Richard Fox comments 29th August 2013
Contents
1.2. NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items Guideline Objective This guideline aims to ensure that systems are in place to prevent and control infection and communicable disease by underpinning national polices It outlines the criteria responsibilities and systems required to manage specific conditions infections The goal of this guideline is to protect patients staff and the public by effective prevention and control of infection and communicable disease Compliance with this guideline is best practice If you have any concerns please discuss with your line manager who will consult the local Infection Control Health Protection Team for advice Il NHS Lanarkshire Section I N H S Health Protection Committee Effective October a From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items SECTION I CONTENTS Page Nos Decontamination of Equipment and the Environment including 11 130 the use of single use and single patient use items 1 INTRODUCTION 14 2 THE USE OF SINGLE USE AND SINGLE 14 PATIENT USE EQUIPMENT 3 PRINCIPLES
3. Bins Clinical Waste Clean with warm water and Include in weekly ward cleaning detergent or use disposable schedule If contaminated with wipes Dry thoroughly blood or body fluids use a chlorine releasing agent Blood Pressure Cuffs Clean with detergent wipes Dry Use disposable for Clostridium thoroughly refer to difficile positive patients Manufacturers user manual 118 NHS Lanarkshire Section I N S Health Protection Committee Effective From October Appendix 2 2013 Saw Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date Environment including the use of single use and single patient use items July 2016 CLEANING SCHEDULES FOR CLINICAL STAFF ee n T FREQUENCY Between After Monthly _ m Chairs Clean with warm water and Fabric chairs are unsuitable for detergent or detergent wipes Dry clinical areas Include in weekly thoroughly If contaminated with ward cleaning schedule blood or body fluids use a chlorine releasing agent Commodes Clean with warm water and detergent or detergent wipes Dry Denture Mugs PREFERRED METHODS COMMENTS Inspect undercarriage handles etc blood or body fluids use a chlorine releasing agent If non disposable wash with warm water and detergent Dry thoroughly Disposable preferred thoroughly If contaminated with Drip Stands etc Clean with warm water and detergent or d
4. gasrtoscopes laparoscopes etc Finger Probes for O2 Clean with detergent wipes Dry Disposable preferred Saturation Monitors thoroughly refer to Manufacturers user manual 1 20 NHS Lanarkshire Section I N S Health Protection Committee Effective From October 2013 r Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items EET SCHEDULES FOR CLINICAL STAFF a T OoOo FREQUENCY oO OS CY Between After Monthly PREFERRED METHODS om O Flower Vases Renew water daily Clean with warm water and detergent or clean in dishwasher Dry thoroughly Glucometers Clean with detergent wipes Dry thoroughly If contaminated with blood or body fluids use a chlorine releasing agent Ice bucket for Swann Clean with warm water and Ganz Catheters detergent Dry thoroughly Ice Cube Making y Follow manufacturer s Machine instructions Clean with detergent wipes Dry thoroughly Infusion EF e D Clean with detergent wipes Dry thoroughly Lead Aprons Clean with detergent wipes Dry thoroughly If contaminated with blood or body fluids use a chlorine releasing agent I21 Appendix 2 COMMENTS Store dry and inverted Not to be used in specialist units e g Burns Unit ITU and SCBU etc Refer to manufacturer s instructions Renew ice daily Ice to be used
5. Chemical agents e g o disinfectants Physical methods not all medical equipment refer to Manufacturers user manual e g o boiling o low temperature steam O pasteurisation Autoclave not all medical equipment refer to Manufacturers user manual Hot air oven Ionizing radiation Low temperature steam amp formaldehyde Ethylene oxide Filtration Chemical agents I5 The environment or equipment not in close contact with mucous membranes or sterile body areas Prior to disinfection or sterilisation Heat labile items in close contact with mucous membranes Items contaminated with pathogenic microbes e g o body fluid spillages Items in contact with broken skin mucous membranes Items which enter a sterile body area NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items 4 GENERAL RULES CLEANING DISINFECTION carry out cleaning in a designated dirty area where possible wear appropriate personal protective equipment PPE e g gloves plastic apron and eye protection even if an ultrasonic bath is used use freshly prepared detergent diluted as per manufacturer s instructions never pre dilute detergents and store them after
6. and Date 2016 single patient use items Correct disassembly and reassembly of surgical instruments It is important that the correct procedures are followed for disassembling and reassembling equipment during decontamination Do not disassemble or reassemble any equipment unless you have been instructed or trained to do so This training or instruction should be recorded Training Managers must ensure that all healthcare workers are appropriately trained and have access to detailed instruction illustrating the correct procedure taking into account the manufacturer s instructions DISINFECTANTS Disinfectants are subject to the Control of Substances Hazardous to Health COSHH Regulations 2002 as amended To comply with COSHH all disinfectants must be kept in locked cupboards Instructions for use must be displayed close to the cupboard When using disinfectants the approved procedure must be followed to ensure that the disinfectant is effective and does not cause harm to patients staff visitors equipment or the environment Personal protective equipment Protective clothing should be worn in accordance the COSHH assessment for the disinfection process to be used and with the National Infection Prevention and Control Manual Chapter 1 Standard Infection Control Precautions pages 11 13 as contained within NHSL s Control of Infection Manual accessible via through FirstPort via http firstport2 staff support healt
7. cleaning rinse items thoroughly with water wipe electromedical equipment do not immerse dispose of cleaning solution via sluice hopper or equipment sink not in clinical wash hand basin use scrupulously clean containers only ensure thorough pre cleaning of items prior to disinfection never use chemical disinfection when sterilisation is required or when cleaning alone is adequate ensure correct measured dilution never pre dilute disinfectants and store them ensure items are immersed in disinfectant the fluid entirely covering articles and penetrating into all crevices including the insides of tubes ensure the recommended exposure time is adhered to no chemical agent acts immediately never store items in a chemical disinfectant after disinfection rinse items thoroughly with water wipe electro medical equipment do not immerse adhere to manufacturers advice regarding shelf life of disinfectants STERILISATION The use of a central sterile services department is recommended items must be physically clean before being exposed to any sterilisation process 16 NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items 5 REUSABLE MEDICAL DEVICES A medical devic
8. E STERILE Eo Sterilized by Ethylene Oxide STERE R STERILE Sterilized by Steam or Dry Heat Sterilized by Irradiation 115 DO N OT REUSE Synonyms for this are Single use Use only once ATTENTION SEE INSTRUCTIONS FOR USE The CE mark indicates that the device complies with the essential requirements for the performance and safety of medical devices supplied or sold in the UK under UK and EU laws Items sold as Sterile will have a number under the CE mark NHS Lanarkshire Section I N S Health Protection Committee Effective From October Appendix 2 2013 Nees one s Replaces Jan 2010 Lanarkshire 2 SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items CLEANING SCHEDULES FOR CLINICAL STAFF E n T FREQUENCY oem Between After baie ao Monthly PREFERRED METHODS COMMENTS a Soiling or Other Disposable or central sterile Non disposable ambu bag supplies department contains a single use bacterial filter to be disposed after use Anaesthetic Equipment The incubating laryngeal mask It is advisable that laryngoscope Difficult intubation trolley airway should be washed in blades are disposable handles detergent to remove soiling and should also be disposable or Intubation laryngeal mask reprocessed in central sterile reprocessed in central s
9. OF CLEANING DISINFECTION 14 AND STERILISATION 4 GENERAL RULES 16 5 REUSABLE MEDICAL DEVICES I7 Risk Categorisation for the Decontamination of I7 Medical Devices Correct disassembly and reassembly of surgical I8 instruments Training I8 6 DISINFECTANTS I8 Personal Protective Equipment I8 Hazard Warning Urine Spillages 18 Spillages on Carpets 19 7 NEW EQUIPMENT PURCHASE FOR NHS 19 RESEARCH TRIAL OR LOAN 8 BENCHTOP STERILISERS AUTOCLAVES 19 Performance Monitoring 19 9 DECONTAMINATION OF HEALTHCARE 110 EQUIPMENT PRIOR TO INSPECTION SERVICE OR REPAIR Equipment Leaving the Premises 110 Planned Preventative Maintenance of On Site 110 Equipment 12 NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items 12 RISK CATEGORISATION OF CLINICAL 112 PROCEDURE FOR ALL TYPES OF CREUTZFELT JACOB DISEASE CJD BIBLIOGRAPHY 113 Appendix 1 Symbols Used On Medical Packaging amp Their 115 Meanings Appendix 2 Cleaning Schedules For Clinical Staff A Z I 16 13 NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single
10. Tick Box A of Clearance Has equipment been contaminated with blood or other potentially contaminated materials Clean and disinfect NO thoroughly E see A to Z for appropriate method Ts this PPM for which Medical Physics have supplied Clearance _ Certification Form 2 ves im Enter B in status column of Clearance Certification Form 2 Tick Box B of Clearance Certification Form 1 Certification Form 1 4 Release send equipment for inspection service or repair see text paragraph 3 1 if equipment leaving premises Ill DN Is dismantling necessary before complete disinfection is possible YES Clean and disinfect all external surfaces see A to Z for appropriate method Tick Box C of Clearance Certification Form 1 NHS Lanarkshire Section I N f S Health Protection Committee Effective From October 2013 V Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date September Environment including the use of single use and 2016 single patient use items 10 RISK CATEGORISATION OF CLINICAL PROCEDURE FOR ALL TYPES OF CREUTZFELT JACOB DISEASE CJD In addition to the Classification of Risk there are also technical requirements for decontamination for specific instruments in relation to CJD Please refer to SECTION W The Management of Patients with Transmissible Spongiform Encephalopathy TSE including all fo
11. cking Planned preventative maintenance of on site equipment Where planned preventative maintenance PPM is being carried out on site it is considered unnecessarily onerous to complete an individual form for each item In these circumstances where lists of equipment scheduled for maintenance are sent to clinical areas in advance such lists should contain a section where the clearance status of each item of equipment can be documented Clearance Certification Form 2 may be used for clearance category A or B items only Form 2 is provided in Appendix 8 of the National Infection Prevention and Control Manual Chapter 1 Standard Infection Control Precautions as contained within NHSL S Control of Infection Manual For clearance category C items an individual Form must be completed SEE FLOW CHART ON NEXT PAGE 110 NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items DECONTAMINATION OF HEALTH CARE EQUIPMENT PRIOR TO INSPECTION SERVICE OR REPAIR M a Clean thoroughly see A to Z for appropriate method 4 Is this PPM for which Medical Physics have supplied Clearance Certification Form 2 l YES NO Enter A in status column of Clearance Certification Form 2
12. cy Re Usable Stainless Steel Vaginal Specula MDA 2003 019 Medical Devices Agency Safety Notice Enteral Feeding Systems MDA SN 2000 27 Medical Devices Agency Single Use Medical Devices Implications and Consequences of Reuse DB 2000 04 Microbiology Advisory Committee to the Department of Health Sterilization Disinfection and Cleaning of Medical Equipment guidance on Decontamination Part Principles Part 2 Protocols amp Part 3 Procedures Microbiology Advisory Committee to the Department of Health 1997 Sterilisation Disinfection and Cleaning of Medical Equipment Guidance on Decontamination Medical Devices Agency NHS HDL 2003 42 Decontamination NHS Scotland Sterile Services Provision Review Group NHS Scotland Sterile Services Provision Review Group Ist Report NHS Scotland The Glennie Report 2001 Safety Action Notice Inadequate disassembly of surgical instruments prior to cleaning and sterilization risk of contamination SAN SC 99 02 Safety Action Notice Reporting of Adverse Incidents in NHS Scotland SAN SC 01 01 113 NHS Lanarkshire Section I N f S Health Protection Committee Effective From October 2013 V Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date September Environment including the use of single use and 2016 single patient use items Scottish Health Facilities Note 30 version 2 Infection Control in th
13. e Built Environment Design and Planning Property and Environmental Forum NHS Scotland 2007 Scottish Office Home amp Health Dept CMO 93 1 Neuro and Ophthalmic Surgery Procedures on Patients with or Suspected to Have or at Risk of Developing Creutzfeldt Jacob Disease CJD or Gerstmann Straussler Syndrome GSS Wilson J 1995 Infection Control in Practice Balli re Tindall 114 NHS Lanarkshire NH S Lanarkshire Section I Health Protection Committee Effective From October 2013 Replaces Jan 2010 SECTION I Decontamination of Equipment and the Review Date September Environment including the use of single use and 2016 single patient use items SYMBOLS USED ON MEDICAL PACKAGING amp THEIR MEANINGS Appendix 1 These symbols are the most common ones appearing on medical devices and their packaging They are explained in more detail in the British and European Standard BS EN 980 1997 Graphical symbols for use in the labelling of medical devices Symbols appearing on medical devices and or their packaging must be adhered to If a user does not understand a symbol they should first look in the instructions for use or user manual explanation BATCH CODE ABC 1234 Synonyms for this are Lot number Batch number USE BY DATE 2002 06 30 DATE OF MANUFACTURE ial 1999 12 SERIAL NUMBER SN ABC123 CATALOGUE NUMBER REF ABC123 STERILE STERIL
14. e is any piece of equipment that is used on a patient It includes all equipment e g stethoscopes blood pressure cuffs as well as surgical instruments Different medical devices require different levels of decontamination The level of decontamination depends on e where the device has been used e the type and amount of contamination e the complexity of the device RISK CATEGORISATION FOR THE DECONTAMINATION OF MEDICAL DEVICES Items in close contact with a break in Sterilisation decontamination to the skin or mucous membrane or be undertaken in a specialist introduced into a sterile body area facility e g Sterile Services Dept refer to Manufacturers user manual Items in contact with intact skin Sterilisation or disinfection particularly after use on infected required Decontamination to be INTERMEDIATE patients or prior to use on immuno undertaken ina specialist facility compromised patients or items in e g Sterile Services Dept or an area contact with mucous membranes or approved in conjunction with the body fluids Infection Control Team Items in contact with healthy skin or not Decontamination may be in contact with patient undertaken in the clinical area 17 NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use
15. es occur on carpets NB _ Spillages within community healthcare settings Healthcare workers cannot use disinfectants to deal with blood and body fluid spillages occurring in the patient s own home because of the possibility of damage Contact a member of the Infection Control Team for further advice NEW EQUIPMENT PURCHASE FOR NHS RESEARCH TRIAL OR LOAN In line with MDS DB 9801 Guidance on the sale transfer of ownership and disposal of used medical devices for hospitals and community based organisations the person who intends to purchase use or loan the equipment must first seek the advice of a member of the Infection Control Team prior to purchase or loan of any equipment which requires and is authorised by the manufacturer for decontamination between patients The NHSL Business Case Form is provided in Appendix 9 of the National Infection Prevention and Control Manual Chapter 1 Standard Infection Control Precautions as contained within NHSL S Control of Infection Manual accessible via through FirstPort via http firstport2 staff support healthcare associated infection Control 20o0f 20Infection 20Manual Chapter 201 Version 202 1 pdf BENCHTOP STERILISERS AUTOCLAVES Bench top sterilisers autoclaves should only be used to decontaminate instruments if sending them to a central sterile service department is not a viable option and only after discussion with the Infection Control Team Performance monitoring To ensure perfor
16. estic Specimen Scales Clean with warm water amp neutral See ward cleaning schedule detergent or detergent wipe Dry thoroughly Shelving amp storage Clean with warm water amp neutral See ward cleaning schedule IV fluids dressings etc detergent or detergent wipe Dry thoroughly NHS Lanarkshire Health Protection Committee NHS Lanarkshire Section I Effective From October A ndix 2 2013 ppe a Replaces Jan 2010 SECTION I Decontamination of Equipment and the Environment including the use of single use and single patient use items Review Date July 2016 EQUIPMENT ITEM Shower chairs Specula vaginal Sphygmomanometer criticon etc Stethoscope Suction equipment wall mounted amp portable Telephones If communal use TENS machines NI CLEANING SCHEDULES FOR CLINICAL STAFF FREQUENCY Between After Monthly 4 4 NI NI NI A 1 24 PREFERRED METHODS COMMENTS Clean with warm water amp neutral If contaminated with blood or detergent or detergent wipe Dry body fluids use a chlorine thoroughly releasing agent Disposable recommended single use Clean with detergent wipe Check manufacturers instructions Clean with detergent wipe Do not use alcohol as it will erode the rubber Clean with warm water amp neutral Filter in a pipeline suction unit detergent or detergent wipe Dry should be c
17. etergent wipes Dry thoroughly Water impermeable cover Clean with warm water and detergent Dry thoroughly Clean with warm water and detergent or detergent wipes Dry thoroughly Include in weekly ward cleaning schedule If contaminated with blood or body fluids use a chlorine releasing agent Include in weekly ward cleaning schedule NHS Lanarkshire Section I N S Health Protection Committee Effective From October Appendix 2 2013 Nees one s Replaces Jan 2010 Lanarkshire 2 SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items CLEANING SCHEDULES FOR CLINICAL STAFF me n T FREQUENCY em Between After baie ao Monthly PREFERRED METHODS COMMENTS Patients Soiling or Other ECG Leads Clean with detergent wipes Dry thoroughly refer to Manufacturers user manual Electric Fans If all areas of the equipment are Include in weekly ward cleaning accessible clean with detergent schedule Complete a wipes Dry thoroughly If unable decontamination certificate before to do so cleaning should be sending equipment to Estates carried out by Estates Department Department on request Endoscopes Manually cleaned to remove soil Follow local guidance on the arthroscopes and then reprocessed in an decontamination of endoscopes bronchoscopes automated endoscope washer colonoscope cystoscopes
18. for clinical purposes only Include in weekly ward cleaning schedule Refer to manufacturer s instructions If unable to decontaminate item appropriately contact the Infection Control Team This is the responsibility of the user Include in weekly cleaning schedule NHS Lanarkshire Section I N S Health Protection Committee Effective From October 2013 M Repl Jan 2010 Lanarkshire eee an SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items CLEANING SCHEDULES FOR CLINICAL STAFF FREQUENCY Between After Monthly Clean with warm water and detergent Dry thoroughly NI N NI Send to Laundry or use N a disposable Disposable jugs recommended EQUIPMENT ITEM PREFERRED METHODS Manual Handling Equipment Ambulift Hoist Hoist slings Measuring Jugs blood body fluids Medicine Cups Nebuliser chamber amp compressor unit Use detergent wipe for compressor The chamber is disposable Occupational Therapy equipment thoroughly o aon 122 Disposable mouthpieces Wash with warm water amp neutral detergent or detergent wipes Dry Appendix 2 COMMENTS Include in the weekly cleaning schedule and include underside feet etc Ensure single patient use Refer to manufacturers guidance If contaminated with blood or body fluids use a chlorine releas
19. for inspection maintenance or repair Guidance on methods of decontamination is provided in Appendix 2 of this guidance For items not covered advice must be obtained from the Infection Control Team An Inspection Servicing or Repair of Medical and Laboratory Equipment Clearance Certification Form 1 must be completed and accompany equipment otherwise repairs may be delayed When completing the form tick one box only i e A B or C fill in the appropriate decontamination details and sign the form The form is provided in Appendix 8 of the National Infection Prevention and Control Manual Chapter 1 Standard Infection Control Precautions as contained within NHSL S Control of Infection Manual accessible via through FirstPort via http firstport2 staff support healthcare associated infection Control 200f 20Infection 20Manual Chapter 201 Version 202 1 pdf Items of equipment which cannot be decontaminated without dismantling by an engineer must be surface cleaned to remove visible soiling and labelled Danger of Infection before being sent for inspection maintenance or repair In these circumstances Box C should be ticked on the form Equipment leaving the premises If equipment is to leave the premises an Inspection Servicing or Repair of Medical and Laboratory Equipment Clearance Certification Form 1 must be enclosed in an envelope affixed to the outside of the package The envelope must be marked Examine enclosed documents before unpa
20. hanged when they thoroughly become discoloured or damp The filters should also be changed after use with a patient with an Infectious Disease Use detergent wipe If contaminated with blood or body fluids use chlorine releasing agent Clean with detergent wipe Refer to manufacturer s instructions Assign to individual patients NHS Lanarkshire Section I N S Health Protection Committee Effective From October Appendix 2 2013 Nees one Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items CLEANING SCHEDULES FOR CLINICAL STAFF EQUIPMENT FREQUENCY ITEM Between After Dai weeae Monthly PREFERRED METHODS COMMENTS Patients Soiling or Other y y Thermometer Clean with detergent wipe Refer to manufacturers instructions Toilet seat raiser Clean with warm water amp neutral Store off the floor detergent If contaminated with blood or body fluids use chlorine releasing agent Clean with warm water amp neutral Toys used in communal areas detergent or detergent wipe Dry must be hard plastic or similar thoroughly If heavily soiled and easily decontaminated Soft discard toys should be patients own For specific detailed guidance please contact the Infection Control Nurse P Disposable recommended Trolleys Use detergent wipe or warm d
21. hcare associated infection Control 200f 20Infection 20Manual Chapter 201 Version 202 1 pdf Hazard warning urine spillages NB Acidic solutions such as urine may react with the chlorine releasing agents and cause the release of chlorine vapour Chlorine releasing agents should therefore not be used directly on urine spills The procedure for managing blood and body fluid spillages is provided in Appendix 11 of the National Infection Prevention and Control Manual Chapter 1 Standard Infection Control Precautions as contained within NHSL S Control of Infection Manual accessible via through FirstPort via http firstport2 staff support healthcare associated infection Control 200f 20Infection 20Manual Chapter 201 Version 202 1 pdf 18 NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items Spillages on carpets Carpets are not recommended for clinical areas Carpets in healthcare premises should be able to withstand decontamination with 10 000 parts per million available chlorine If there are areas that do not meet this standard discolouration will likely occur during decontamination Contact a member of the Infection Control Team for further advice and if large volume body fluid spillag
22. ing agent Where possible allocate machine to patient Meter should be cleaned with detergent wipes if not single use NHS Lanarkshire Section I N S Health Protection Committee Effective From October Appendix 2 2013 Nees one Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items CLEANING SCHEDULES FOR CLINICAL STAFF EQUIPMENT FREQUENCY ITEM Between After baie weete Monthly PREFERRED METHODS COMMENTS Patients or Other Physiotherapy Wash with warm water amp neutral Refer to manufacturers guidance equipment detergent or detergent wipes Dry amp use disposable paper on Wax baths thoroughly benches for each patient Use only on patients with intact skin amp without skin conditions Refer to local guidance for wax Pillows Should have water impermeable cover Wash with warm water amp neutral detergent or detergent wipe Dry thoroughly If contaminated with blood or body fluids use a chlorine releasing agent Clean with warm water amp neutral detergent Podiatry foot baths amp foot rests Refrigerators Clean with warm water amp neutral See ward cleaning schedule detergent or detergent wipe Dry Spillage in a specimen fridge thoroughly should be cleaned using a chlorine releasing agent Drug Dom
23. m water and detergent or use disposable wipes between patients Dry thoroughly Beds as per manufacturer s instructions 117 Clean with warm water and detergent or use disposable wipes Dry thoroughly Clean with warm water and detergent Dry thoroughly Wash tops with detergent wipes daily Wash inside with detergent wipes weekly Clean with warm water and detergent or detergent wipes COMMENTS Store inverted when not in use Do not store items on the floor Do not use alcohol wipes on mattresses NHS Lanarkshire Section I N S Health Protection Committee Effective From October Appendix 2 2013 Nees one Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items CLEANING SCHEDULES FOR CLINICAL STAFF EQUIPMENT FREQUENCY ITEM Between After baie Weeae Monthly PREFERRED METHODS COMMENTS Patients n or Other Bed Pan Holders Clean with warm water and Cleaning should be carried out in detergent or use disposable dirty sink in the sluice wipes Dry thoroughly If contaminated with blood or body fluids use achlorine releasing agent Bed pan Clean the outside with warm Macerator Destructor water and detergent Dry thoroughly Clean with warm water and detergent or use disposable wipes Dry thoroughly Bedpan Storage Rack
24. mance equipment must be maintained and tested as per Health Technical Memorandum HTM 2010 Each steriliser autoclave must have a log book in which the results of routine monitoring examinations tests faults repairs etc are recorded Indicator test strips only demonstrate that a load has been through a steriliser autoclave and cannot be relied on to assess accurately whether sterilisation has been achieved FAILURE TO CARRY OUT PERIODIC TESTS AND MAINTENANCE COULD COMPROMISE SAFETY AND MAY HAVE LEGAL AND INSURANCE IMPLICATIONS N B Anyone operating bench top sterilisers autoclaves must contact their Estates Department for detailed guidance 19 NHS Lanarkshire Section I N H S Health Protection Committee Effective October N J From 2013 Lanarkshire Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items DECONTAMINATION OF HEALTHCARE EQUIPMENT PRIOR TO INSPECTION SERVICE OR REPAIR Equipment which has been contaminated by contact with blood other body fluids or pathological specimens require decontamination prior to examination by third parties Third parties include staff of hospital engineering and medical physics departments manufacturers employees and others who perform inspection and service of equipment Equipment which is visibly soiled must never be presented or sent to third parties
25. ressing water amp neutral detergent Dry thoroughly treatment i e Stryker medicine Ventilation Use detergent wipe on outer This guidance is for loan Home CPAP BIPAP casing equipment only Check manufacturer s guidance NHS Lanarkshire Section I N S Health Protection Committee Effective From October Appendix 2 2013 Nees one s Replaces Jan 2010 Lanarkshire 2 SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items CLEANING SCHEDULES FOR CLINICAL STAFF an T FREQUENCY oem Between After baie weete Monthly PREFERRED METHODS COMMENTS Patients or Other Walking aids Use detergent wipe or warm If contaminated with blood or water amp neutral detergent body fluids use a chlorine Dry thoroughly releasing agent Wheelchairs y Use detergent wipe or warm If contaminated with blood or water amp neutral detergent body fluids use a chlorine Dry thoroughly releasing agent Work surfaces y Use detergent wipe or warm If contaminated with blood or Clinical areas water amp neutral detergent body fluids use a chlorine Dry thoroughly releasing agent X ray equipment y Use detergent wipe or warm Refer to manufacturer s fixed amp portable water amp neutral detergent instructions Dry thoroughly If contaminated with blood or body fluids use a chlorine releasing agent I 26
26. rms of Creutzfeldt Jacob Disease CJD as contained within NHSL s Control of Infection Manual accessible via http firstport2 staff support healthcare associated infection Control 200f 20Infection 20Manual Sect 20W pdf Please contact a member of the Infection Control Team for further advice 112 NHS Sw Lanarkshire NHS Lanarkshire Section I Health Protection Committee Effective From October 2013 Replaces Jan 2010 SECTION I Decontamination of Equipment and the Review Date September Environment including the use of single use and 2016 single patient use items BIBLIOGRAPHY Ayliffe G A J Lowbury E J L Geddes A M amp Williams J D 2000 Control of Hospital Infection A Practical Handbook Chapman amp Hall Health Protection Scotland Compendium of Healthcare Associated Infection Guidance accessible via http www documents hps scot nhs uk hai hai compendium hai compendium y 2 4 pdf Health Protection Scotland Standard Infection Control Precautions National infection Prevention and Control Manual Version 2 1 accessible via http www hps scot nhs uk hatic ic guidelinedetail aspx id 49785 Health Service Guidelines HSG 93 Decontamination of Equipment Prior to Inspection Service or Repair Medical Devices Agency Guidance on the Sale Transfer of Ownership and Disposal of Used Medical Devices MDA DB 9801 Supplement 2 Oct 2001 Medical Devices Agen
27. se must be used once on one patient and discarded as clinical waste Items marked Single Patient Use may be decontaminated and only reused on the same patient provided the manufacturer s instructions on decontamination and reuse are followed PRINCIPLES OF CLEANING DISINFECTION AND STERILISATION The decontamination method selected should be based on the risk of the item acting as a source or vehicle of infection and the optimum process that the item will tolerate 14 NHS Lanarkshire NHS Lanarkshire Section I Health Protection Committee Effective October From 2013 Replaces Jan 2010 SECTION I Decontamination of Equipment and Review September the Environment including the use of single use and Date 2016 single patient use items PRINCIPLES OF CLEANING DISINFECTION AND STERILISATION PROCESS DEFINITION METHOD WHEN CLEANING DISINFECTION STERILISATION Physically removes contaminants including dust soil large numbers of micro organisms and the organic matter that protects them Reduces the number of micro organisms to a safe or relatively safe level Bacterial spores are not usually destroyed A process which if specified conditions are met renders a device sterile i e from all micro organisms and spores BS EN 556 2 2003 Warm water on a damp cloth using a measured dose of general purpose detergent solution in warm water or use detergent wipe
28. terile Laryngoscope blade v supplies department supplies department Laryngoscope handle Laryngoscope handles should be Suction filter cleaned with detergent wipes wall portable do not immerse Auroscope Ear pieces Clean with warm water and detergent or detergent wipes Dry thoroughly or use disposable lt lt 2 f E lt lt 2 ee Baby Equipment Use warm water amp detergent or Breast pump pack disposable baby baths detergent wipes Dry thoroughly Water and detergent not to be used on electrical equipment electric breast pump quip kanmed baby warmer unit and plastic mattress Baby Incubators Clean with detergent wipes and Include in weekly ward cleaning dry thoroughly If contaminated schedule with blood or body fluids use a chlorine releasing agent NHS NHS Lanarkshire Health Protection Committee Section I Effective From October A ndix 2 2013 ppe a Replaces Jan 2010 Lanarkshire SECTION I Decontamination of Equipment and the Review Date July 2016 Environment including the use of single use and single patient use items OEE SCHEDULES FOR CLINICAL STAFF a T OoOo FREQUENCY oO OS CY oem Between After baie ao eee PREFERRED METHODS Patients Soiling Basins plastic Baths showers Shower chairs Beds amp accessories cot sides cradles frames mattresses Beds Specialist Bedside lockers Bed tables or eee Damp dust weekly and clean with war
29. use and Date 2016 single patient use items 1 INTRODUCTION It is not always possible to identify people who are infectious from those who are not Therefore to ensure the safety of those being cared for staff and visitors in the care environment must apply Standard Infection Control Precautions SICPs SICPs are intended for use by all staff in all care settings at all times for all individuals whether infection is known to be present or not This guideline should be read in conjunction with the National Infection Prevention and Control Manual Chapter 1 Standard Infection Control Precautions as contained within NHSL S Control of Infection Manual accessible through FirstPort via http firstport2 staff support healthcare associated infection Control 200f 20Infection 20Manual Chapter 201 Version 202 1 pdf This guideline provides additional actions necessary for the safe use of medical devices and appropriate use of decontamination processes in NHS Lanarkshire to minimise the risk of healthcare associated infection Medical devices can pose significant hazards to patients if they are reprocessed inadequately or incorrectly Additionally risks can arise from equipment that should not be reprocessed i e single use items THE USE OF SINGLE USE AND SINGLE PATIENT USE EQUIPMENT Prior to use packaging must be checked for single use markings and decontamination instructions see Appendix 1 Items marked Single U
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