The solution used to disinfect bed-linen of HIV positive patient is?

WCL Staff Nurse - 2019

Applied Microbiology & Infection control

Hard

Appeared in: WCL Staff Nurse - 2019

Explanation

Sodium hypochlorite is a chlorine-releasing agent, which is a powerful and broad-spectrum disinfectant.
It is highly effective against viruses, including HIV, bacteria, and fungi, making it the standard recommendation for decontaminating blood and body fluid spills.
According to guidelines, a 0.5% to 1% solution is used for soaking contaminated linen before laundering.
It is inexpensive, fast-acting, and effectively removes fixed organisms from surfaces and fabrics.

Option A: Dettol's active ingredient, chloroxylenol, is a phenolic compound that is significantly less effective in the presence of organic matter like blood. It is primarily a household disinfectant and skin antiseptic, not suitable for high-risk clinical decontamination.
Option B: Lysol contains phenolic compounds (cresols) and is primarily used for disinfecting hard surfaces, floors, and drains. It is not recommended for disinfecting fabrics like bed linen, especially when contaminated with blood.
Option C: Savlon is an antiseptic, not a disinfectant for inanimate objects. Its active ingredients, cetrimide and chlorhexidine, are designed for use on skin to prevent infection in cuts and grazes. It is not potent enough for decontaminating infectious material on linen.

Clinical Relevance

Nursing practice connection: Use the key finding related to Infection control and disinfection protocols for blood-borne pathogens to guide bedside assessment, documentation, and the next nursing action.
Proper disinfection of contaminated linen is a critical component of Standard Precautions to prevent the transmission of blood-borne pathogens like HIV, Hepatitis B, and Hepatitis C to healthcare workers, other patients, and the environment.
Failure to use the correct disinfectant and procedure can lead to nosocomial (hospital-acquired) infections and occupational exposure incidents.
What if? If the item to be disinfected was a heat-sensitive instrument that cannot be soaked in bleach (e.g., certain endoscopes)? The nurse would need to follow manufacturer guidelines, which might specify other high-level disinfectants like glutaraldehyde or ortho-phthalaldehyde (OPA).

How to Approach the Question

First, identify the key elements of the question: 'disinfect', 'bed-linen', and 'HIV positive patient'. This combination points towards infection control for blood-borne pathogens.
Recall the different levels of disinfection and the agents used for each. The context requires a high-level disinfectant effective against viruses and organic material.
Evaluate each option based on its chemical class and primary application.
Eliminate options that are primarily skin antiseptics (Savlon) or are inactivated by organic matter (Dettol).
Differentiate between surface disinfectants (Lysol) and disinfectants suitable for soaking contaminated fabrics.
Select the option that is the standard protocol for blood and body fluid decontamination, which is sodium hypochlorite.

Concept Tested & Keywords

Concept Tested: Infection control and disinfection protocols for blood-borne pathogens.
Stem keywords: disinfect, bed-linen, HIV positive patient
Lead-in keywords: solution used
Clinical cues: The mention of 'HIV positive patient' is a critical cue indicating potential contamination with blood or body fluids, which requires a high-level disinfectant effective against blood-borne viruses.

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) pp. 127-129, 128-130