including Mycobacterium tuberculosis), fungi (not necessarily effective against some spores) and viruses, when used according to the manufacturer’s instructions.
High-level disinfectants are defined as those that kills all microbial pathogens except large numbers of bacterial endospores, when used according to the manufacturer’s instructions. These are not used for general cleaning. General practices and other office-based healthcare practices generally do not use high-level disinfectants.
Disinfection: Any process that kills, inhibits or reduces disease-causing organisms such as viruses, bacteria or protozoa. It may not destroy spores. Disinfection is not the same as sterilisation.
E
Enzymatic indicators: Tablet or strip containing enzymes from microorganisms to imitate biological indicators
Equilibration time: See Penetration time
Exposure-prone procedures: see Procedures
F
Filtering mask: (also called filtering face-piece respirator or N95/P2 masks) – see N95/P2 mask
Full-body gown: A gown (see Gown) that is fluid-impervious and has long sleeves to protect clothing and arms
G
Gown: A fluid-impervious garment worn over clothes, with long or short sleeves
H
Hand hygiene: The practice of minimising pathogenic microorganisms on hands by thoroughly cleaning hands whenever necessary, using either alcohol-based handrub or appropriate liquid soap and water. In this guideline, both ‘perform hand hygiene’ and ‘cleanse hands’ means to follow one of the standardised methods.
Health professional: Someone who provides clinical care
Herd immunity: Immunity of a group or community. The resistance of a group to invasion and spread of an infectious agent based on the resistance to infection of a high proportion of individual members of the group
High-efficiency filtration: Filtration with a particle removal efficiency of 90–95%
Holding time: Minimum time at a given temperature that has been established to destroy all microorganisms
Hollow items: If a device is open at one end, it is hollow if the ratio of cavity length to diameter is greater than 1. If a device is open at both ends, it is hollow if the ratio of cavity length to diameter is greater than 2.
Narrow lumen items: Hollow device beyond the range for a simple hollow item, and neither solid nor porous
Simple hollow items: single-ended open-space items where the ratio of length to diameter of the cavity is ≥1 and ≤5 and where the diameter is ≥ 5 mm or double-ended open-space items where the ratio of the length to diameter of the cavity is ≥ 2 and ≤10 and where the diameter is ≥ 5 mm.
I
Iatrogenic: Resulting from the professional activities of health professionals. In the infection prevention and control context, this refers to infections acquired by the patient during the course of treatment
Immunity: The state of being protected from infection
Immunocompromised: A person whose immune system is not functioning well (eg those undergoing chemotherapy, or on antirejection medication or high doses of steroids)
Instrument detergent: A detergent developed for cleaning instruments and equipment
L
Low-level disinfectant: see Disinfectant
N
N95/P2 mask: A high-efficiency filtration mask capable of filtering extremely small particles. Used with airborne precautions
P
P2/N95 mask: A high-efficiency filtration mask capable of filtering extremely small particles. Used with airborne precautions
Particulate filter respirator: (also called filtering face-piece respirator or N95/P2 mask) – see N95/P2 mask
Particles: solid or liquid substances in the form of aggregated molecules or particles. Airborne particulate matter is typically in the size range of 0.01–100 μm diameter
Pathogen: Any disease-causing microorganism
Pathogenic: Having the capability to cause disease
Penetration time (equilibration time): The time taken to heat the centre of a pack to the sterilising temperature from when the steriliser chamber has reached the sterilising temperature
Personal protective equipment: Equipment used as an infection prevention and control measure. Includes the use of gloves, waterproof gown, goggles/face shield, mask and appropriate footwear
Physical distancing: Maintaining distance between people to reduce the risk of contact, droplet and airborne spread of disease.
Procedures, non-exposure-prone: (with respect to blood-borne viruses) procedures in which the healthcare worker’s hands and fingers are visible and outside of the body at all times, and which do not involve possible hand injury by sharp instruments or exposure to tissues if the healthcare worker follows routine infection prevention and control procedures (eg routine oral examination with appropriate personal protective equipment, insertion and maintenance of intravenous lines).
Procedures, exposure-prone: (with respect to blood-borne viruses) procedures in which there is an increased risk of transmitting blood-borne viruses between healthcare workers and patients. These include invasive procedures in which there is potential for direct contact between the healthcare worker’s skin (typically hands) and sharp objects or surgical instruments (eg needles, fractured bones, teeth).
Process challenge device: A device containing a chemical indicator used as a test of steriliser function
Prion: A microorganism resistant to most cleaning, disinfection and sterilisation techniques. Prions are responsible for Creutzfeldt-Jakob disease.
Q
Qualification: process of checking whether reprocessing is being performed correctly (eg includes physical qualification, microbiological qualification and process qualification)
R
Respiratory etiquette: (also called respiratory hygiene and cough/sneeze etiquette) Public health measures used to reduce the spread of respiratory infections by covering the mouth when coughing or sneezing, using tissues to blow the nose, disposing of tissues into waste, and washing hands after touching the nose
S
Safety data sheets: A document prepared by the manufacturer of a hazardous substance which describes its properties, uses, health hazard information, and precautions for use, safe handling information and first aid information. A safety data sheet can be obtained by contacting the distributor/manufacturer
Safety factor: Extra time included in the holding time to ensure sterilisation is achieved. It is a precautionary measure and forms 25% of the holding time
Skin disinfection (antisepsis): a process that involves the application of a disinfectant to reduce levels of microorganisms on the skin/mucosa
Skin asepsis: The removal, or elimination, of transient microorganisms from the skin and a reduction in the resident flora
Soil: Any matter that contaminates objects and may protect microorganisms from disinfection or sterilisation (eg blood and other body substances)
Staff: All people who work in or provide care within the practice, including employees and contractors (eg doctors, nurses, receptionists, practice managers, allied health professionals, administrative staff, cleaners including contract cleaners). ‘Clinical staff’ refers to health professionals (including doctors, nurses, Aboriginal health workers, and allied health care professionals).
Standard precautions: The range of methods and practices used by health professionals to prevent infection transmission, based on the assumption that all blood and body substances are potentially infectious
Standards, The: The Royal Australian College of General Practitioners. Standards for general practices. 5th edition. East Melbourne, Vic: RACGP, 2020
Sterile: The absence of protozoa, spores, mycobacteria, fungi, Gram-positive and Gram-negative bacteria, chlamydia, Rickettsia, mycoplasma and viruses
Sterilisation: A validated process used to render a product free from all forms of viable microorganisms. The nature of microbial death is described by an exponential function, and although the probability can be reduced to a very low number, it can never be reduced to zero
Sterilisation time: The total time of the sterilisation stage after the sterilising chamber has reached the sterilising temperature (penetration time plus holding time)
T
The Standards: The Royal Australian College of General Practitioners. Standards for general practices. 5th edition. East Melbourne, Vic: RACGP, 2020
Time at temperature testing: Testing performed to check that the correct temperature is maintained within the challenge pack for the entire sterilisation cycle. It is performed during validation and can be extended to check penetration and drying times
Transmission-based precautions: Precautions taken by health professionals, in addition to standard precautions, against a particular mode of transmission. They include droplet precautions, airborne precautions and contact precautions and involve the use of personal protective equipment, isolation and other measures
V
Validation: A documented procedure for obtaining, recording and interpreting the results of testing of sterilisers required to establish that a process consistently yields sterile products
References
- National Health and Medical Research Council. Australian guidelines for the prevention and control of infection in healthcare (2019). Version 11.12 Updated March 2022. Canberra: National Health and Medical Research Council; 2019 [Accessed 29 September 2022].