Cleaning Reusable Medical Devices
Cleaning Reusable Medical Devices
Cleaning Reusable Medical Devices
issue
THE
Introduction
By Susan Shoemake, BA and . patient skin, blood and other body fluids and tissues
Kathleen Stoessel, RN, BSN, MS
each year.3 According to the FDA, a medical device
Common Types of Cleaning Solutions...... 6 impact would that have on patients? This article
Factors for Effective Use............................. 7 discusses the risks associated with improper cleaning
Conclusion . .................................................. 9
of reusable medical devices and provides medical
of cleaning solutions.
Cleaning Reusable Medical Devices: A Critical First Step
Figure 1.
Return to Use and
Inventory Contamination
Sorting and
Presoaking
Disassembly
Proper cleaning is essential to reducing the risks associated with improper or inadequate
medical device reprocessing.
Cleaning Reusable Medical Devices: A Critical First Step
Cleaning Reusable Medical Devices: A Critical First Step
Cleaning Reusable Medical Devices: A Critical First Step
Cleaning Reusable Medical Devices: A Critical First Step
Figure 2.
Water
Amylase Enzyme
Detergent
Cellulase Enzyme
Surfactant
Lipase Enzyme
Buffer
Protease Enzyme
Chelating Agents
Most cleaning solutions for medical devices are composed of the following: water, detergents,
surfactants, buffers, chelating agents, and one or more enzymes.
Cleaning Reusable Medical Devices: A Critical First Step
1. Personnel training
Personnel Training
Personnel training is essential for the
effective use of cleaning solutions. It is
critical that personnel with responsibility Appropriate use of PPE is a key factor for the
for any part of device reprocessing be effective use of cleaning solutions.
properly trained and provided with the
tools needed to complete their task Liquid resistant coverings with sleeves,
effectively and safely. surgical face masks and eye protection
should be worn in the decontamination
The training program should include
area. Protective apparel should be changed
education on:
daily and immediately if wet, heavily
■ OSHA Bloodborne Pathogens soiled or visibly contaminated by blood
Standard or body fluids. Surgical head coverings
■ Standard Precautions should completely cover all head and facial
■ Mechanisms of disease transmission hair except for eyebrows and eyelashes.
Clean shoes, designated for facility use
■ Safe handling of chemicals
only, should be skid resistant and durable
■ Reprocessing procedures enough to prevent injury from dropped
■ Device design and component parts items. If shoe covers are selected,
■ Procedures for waste management they should be skid resistant and liquid
■ Maintenance of a safe work resistant or liquid proof. Designated shoes
environment17 and/or shoe covers should be removed
upon exiting the decontamination area.
Appropriate use of PPE
Additionally, general purpose utility gloves
When handling contaminated devices,
should be worn. If gloves become torn,
medical professionals should wear
they should be replaced immediately after
appropriate PPE based upon the degree
appropriate hand washing. Jewelry and
of risk. In the decontamination area, clean
wrist watches should not be worn
uniforms should be donned at the facility.
Cleaning Reusable Medical Devices: A Critical First Step
washed with soap and water. Additionally, the efficacy of the cleaning solution and
hands should be decontaminated after cause spotting on devices. Ideally water
gloves and other PPE are removed in should be filtered through a 0.2 micron
accordance with good personal hygiene filter. Potable tap water may also be used.
practices and departmental policy.12 Filtered water or sterile water is preferable
for rinsing the devices.17
Proper Device Preparation
Prior to cleaning, proper preparation Adherence to Guidelines and
aids in exposing all device surfaces Manufacturer's Directions for Use
to the cleaning solution. This includes It is important to adhere to the
opening scissors, box locks and jaw type manufacturer’s directions for use and
devices, disassembling complex devices applicable guidelines. This will ensure
and pre-cleaning flexible endoscopes. It optimal performance of the solution.
should be noted that “more healthcare- Always refer to the package label for
associated infections have been linked the correct use parameters including
to contaminated endoscopes than to temperature, dilution ratio and soak
any other medical device.”15 Therefore, time, as well as rinsing and drying
endoscopes should be pre-cleaned as per requirements.
the Society of Gastroenterology Nurses &
Typically, a minimum temperature is
Associates [SGNA] Guidelines.3,18
required for the solution to become
To prevent damage to sharp objects and active and to provide adequate cleaning
to protect health care workers from cuts, action. Using water that is hotter than
always isolate sharp objects from other recommended is not advisable as it may
devices. inactivate enzymes contained in the
solution or cause denaturing of protein-
Water Quality
based soils making them harder to
Good quality water is essential. Almost
remove.
all cleaning solutions are packaged as
concentrates; and must be diluted with The dilution ratio needs to be accurately
water. Poor water quality can reduce measured based on the manufacturer’s
Cleaning Reusable Medical Devices: A Critical First Step
Conclusion
Inadequate or improper cleaning of reusable medical devices puts patients at risk for
healthcare-associated infections. HAIs are a major concern in healthcare today and it
is imperative that all medical professionals do their part to reduce these preventable
infections. One step toward this goal is to ensure adequate and proper cleaning of
reusable medical devices. Cleaning essentials for these devices include a thorough
understanding of the risks associated with improper cleaning, the basic components of
cleaning solutions and the factors necessary for the effective use of cleaning solutions.
With this knowledge, medical professionals will be better equipped to promote optimal
patient outcomes.
References
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10
Cleaning Reusable Medical Devices: A Critical First Step
15. D
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Technologies Require Thorough
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