Cleaning & Disinfection of Patient Care Equipment

Elinore Matiga

DEFINITIONS:

A.Cleaning – The physical removal of foreign material.

e.g. dust, oil, organic material such as blood, secretions, excretions and micro-organisms.

B. Disinfection – A process that eliminates many or all pathogenic microorganisms with the exception of bacterial spores from inanimate objects. This is generally accomplished by the use of liquid chemicals ..

Cont…..

C. Sterilization- The complete elimination or destruction of all forms of microbial life. It is accomplished in the hospital by either physical or chemical processes. Steam under pressure, dry heat, low temperature sterilization processes (plasma sterilization), and liquid chemicals are principal sterilizing agents used in the hospital.

Cont….

D. Non-Critical Equipment – Those items that either touch only intact skin (but not mucous membranes )or do not directly touch the patient.

E. Personal Protective Equipment (PPE) – Equipment to be worn if hazardous situations. PPE will either prevent or reduce the severity of an injury should an accident occur. PPE can include, but is not limited to: Safety Goggles, Respirators, Gloves, Protective Gowns, face shield.

PURPOSE:

The overall goal of infection preventionpractices is to eliminate the risk of the transmission of  pathogens between patients and between patients and the health care worker.

POLICY:

1)Critical medical and surgical devices and instruments that enter normally sterile tissue or the vascular system or through which a sterile body fluid flows (e.g., blood) are sterilized before use on each patient.

Cont….3) Noncritical patient-care surfaces / equipment (e.g., bedrails, over-the-bed table) and equipment (e.g., blood pressure cuff) that touch intact skin receive low-level disinfection with a hospital-grade disinfectant before us on each patient, e.g., surfaces that come into contact only with intact skin, but could be contaminated with body secretions, e.g. stethoscopes, blood pressure cuffs, splints.

RESPONSIBILITIES:

Cleaning is a shared responsibility between the NURSING and HOUSEKEEPING departments.

PROTECTIVE BARRIERS:    1. Disposable gloves. Gloves must be changed as  required, i.e., when torn, when hands become  wet inside the glove or when moving between  patient rooms.  2. Household gloves can be worn, but they must

 be  discarded when the cleaning is complete.3. Protective Eye wear (goggles, face shield or 

mask  with eye protection)  4. Masks (surgical or procedural masks sufficient)  5. Gowns 

Disinfectant Solutions Used for Low-Level Disinfection include: 

1. Alcohol  (Isopropyl alcohol 70%(Ultrafast) 2. SURFA’SAFE  3. Quaternary Ammonium Compounds (S.S.D.D.-50)

The concentration and contact time for each product will differ. For that reason it is important to read  theproduct label prior to commencing any cleaning and disinfection process. 

RECOMMENDED PROCEDURES FOR CLEANING AND DISINFECTION OF PATIENT CARE EQU

IPMENT

1. Gather all equipment, cleaning solutions and materials

 to clean the patient care devices.    2. WASH hands and put gloves prior to cleaning the  devices. Personal protective equipment should be  changed if torn or soiled. 

3. Visible or gross soil present and/or blood or body  fluid spills must be removed prior to cleaning.    [See Protocol for Cleaning & Disinfecting a Blood or Body Fluid spill.] 

Cont…

4. As appropriate, clean all surfaces of the  patient care equipment or devices using   a detergent or  enzymatic solution.  When  appropriate, dismantle the devices  to ensure that all surfaces can be  cleaned.  To ensure that cross contamination does  not occur use clean cloths for each device  to be  cleaned.    

Cont…

6. If using a 1‐Step Cleaning‐Disinfecting  Solution a separate cleaning step is not  necessary unless the surfaces are visibly  soiled. To ensure disinfection occurs,  the cleaner‐disinfectant solution may need  to be applied multiple times in order to  achieve the contact time as specified on the product label. 

Cont..

7. Soiled rags should be placed in a bag for  laundering.   Disposable cloths should   disposed as  regular waste in garbage bags.   

8. Remove and discard gloves, PPE. 

WASH HANDS. 

Table I: Non-Critical Items - Items on this list must be disinfected between patients. The focus is on parts that touch patients or HCW hands.

High Touch Components .

Product

1. Carts – CPR Trolley, Medication Trolley, Dressing Trolley, drawers & surfaces handled

Ultrafast (70%

Isopropyl alcohol)

Surfa’safe

S.S.D.D.-50

3. BP machines (Dynamap), ECG machine, Steam Inhalation machine

4. ICU equipment: (Cardiac Monitor, Ventilators, CPAP mask, NIV machine, infusion/syringe pump suction machine.

5. X-ray & Ultrasound machine contact points (portable) touchpads.

HIGH TOUCH COMPONENTS PRODUCT

6. Pulse Oximeter probes (reusable) Ultrafast (70%

Isopropyl

alcohol)

Surfa’safe

S.S.D.D.-50

7. Stethoscope, Thermometers8. Glucose meter and B/P cuff, Thermometer probe.9. Keyboards on computers or portable equipment10. Monitor cables11. Walker – hand rail, Wheelchairs – hand contact points 12. Clipboards, notebooks, charts

Table II: Semi-critical Patient Care Equipment

Product Contact time U Uses Used by

Cidex OPA

5-minute soak time at a minimum of 25°C in an automatic endoscope reprocessor

12-minute soak time at room temperature (20°C)

TEE scope Cardiology

Snares, scope Endoscopy

TEE Scope Surgery

Urology Scopes OR

Electrodes, CPAP Mask

Sleep Lab. And EEG Tech.

Glidoscope ICU,ER

INDICATIONS FOR USE:

CIDEX OPA Solution =is a high level disinfectant for reprocessing heat sensitive semi-critical medical devices, for which sterilization is not suitable, and when used according to the Directions for Use.

Manual Processing: High Level Disinfectant at a minimum of 20ϒC (68ϒF). CIDEX OPA Solution is a high level disinfectant when used or reused, according to the Directions for Use.

RFERENCES:1.Provincial Infectious Diseases Advisory Committee,

Best Practices for Cleaning, Disinfection and Sterilization in All Healthcare Settings, 2006

2.Public Health Agency of Canada, Infection Control Guidelines for Hand Washing, Cleaning, Disinfection and Sterilization in Healthcare, Volume 24S8, 1998 .

3. Central Disease Control and Prevention.

4. Mayhall CG. Hospital Epidemiology and Infection Control,

 3rd Ed. Philadelphia. Lippincott Williams &  Wilkins, 2004

THANK YOU !!!