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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 prevention
practices 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 the
product label prior to commencing any cleaning
and disinfection process.
RECOMMENDED PROCEDURES FOR CLEANING AND
DISINFECTION OF PATIENT CARE EQUIPMENT
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, Thermometers
8. Glucose meter and B/P cuff,
Thermometer probe.
9. Keyboards on computers or portable
equipment
10. Monitor cables
11. 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 !!!

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Cleaning and disinfection of p atient care equipment

  • 1. Cleaning & Disinfection of Patient Care Equipment Elinore Matiga
  • 2. 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 ..
  • 3. 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.
  • 4. 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.
  • 5. PURPOSE: The overall goal of infection prevention practices is to eliminate the risk of the transmission of pathogens between patients and between patients and the health care worker.
  • 6. 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.
  • 7.
  • 8. 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.
  • 9.
  • 10. RESPONSIBILITIES: Cleaning is a shared responsibility between the NURSING and HOUSEKEEPING departments.
  • 11. 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
  • 12.
  • 13. 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 the product label prior to commencing any cleaning and disinfection process.
  • 14.
  • 15.
  • 16. RECOMMENDED PROCEDURES FOR CLEANING AND DISINFECTION OF PATIENT CARE EQUIPMENT 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.]
  • 17. 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.
  • 18.
  • 19. 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.
  • 20. 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.
  • 21. 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.
  • 22. HIGH TOUCH COMPONENTS PRODUCT 6. Pulse Oximeter probes (reusable) Ultrafast (70% Isopropyl alcohol) Surfa’safe S.S.D.D.- 50 7. Stethoscope, Thermometers 8. Glucose meter and B/P cuff, Thermometer probe. 9. Keyboards on computers or portable equipment 10. Monitor cables 11. Walker – hand rail, Wheelchairs – hand contact points 12. Clipboards, notebooks, charts
  • 23. 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
  • 24. 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.
  • 25. 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

Notas do Editor

  1. CDC Center for Disease control and prevention.
  2. “Cleaning reduces or eliminates the reservoirs of potential pathogenic organisms. It is accomplished with water, detergents and mechanical action.
  3. gle
  4. We prevent cross-infection from patient/patient things to the health care worker whether it’s direct contact or indirect contact.
  5. As per CDC guidelines , instrument machines that is with contact with patients tissue and or blood must be sterilized before use to other patient. Such as instrument used during operation.
  6. Saurfa’fast-(Didecyldimethyammonium chloride-N, Polyhexamethylene biguanide Hydrochloride.. SSDD-50= strong surfaces disinfectant and devices. Phenolics- strong chemical compound consist of hydroxyl group.
  7. Transesophageal Echocardiogram (TEE)-ultrasound of the heart.
  8. The Centers for Disease Control and Prevention (CDC) is the national public health institute of the United States. CDC is dedicated to protecting health & promoting quality of life through prevention and control of disease, injury, and disability.