ATS Pulmonary Function Laboratory Manual

chapter  4

3. Cystic Fibrosis (CF) 3.1. All individuals with CF, and their family members and friends, should perform appropriate hand hy- giene (with either alcohol-based hand rub or antimicrobial soap and water) when there is a potential for contamination of hands with pathogens (13). 1. Contamination of hands may occur when entering or exiting a CF clinic, clinic exam room, or hospital room, or from respiratory secretions after coughing performing PF tests, or perform- ing chest physiotherapy (13). 3.2. Perform pulmonary function testing in one of the following ways to reduce transmission from one person with CF to another person with CF: 1. Allow at least 30 minutes to elapse between CF patients in the exam room. 2. Perform PF testing in a negative pressure room (airborne infection isolation room). 3. Perform PF testing in a room equipped with high-efficiency particulate (HEPA) filters. 4. Perform PF testing in a room without HEPA filters, allowing at least 30 minutes to elapse be- tween individuals with CF. 3.3. Isolation Precautions: 1. The CF Foundation recommends that all healthcare personnel implement Contact Precautions (i.e., wear a gown and gloves) when caring for all people with CF regardless of respiratory tract culture results, in ambulatory and inpatient settings (13). 2. The CF Foundation recommends that all people with CF, regardless of their respiratory tract culture results, be separated by at least 6 feet (2 meters) from other people with CF in all set- tings, to reduce the risk of droplet transmission of CF pathogens (13). Cleaning and Disinfecting Procedures and Use of Filters for PF Equipment 1. Not all PF equipment is designed for easy disassembling and disinfection. Therefore, the laboratory should work in concert with the institution’s infection control department to design and implement policies and procedures which describe the method(s) to disinfect PF equipment as well as monitors to ensure effective- ness of disinfection. 2. Disinfection procedures should meet or exceed manufacturer’s recommendations. 3. All materials must be cleaned of debris before undergoing the disinfection process. Depending on the type of disinfection processes employed, other preparation issues may need to be addressed (e.g., special wrap- ping and tape for steam under pressure). 4. Some common methods for sterilization or disinfection include: 4.1. Heat: Heat is the universally employed and most reliable method of sterilization. 1. Order of efficiency of sterilization and disinfection (9): a. Steam under pressure (autoclave) 1) Variables involved in the autoclaving process include temperature, pressure, and con- centration of steam. Examples of autoclaving cycles include:

a) 121 ° C at 15 psi for 15 minutes b) 126 ° C at 20 psi for 10 minutes c) 134 ° C at 29.4 psi for 3 minutes

37