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Element V-Cleaning, Disinfection, & Sterilization PowerPoint PPT Presentation


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Element V-Cleaning, Disinfection, & Sterilization. Problem: Choosing reprocessing methods for safety and integrity of patient care equipment Controlling the Problem: Professional responsibility for maintenance of safety environment. Universal Principles.

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Element V-Cleaning, Disinfection, & Sterilization

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Element V-Cleaning, Disinfection, & Sterilization

Problem: Choosing reprocessing methods for safety and integrity of patient care equipment

Controlling the Problem: Professional responsibility for maintenance of safety environment


Universal Principles

  • Instruments, medical devices and equipment should be managed and reprocessed according to recommended/appropriate methods regardless of a patient’s diagnosis except for cases of suspected prion disease.

  • Industry guidelines as well as equipment and chemical manufacturer recommendations should be used to develop and update reprocessing policies and procedures.

  • Written instructions should be available for each instrument, medical device, and equipment reprocessed.

Element 5 - Infection Control


Potential for contamination

  • Type of medical device, equipment or environmental surface.

  • Frequency of hand contact with instrument medical device, equipment, or environmental surface.

  • Potential for contamination with body surfaces or environmental sources of microorganisms.

  • Level of contamination.

Element 5 - Infection Control


Steps of Reprocessing

  • Pre-Cleaning

  • Cleaning

  • Disinfection

  • Sterilization

Element 5 - Infection Control


Choice of Reprocessing Methods

  • Intended use:

    • Critical instruments and medical devices

    • Semi-critical instruments and medical devices

    • Non-critical instruments and medical devices

  • Manufacturer’s recommendations

    • Compatibility among equipment, materials and chemicals

    • Equipment heat and pressure tolerance

    • Time and temperature requirements for reprocessing

Element 5 - Infection Control


Critical instruments and devices

  • Enter a sterile body site or bloodstream

  • Must be sterile

    • surgical instruments

    • Implants

    • Plasma

  • Must be cleaned prior to processing

  • Steam, heat, ethylene oxide gas

  • Monitor time, temperature, pressure, concentration

  • Maintain an autoclave log

Element 5 - Infection Control


Semi-Critical Instruments & Devices

  • Have contact with mucous membrane or non-intact skin

  • Need sterilization or high-level disinfection

    • scopes

    • tonometer

    • speculum

  • Chemical sterilization techniques. Use full time mandated for agent selected

Element 5 - Infection Control


Non-Critical Instruments & Devices

  • Have contact with intact skin

    • blood pressure cuff, tub, electrode

  • Have low risk of transmitting infection

    • may cause colonization

  • Use detergent or low-level germicide

Element 5 - Infection Control


Cleaning Environmental Surfaces

  • Use EPA registered disinfectants in accordance with manufacturers instructions.

  • Follow manufacturers’ instructions for cleaning and maintaining noncritical medical equipment.

  • Keep housekeeping surfaces (e.g., floors, walls, and tabletops) visibly clean on a regular basis and clean spills promptly.

    *CDC Guidelines for Environmental Infection Control in Health-Care Facilities

Element 5 - Infection Control


BC Centre for Disease Control

Element 5 - Infection Control


Effectiveness of reprocessing instruments, medical, devices and equipment

  • Cleaning prior to disinfection

  • Disinfection

    • Selection and use of disinfectants

    • Presence of organic matter

    • Presence of biofilms

    • Monitoring

    • Post-disinfection handling and storage

Element 5 - Infection Control


Effectiveness of sterilization process

Effectiveness of the sterilization process is dependent on:

  • Selection and use of sterilization methods

  • Monitoring the sterilization process

  • Post sterilization handling and storage

Element 5 - Infection Control


How Equipment Gets Contaminated

Contamination can occur at any point in handling or reprocessing:

  • Failure to reprocess or dispose of items between patients

  • Inadequate cleaning

  • Inadequate disinfection or sterilization

  • Contamination of disinfectant or rinse solutions

  • Improper packaging, storage and handling

  • Inadequate/inaccurate record keeping of reprocessing requirements

Element 5 - Infection Control


Preventing Cross-Contamination

  • Identify surfaces or equipment which require between patient cleaning.

  • Identify practices which contribute to hand contamination and the potential for cross-contamination.

  • Implications of reuse of disposable equipment or devices.

Element 5 - Infection Control


Disinfection and sterilization methods and agents based on practice setting and responsibilities

All health professionals must:

  • Understand core concepts and principles

    • Standard and Universal Precautions

    • Cleaning, disinfection, and sterilization

    • Appropriate application of safe practices in handing instruments, medical devices and equipment

    • Designation and physical separation of patient care areas from cleaning and reprocessing areas is strongly recommended by NYSDOH

Element 5 - Infection Control


Disinfection and sterilization methods and agents based on practice setting and responsibilities

Health professionals in settings where handling, cleaning and reprocessing is performed elsewhere:

  • Verify with those responsible for reprocessing what steps are necessary prior to submission

    • Pre-cleaning

    • Soaking

Element 5 - Infection Control


Disinfection and sterilization methods and agents based on practice setting and responsibilities

Health professionals with primary or supervisory responsibilities for equipment or device reprocessing:

  • Must also know the consequences of reuse of single-use/disposable instruments, medical devices or equipment

  • Determine Appropriate reprocessing practices

Element 5 - Infection Control


Selection Criteria

  • Antimicrobial efficacy

  • Time constraints

  • Compatibility among equipment/material

  • Toxicity

  • Residual effect

  • Ease of use

  • Stability

  • Odor

  • cost

  • Monitoring

Element 5 - Infection Control


FDA regulations for reuse of medical devices

  • Medical devices rented/leased from third parties may not be adequately disinfected

  • Follow manufacturer’s specifications

  • Follow FDA/ANSI/AAMI sterilization standards

  • Do initial cleaning in procedure room

  • Devices should not be placed in disinfectant prior to cleaning

  • Devices should be dry before gas sterilizing

  • Report adverse events

Element 5 - Infection Control


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