Decontamination Chapter 8 Part One

Decontamination Chapter 8 Part One

Cleaning

The removal of all visible and non-visible soil, and any other foreign material from medical devices being processed.

Is it really clean?

There are tools that can help us to determine if our cleaning is effective. This picture was obtained by use of a borescope.

Yes.

That was dried blood in a difficult to access area inside of a surgical instrument.

Residual protein detection.

There are systems available to detect residual proteins left on surfaces.

Multiple Choice

It is impossible to know if our cleaning is effective.

• Sadly true

• fortunately false

Set up of a decontamination room

The decontamination area should...

• be close to the source of the majority of soiled instruments, the operating rooms. (if possible)

• have a negative pressure, 10 times per hour the air should be evacuated. The air is considered contaminated.

• have temperature maintained between 60° to 65° f. (for worker comfort and to slow the growth of bacteria)

• have relative humidity maintained between 30% and 60%

The decontamination area should be kept clean.

• Work surfaces should be cleaned and disinfected at the beginning and end of each shift.

• Floors should be mopped daily, spills spot-cleaned immediately.

• Biohazardous waste removed frequently.

• It is a dirty area and that is why extra cleaning efforts are necessary.

Multiple Select

Check all that are true.

• The decontamination area is contaminated due to large amounts of biohazardous materials being delivered.

• The decontamination area should be cleaned regularly.

• The decontamination area is a good place to eat lunch.

Protect yourself and others

Personal Protective Equipment (PPE) must be worn when working with biohazards

Decontamination PPE includes

• Hair covering

• Eye protection

• Fluid resistant mask

• Fluid resistant gown

• Decontamination gloves

• Skid resistant shoe covers

Three sink arrangement

Sink one, wash sink

• warm water and enzymes or detergents

• water hardness, pH , temperature and soils will affect the cleaning process

Sink two, intermediate rinse

• may be plain or softened water (Phoenix water is hard)

• Change regularly so chemicals don't build up

Sink three, final rinse

• using purified water (aka critical water)

• to remove all potential contaminants and not redeposit impurities

• change frequently

Purified (critical) water

final rinse should always be done with purified (critical) water

Water purification systems

• Distillation, heated to steam and condensed

• Deionization, minerals removed through ion exchange

• reverse osmosis (RO), removes pyrogens

Multiple Choice

Purified water is necessary for final rinse and Reverse Osmosis is capable of removing pyrogens from water

• true

• false

Cleaning tools

• Water

• Brushes

• Cloths

• Sponges

• Forced water

• Instrument air

Quality water is the most overlooked yet important cleaning tool

poor quality water can impact the performance of cleaning and disinfecting chemicals

Brushes

• Choose the correct brush

• The brushes pictured are all lumen brushes for different sized lumens.

Using a brush that is too small would be like sweeping a floor with the broom only touching the floor occasionally

why would you do that?

Using too big of a brush is equally ineffective

manufacturer's IFU is a good way to find the recommended brush size

Most commercially available brushes are semi-disposable and should be replaced when worn

Cleaning cloths

reusable, should be lint free, replace often to avoid cross contamination

Sponges

cannot be cleaned