Cleaning And Disinfection Of The Environment & Reusable Medical Devices

1y ago
6 Views
1 Downloads
1.66 MB
11 Pages
Last View : 2m ago
Last Download : 2m ago
Upload by : Kian Swinton
Transcription

CLEANING AND DISINFECTION OFTHE ENVIRONMENT& REUSABLE MEDICAL DEVICESSTANDARD PRECAUTIONSINFECTION PREVENTION AND CONTROLMSF ACADEMY FOR HEALTHCAREMSF Academy for Healthcare – 2020 - Éditors: MSF Academy / IPC advisors MSF-intersection - Graphic Design : S. Van de Spiegle

CONTENTSA. What is environmental decontamination and why is it important? .3B. Cleaning & disinfection of environmental surfaces in patient zone .5C. Cleaning & disinfection of reusable medical devices .7D. Cleaning & disinfection of biomedical equipment .9E. Principles to respect when cleaning and disinfecting environmental surfaces and reusable non-critical medical devices . 10Summary.11ACRONYMESIPC.Infection Prevention and ControlHAI.Health care Associated InfectionHCW. Health Care WorkerHVF. Haemorrhagic Viral FeverMDRO. Multi-Drug Resistant Organism (ESBL, MRSA, VRE, pAmpC, CRE, etc.)PPE. Personal protective equipmentBIBLIOGRAPHY MEDECINS SANS FRONTIERES, Cleaning & disinfection of the environment & reusable medical devices, IPCPillar 2, Feb 2019. MEDECINS SANS FRONTIERES, TEMBO, Cleaning and disinfection of the environment (e-learning platform) MEDECINS SANS FRONTIERES, TEMBO, Safe processing of reusable medical devices and equipment (e-learningplatform) MEDECINS SANS FRONTIERES, Medical Material Treatment, 08 2018 (excel table) WHO, Decontaminating & reprocessing of medical devices for health care facilities, 2016 NURSING TIMES, Environmental decontamination 1: what is it and why is it important? July 2018. -is-it-and-why-is-itimportant-02-07-2018/This manual is a collective effort by health and education professionals acting as a reference in their area of expertise andhaving all field experience. Despite all efforts, it’s possible that certain errors may have been overlooked in this manual.Please inform the authors of any errors detected at the following email address:msfacademy.nursing@msf.orgThe authors would be grateful for any comments or criticism to ensure that this manual continues to evolve and remainsadapted to the field reality.2MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

A.WHAT IS ENVIRONMENTAL DECONTAMINATION AND WHYIS IT IMPORTANT?ENVIRONMENTAL DECONTAMINATION IS ONE OF THE MOSTIMPORTANT IPC MEASURES TO PREVENT HAIs.RESEARCH SHOWS THAT THE COMPLIANCE FOR CORRECT ANDADEQUATE ENVIRONMENTAL DECONTAMINATION PRACTICES IS LOW.NOT PRACTICING ADEQUATE ENVIRONMENTAL DECONTAMINATIONPUTS PATIENTS AND HEALTHCARE WORKERS (HCWs) AT RISK TOBECOME COLONIZED AND POTENTIALLY INFECTED WITH MDROSAND OTHER COMMUNICABLE DISEASES.Figure 1: Reminder of cross transmission via contact with contaminated environment3MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

Environmental decontamination programs entail cleaning, disinfection (and sterilization) to prevent the presence,replication and transmission of microorganisms in healthcare facilities and therefore to protect patients,HCWs and visitors.The decontamination is the mechanical removal of blood and organic material or bio burden of soil anddisease-causing microorganisms from objects, so they are safe to handle (before further re-processing for re-use or safe discard).The environment covers: Environmental surfaces: Surfaces in non-clinical areas such as offices, technical locations,logistics, pharmacy, etc. where not in contact with patient. Surfaces in clinical areas including high-touch surfaces that arein the patient zone and that are touched frequently by the patienthimself or the HCW (e.g.: beds (bedrail, mattresses), bedside tables,infusion poles, door handles, surfaces in the nurse station (depending onlocation)). The medical devices: Instruments intended for use in the diagnosis of disease or30 9027120/85other conditions, or in the examination, mitigation, treatment, orprevention of disease (e.g.: bedpan, ultrasound machine, infusionpump, blood pressure cuff, biomedical equipment).N.B.The biomedical equipment covers all medical devices requiring calibration, maintenance,repair, user training and decommissioning.Biomedical equipment excludes implantable, disposable or single-use medical devices.4MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

B.CLEANING & DISINFECTION OF ENVIRONMENTAL SURFACESIN PATIENT ZONEThe patient zone contains the patient and their immediate surroundings, including inanimate surfaces that aretouched by or in direct physical contact with the patient (i.e. bed, bedside table, bed linen, infusion tubing, bedpans, urinals) and surfacesfrequently touched by HCWs during patient care, such as monitors, knobs and buttons and other high touch surfaces.The patient zone is the zone with most risk.It is recommended to clean AND disinfect all environmental surfaces in patient zone : On daily basis: A daily cleaning/disinfection schedule should be available andinclude schedules for cleaning of all clinical and non-clinical areas. Prioritizehigh-touch surfaces. On terminal cleaning/disinfection: after discharge of the patient before admittinga new patient, the patient zone must be thoroughly cleaned/disinfected.The cleaning is the removal of gross, or visible soil/dirt/fluids from objects and surfaces using water with detergents/soap or enzymatic products. It is always done BEFORE disinfecting.e.g.: liquid soap bought locally, The disinfection describes a process that eliminates many or all disease-causing microorganisms (except bacterial spores)on inanimate objects. It is done AFTER a proper cleaning with water and detergent.e.g.: chlorine solution, 5MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

Products available in MSF settingsDETERGENT: SoapFigure 2 : example of detergent in MSF settings(ITC catalogue) used for cleaning purpose only.DISINFECTANT: Chlorine 0.1%,are used only for special indications (Asdisinfectant, the chlorine would be deactivated by dirt if thesurface is not cleaned beforehand and due to its toxic effectsfor patients, HCWs and material with “risk of corrosion”)Chlorine is a disinfectant to disinfect surfacesafter a proper cleaning with some water andany detergent rinsing, two-steps procedureCHLORINE( step 1: cleaning rinsing with soap/water and step 2:disinfection with chlorine).0,1%Chlorine is used in absence of Surfanios (seePillar 2 guideline).For outbreaks, refer to appropriate guidelines(e.g.: HVF and cholera outbreak).DETERGENT/DISINFECTANTcombination : Surfanios,is a combined detergent with a disinfectant thatis used in one-step procedure (Step 1: cleaning anddisinfection) although it must be used on a nonvisibly soiled surface to be effective and needs15 min of contact to kill microorganisms (do notrinse but leave it dry).15’Figure 3 : combined detergent/disinfectantused in MSF settings6MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

C.CLEANING & DISINFECTION OF REUSABLE MEDICAL DEVICESMost of MEDICAL DEVICES come in DIRECT CONTACT WITH THE PATIENT and /or WITH BODILY FLUIDS. Theycan therefore spread microorganisms that can cause an infection if they are not treated properly. Medical staff isresponsible for the proper treatment of medical devices, which has a considerable impact on HAIs prevention.THE TREATMENT OR CLEANING/DISINFECTION OF MEDICAL DEVICES IS A BIGPRIORITY TO AVOID HAISMedical devices are divided in TWO MAIN CATEGORIES : Single use : ONE USE ON ONE PATIENT, must be discarded immediately after oneuse on one patient in the appropriate waste container. They must never be reusedor treated to be reused twice on the same patient or on any other patient. (these itemstend to have a 2 with a diagonal line across it on the outer packaging as an indication it is single use)›e.g.: venous catheter, needle, syringes, urinary catheter, N.B. Single use: MULTIPLE USES FOR ONE PATIENTA few medical devices are said to be single patient use. They should be cleanedwith water and soap, preferably after each use. When the treatment has ended orif they are damaged, they must be discarded (e.g.: oxygen mask, ). Then must neverbe reused or treated to be reused on another patient. ›Reusable : must all be TREATED after use BETWEEN EACH PATIENT accordingtheir level of risk to avoid the transmission of microorganisms during the nextutilization on another patient.e.g.: surgical instruments, oropharyngeal airway, resuscitator, vaginalspeculum, blood pressure cuff, oxygen concentrator, pulse oximeter, Cleaning and disinfection of reusable medical devices should occur between patients (or after the device has beenused for a patient) and after patient discharge (all medical devices in the patient zone are cleaned/disinfected).7MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

Reusable medical devices are divided in 3 GROUPS according tothe level of risk for transmission of microorganisms:1 Critical (high-risk): touches sterile site. Theymust always be treated in a full process ofsterilization that is meant to fully eliminatepathogenic microorganisms, including spores.›e.g.: surgical instruments, instruments from delivery set, 2 Semi-critical (moderate-risk): touchesmucous membrane or non-intact skin. Theyalso must be sterilized after being used.›e.g.: vaginal speculum, oropharyngeal airway, resuscitator, 3 Non-critical (low-risk): touches in-tact skin.They must be systematically cleaned ANDdisinfected between each patient use (Surfaniosis the product of choice in MSF settings).›e.g.: stethoscopes, blood pressure cuff, thermometer,tourniquet, dressing tray, nursing trolley, ( exception : bedpan and urinals: need to be cleaned anddisinfected using soap/water and chlorine solution)8MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

D.CLEANING & DISINFECTION OF BIOMEDICAL EQUIPMENTThe biomedical equipment is part of the medical devices and therefore their cleaning and disinfection is part of theIPC program, as it is an important measure to reduce the transmission of microorganisms that cause infection,but it also impacts the maintenance of the equipment itself allowing to keep a good effectiveness and increasingthe life expectancy.Each HCW must be aware that it plays a crucial role in the environmental decontamination maintenance SAFETY.Therefore, the obstacles/difficulties identified to ensure this should be discussed with the team in order to findpossible solutions.Many challenges in the cleaning and disinfection of the biomedical equipment has been observed as for example: Policy about biomedical equipment not defined or not clearly mentioned Involvement of several departments (medical and non-medical) which often makes the roles andresponsibility of each other unclear Lack of knowledge in biomedical equipment (numerous different models with different recommendationsfrom manufacturers) HCWs don’t have time and don’t want to be burdened with more responsibility The recommendations for cleaning and disinfection differ from one component to the otherwithin the same biomedical equipment, which can bring misunderstanding and mistakee.g.: about the oxygen concentrator› The external part is a low-critical medical device and should be cleaned anddisinfected between each patient with Surfanios.› The humidifier is a semi-critical medical device and should be sent to sterilizationbetween patient.› The oxygen mask and tubes are single patient use and should be discarded once thepatient is discharged. The shortage of some spare parts often leads to alternative method for cleaning anddisinfection that does not respect the protocols The poor infrastructure doesn’t allow to respect the protocols about cleaning and disinfection(e.g.: no sterilization available) CLEANING AND DISINFECTION OF BIOMEDICAL EQUIPMENT MUST BE INCLUDED IN THEENVIRONMENTAL DECONTAMINATION LOCAL POLICY.9MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

E.PRINCIPLES TO RESPECT WHEN CLEANING ANDDISINFECTING ENVIRONMENTAL SURFACES AND REUSABLENON-CRITICAL MEDICAL DEVICESAll HCWs (including doctors, nurses, midwives, and cleaners,.) have roles and responsibilities for cleaning and disinfection.These responsibilities should be clearly defined in the local policy Medical staff must oversee that cleaning/disinfection of medical areas is properly done (by cleaners). Medical staff are responsible of cleaning/disinfection of reusable medical devices. Wear the appropriate work attire and PPE. Material used for cleaning/disinfection of medical devices must be different than the one used for environmentalsurfaces. Always clean before disinfecting. Best practice is to use one cloth for one patient area, changing cloth in between (and send cloth to laundry). Move from clean to dirty areas and from high to low surfaces. Perform HH after removing gloves used during the procedure of after touching and/or after touching the patientsurroundings. Damaged materials (surfaces and medical devices) that cannot be cleaned and disinfected properly should be replacedor repaired systematically.10MSF ACADEMY FOR HEALTHCARECLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICES

27120/8530 90MEDICALDEVICES(bedpan, ultrasond machine, infusion pump,blood pressure cuff, biomedical equipment, .)SINGLE USE AND REUSABLEINSTRUMENTS INTENDEDFOR USE IN THE DIAGNOSIS,EXAMINATION, MITIGATION,TREATMENT ORPREVENTION OF DISEASE :(beds, bedside tables, infusion poles,door handles, surfacesin the nurse station, .)SURFACES INCLINICAL AREASMSF ACADEMY FOR HEALTHCAREMEDICALDEVICESDETERGENT : Soaptreat according levelof risk between patientREUSABLEFor the patient AFTEReach use cleaning withwater/soapSINGLE isk)CRITICAL(high-risk)MULTIPLE USESON ONE PATIENTONE USE ONONE PATIENT( step 1: cleaning rinsingwith soap/water and step 2:disinfection with chlorine) Most used in MSF settings Only for special indications Two-steps procedureTouchesin-tact skinTouches mucousmembrane ornon-in-tact skinTouchessterile siteAfter each useSoap/waterCLEAN/DISINFECTbetween patientSTERILIZATIONSTERILIZATIONDISCARD whentreatment endedor damagedDISCARD IMMEDIATELYafter ONE USEON ONE PATIENT( Step 1: cleaning and disinfection) One-step procedureto kill micro-organisms 15 minutes of contactEnvironmental surfacesLow-critical reusablemedical devicesfor BOTH cleaningand disinfectionDETERGENT/DISINFECTANTcombination: Surfanios15’DISINFECTANT: Chlorine 0.1%0,1%CHLORINEProducts available in MSF settings.CLEANING AND DISINFECTION OF THE ENVIRONMENT & REUSABLE MEDICAL DEVICESIt is recommended to clean AND disinfect all environmental surfaces in patient zoneDisinfection process that eliminates many or all disease-causing micro-organisms(except bacterial spores) on inanimate objects always AFTER a proper cleaning.Cleaning removal of gross, or visible soil/dirt/fluids from objects and surfaces usingwater with detergents/soap always BEFORE disinfecting.ENVIRONMENTSURFACES(offices, technical locations, logistics, pharmacy, .)SURFACES INNON-CLINICAL AREASNot practicing adequate environmental decontamination puts patients and healthcareworkers (HCWs) at risk to become colonised and potentially infected with MDROs andother communicable diseasesEnvironmental decontamination is one of the most important IPCmeasures to prevent HAIs.SUMMARY

On daily basis: A daily cleaning/disinfection schedule should be available and include schedules for cleaning of all clinical and non-clinical areas. Prioritize high-touch surfaces. On terminal cleaning/disinfection: after discharge of the patient before admitting a new patient, the patient zone must be thoroughly cleaned/disinfected.

Related Documents:

Silat is a combative art of self-defense and survival rooted from Matay archipelago. It was traced at thé early of Langkasuka Kingdom (2nd century CE) till thé reign of Melaka (Malaysia) Sultanate era (13th century). Silat has now evolved to become part of social culture and tradition with thé appearance of a fine physical and spiritual .

May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)

WFHSS-ÖGSV Basic Script Fundamentals of Cleaning, Disinfection, Sterilization Page2/30 TABLE OF CONTENTS . 1 TERMS 3 1.1 Cleaning 3 1.2 Disinfection 3 1.3 Sterilization 3 2 CLEANING 4 2.1 Detergents and methods of cleaning (summary) 5 3 DISINFECTION 7 3.1 Chemical disinfection 8 3.2 Thermal disinfection 17

̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions

Dr. Sunita Bharatwal** Dr. Pawan Garga*** Abstract Customer satisfaction is derived from thè functionalities and values, a product or Service can provide. The current study aims to segregate thè dimensions of ordine Service quality and gather insights on its impact on web shopping. The trends of purchases have

On an exceptional basis, Member States may request UNESCO to provide thé candidates with access to thé platform so they can complète thé form by themselves. Thèse requests must be addressed to esd rize unesco. or by 15 A ril 2021 UNESCO will provide thé nomineewith accessto thé platform via their émail address.

Chính Văn.- Còn đức Thế tôn thì tuệ giác cực kỳ trong sạch 8: hiện hành bất nhị 9, đạt đến vô tướng 10, đứng vào chỗ đứng của các đức Thế tôn 11, thể hiện tính bình đẳng của các Ngài, đến chỗ không còn chướng ngại 12, giáo pháp không thể khuynh đảo, tâm thức không bị cản trở, cái được

PRODUCT CATALOGUE. 1 Company Profile 2 Disinfection Liquid Products C O N T E N T 3 Disinfection Gel Products 4 Disinfection Powder Products 5 Permits&Certificates. 1.Company Profile . Disinfection gel products 100,000 pcs/day Disinfection powder products 500 tons/day Key Customers:West China Hospital Sichuan University, Xiangya Hospital .