Policy on Cleaning and Disinfection of Equipment, Surfaces
Contents
1. Hair Brushes Single patient use Height stick Clean using either detergent and hot water or detergent wipes after use at the end of each session and store clean and dry Hoists At Hospital sites Clinics Clean between each patient use either detergent and hot water or a detergent wipe Hoists are also subject to a pre planned maintenance work through the works department In patients own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid Hoists are subject to a maintenance programme through central equipment stores When no longer required these should be returned to central equipment stores for cleaning prior to re issue Hoist slings and Hoist slings At hospital sites Any soiling of fabric items slide sheets fabric Patients must have either their own re useable hoist sling or must be laundered disposable sling until discharge from hospital On discharge immediately and must not it should be sent for laundered or disposal be washed by hand in the Hoist slings In patients own homes department Patients must have their own hoist sling When no longer required these should be returned to central equipment All hoist slings are subject to stores for cleaning prior to re issue maintenance programme Sliding sheets At hospital sites either through works Patients must have their own sliding sheet if required which depar2. Policy Statement This policy is recommended for best practice and providers are expected to implement wherever practicable risk assessments must be submitted to the decontamination lead for instances when this policy is not adhered to 4 Responsibilities It is the responsibility of all staff to ensure that they adhere to best practice 5 Policy monitoring It is the responsibility of all department heads professional leads to ensure that the staff they manage adhere to this policy The community services decontamination lead will audit the use of this policy in conjunction with department heads professional leads of Community Services bi annually and submit to JICC as part of the annual decontamination report Team leaders are required to complete all required audits 6 Review This policy will be reviewed by the Infection Prevention and Control Team in conjunction with community services decontamination lead 7 Guidance on the use of Health Care Devices Single use The medical device is intended to be used once on an individual patient during a single procedure and then discarded It is not intended to be re processed or re used on another patient The re use of single use medical devices can affect their safety performance and Page 4 of 24 effectiveness exposing patients and staff to unnecessary risk Current Health Service Circulars HSC s and MDA guidance clearly state that medical devices designated for single use must neve
3. and hot water detergent wipe between patients and at weekly intervals rinse and dry Disposable paper sheeting should be used to cover the examination couches This covering should be single use only and changed between patients If the plastic cover becomes torn or damaged the couch should be re upholstered or replaced Alcohol wipes should not be used to clean this equipment Crockery cutlery Machine wash Rinse temp above 80C Curtains Routine change every six months immediately if contaminated Infection Prevention and Control team may request additional cleaning for some specific infections Damp dusting Detergent and hot water using appropriate colour coded cloth Denture pots Patients must have their own named denture pot These must remain single patient use Clean with hot water and detergent Store dry when not in use Discard after patient discharge Dental chair Clean with hot water and detergent and dry before and after each session Drip stands At Hospital sites Store clean and dry and Clean with detergent and hot water between patient use if soiled and at least weekly If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry keep dust free when not in use Page 14 of 24 Item Recommended Method Comments thoroughly In patients own homes It is the user s
4. by cleaning e Incorrect concentrations may render a disinfectant ineffective 9 3 Sterilisation Sterilisation is a process used to render objects free from viable micro organisms including bacterial spores and viruses Page 8 of 24 10 Choosing the appropriate method of Decontamination Risk Indication Recommendation High Items that penetrate skin Cleaning followed by Sterilisation mucous membranes or enter sterile body areas Medium Items in contact with intact Cleaning followed by Disinfection mucous membranes or Except for instruments used in the contaminated with blood body vagina or cervix e g speculae which fluids must be sterilised between each use Low Items in contact with intact skin Cleaning or not in direct patient contact Chlorine Tablet size 0 5g 1 7g 2 5g 5g releasing tablets tablets tablets tablets agent dilution instructions Blood spillage Number of tablets 18 10 7 4 Opener Amount of water in litres 0 5 1 1 1 General clinical Number of tablets 4 1 1 1 o Amount of water in litres 1 1 1 5 3 It is essential that fresh batches of the chlorine releasing solutions are made up as required Made up solutions must be discarded after 24 hours Inpatient areas must use Acticlor plus for high level cleaning to kill bacteria viruses and spores It is vital that where possible the area is well ventilated when using this product and P
5. detergent wipe Vaginal Probes Single patient use Vacutainer needle holders Single use discard after each procedure Page 21 of 24 Item Recommended Method Comments Vaginal Cones Single patient use Volumatic Single patient use Vomit bowls Disposable single use discard into macerator or dispose of contents into a lavatory and then dispose of receptacle in yellow clinical waste bag Wax baths Wax should be processed between patients at 70 C for at Only use on patients with least 3 minutes intact skin and without skin condition Wheelchairs At Hospital sites Clean weekly and when visibly soiled with hot water and detergent detergent wipes If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly In patients own homes It is the users responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid Weighing scales Line with disposable paper towels Clean with hot water and seated adult detergent detergent wipe If contaminated with blood or body fluids clean with detergent and hot water followed by disinfection using a chlorine releasing agent and dry thoroughly Work Surfaces Clean daily with hot water and detergent detergent wipes If there is a particular item not stated above please contact the Infe
6. e g mattresses cushion At Hospital sites Must be allocated to an individual patient cleaned when soiled and on discharge using hot water and detergent and dried thoroughly In patients own homes If contaminated with body fluids refer to manufacturers instructions Page 19 of 24 Item Recommended Method Comments It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue Razors wet shave Use disposable single use or patients own Do not allow sharing of razors Razors electric Patients own only clean as per manufacturers instructions Do not allow sharing of razors Scales Clean with detergent and hot water or detergent wipes after each use Scissors Use sterile scissors for aseptic procedures discard single use into sharps container return reusable scissors to HSDU for reprocessing Non sterile scissors should not be used for wound dressings Any non sterile scissors used for non clinical tasks e g flowers admin should be washed and dried thoroughly in detergent and hot water and wiped over with steret before and after each clean use Speculae vaginal Single use items Sputum pots Single use items change daily Sphygmomanomet See b
7. must be used in all cases Bed pans In patients own homes Empty contents down the lavatory wash with detergent and hot water and dry Store to keep dust free When no longer required these should be returned to central equipment stores for cleaning prior to re issue When undertaking these procedures appropriate personal protective equipment must be worn Bedpan holders slipper pan holders Wash with detergent and hot water after every use dry and store If visibly contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent These items should be replaced if showing signs of degradation Blinds horizontal and vertical Keep dust free clean as per manufacturers instructions Contact Infection Prevention and Control if considering purchasing blinds or replacing existing blinds Blood glucose monitoring pen Single patient use only only use for one patient Totally disposable units The lancet containing the sharps should be discarded into sharps container conforming to British or United Nations current standards Blood pressure sphygmomanomet er and cuff Wipe with hot water and detergent at least weekly or sooner if visibly contaminated If unable to clean following contamination discard Blood pressure cuff should not be placed next to broken skin if this unavoidable please contact infection prevention and control F
8. own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue age or wear and tear they must be taken out of use and disposed of Lavatory brushes Store dry Rinse thoroughly in toilet in flushing water and leave to dry in open sided holder This is covered by the contracted cleaning team The brushes should be changed when visibly soiled and always discarded following an outbreak or if used to clean a lavatory used by patients suffering from Clostridium Difficile Linen Trolley Linen Skip Should be cleaned with hot water a detergent at least weekly If contamination occurs it should be cleaned immediately If contaminated with blood or body fluids clean with detergent and hot water followed by disinfection using a chlorine releasing agent and dry thoroughly Locker Tops and Tables At Hospital sites Clean with detergent and hot water and dry thoroughly daily and on patient discharge If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly In patients own homes Page 18 of 24 Item Recommended Method Comments It is the user s responsibility to keep equipment dust free If visibly soiled pleas
9. responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid and dry thoroughly Dressing trolleys Wash entire trolley with hot water and detergent or use detergent wipe before and after use If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly Drainage and suction jars 1 Disposable vacuum containers 2 Suction jars 3 Under water seal bottles Use Vernagel gelling granules Place in double yellow orange bag for incineration Where possible use disposable Non disposable i e glass and re useable empty down sluice clean with hot detergent and water and disinfect bottle in 10 000ppm chorine releasing agent then dry thoroughly Use disposable Store clean and dry and keep dust free when not in use For non disposable suction jars used for one individual patient the contents of the jar should be emptied into a lavatory if a sluice is not available Then clean the jar with detergent and hot water It will require disinfection before use on another patient Ear syringing equipment Propulse Each day before use the propulse must be disinfected using a chlorine based product to strength 1 000ppm Fill tank with solution run the machine to allow the solution to fill the pump and flexible tubing Leave to stand for 10 minutes Empty the tank
10. settings in south west London sector Health Protection Agency 2003 Infection Control in the Community 2003 Lawrence J May D Churchill Livingstone http www infectioncontrolservices co uk wound_ cleaning htm Infection Control Manual Decontamination Guidelines 2006 http www infectioncontrolservices co uk disinfection decontamination htm Infection Control Prevention of Healthcare Associated Infection in Primary and Community Care 2003 National Institute for Clinical Excellence Irrigating simple traumatic wounds A review of the current Literature 2005 Dulecki M Pieper B Mich D Journal of Emergency Nursing 31 2 p156 160 Keep it Clean and Healthy Infection Control Guidance for Nurseries Playgroups and other Childcare Settings ICNA and CPHVA MDA Bulletin MDA DB2000 04 Single Use Medical Devices Implication and Consequences of Reuse August 2000 Principles and Practice of Disinfection Preservation and Sterilization third edition 1999 Hugo W B Ayliffe G A J Blackwell Science Single Use Medical Devices Implications and Consequences of Reuse MHRA DB2006 04 October 2006 Safety of electrical motor operated industrial and commercial cleaning appliances Specification for type H industrial vacuum cleaners for dusts hazardous to health 1986 BS5415 2 2 supplement No 1 Saving Lives High Impact Intervention No 2b Peripheral Line Care Department of Health 2006 The NHS Cleaning Manua
11. GE 1 Introduction 4 2 Purpose and scope 4 3 Policy statement 4 4 Responsibilities 4 5 Policy monitoring 4 6 Review 4 7 Guidance on the use of Health Care Devices 4 6 8 Examples of commonly used symbols 7 9 Methods of decontamination 8 10 Choosing the appropriate method of decontamination 9 11 Environmental cleaning following patient discharge or bed 9 movement 12 Cleaning of skin 10 13 Cleaning disinfection chart A Z 11 22 14 Dealing with spillages 22 23 15 References 24 16 Author 24 Page 3 of 24 1 Introduction All medical devices equipment and the environment in healthcare settings may become contaminated with micro organisms and thus can present a risk to patients as well as to those subsequently handling or using equipment Safe and effective decontamination of all re useable equipment between uses is an essential part of routine infection prevention and control practice Inadequate decontamination has been responsible for outbreaks of infection in healthcare establishments Similarly skin may also be contaminated with micro organisms and can develop into a source of infection due to flora transfer both to the patient and others It is therefore essential to practice and encourage standard principles of infection control including hand hygiene at all times and with all patients 2 Purpose and scope This document applies to all staff employed by NHS Great Yarmouth and Waveney 3
12. Great Yarmouth and Waveney Policy on Cleaning and Disinfection of Equipment Surfaces Environment and Skin Page 1 of 24 Document Control Sheet Name of Document Policy on Cleaning and Disinfection of Equipment Surfaces Environment and Skin Version 4 File location Document name Date of this version February 2011 Produced by Community Infection Control Nurse Reviewed by JICC Synopsis and Outcomes of Consultation Undertaken JICC Reference to key guidance documents Synopsis and Outcomes of Equality amp Diversity Impact Assessment No specific issues National EIA gives more details on measures to reduce HCAls Board committee approval at meeting on JICC 8 3 2011 Publication date March 2011 Distribute to Clinical staff Due for review by Board committee no later than 31 March 2013 Enquiries to gyw pct infectionprevention nhs net Revision History Revision Summary of changes Author s Version Date Number February References updated Decontamination 4 2011 lead and Infection Prevention and Control Specialist Approvals This document requires the following approvals either individual s group s or board Name Title Date of Issue Version Number JICC 8 3 2011 4 Page 2 of 24 CONTENTS PA
13. PE is worn when mixing as well as using chlorine releasing products cold water dilution will minimize the odour are to be followed 11 Environmental cleaning following patient discharge or bed movement 1 Patient bed areas to include beds table locker chair and all other equipment used in that area e g drip stands must be cleaned thoroughly with hot water and detergent following discharge before next patient can be admitted into the vacated bed space 2 Areas occupied by patients with a known infection should be cleaned using hot water and detergent then disinfected using a chlorine releasing agent 3 The Infection Prevention and Control team may be contacted for further advice regarding curtain changes and steam cleaning etc 4 Any contamination of the walls should be cleaned immediately therefore terminal wall washing is not required Page 9 of 24 12 Cleaning of skin Procedure Product Skin Hand Washing For normal hand washing liquid soap is adequate Patients at bed side must be offered hand wipes after using the commode and before meals if unable to access soap and water Skin Hand sanitiser should be used if hands Hand rubs visibly clean and no contact with patient suffering from diarrhoea This gel should be available at the point of use and be an approved brand Skin Injection Sites Venepuncture Cannulation site Clean with 70 isopropyl alcohol e g steret me
14. ash with detergent and hot water dry thoroughly Following use discharge of In patients own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue a patient with a known infection or when contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent Bedside tables In Hospital setting Page 11 of 24 Item Recommended Method Comments Clean with detergent and water and dry thoroughly daily if soiled or if patient discharged If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent for dilution see page 9 and dry thoroughly In patients own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue Bed pans Disposable disposed of into macerator In the event of machine failure inform works department immediately and dispose of bedpan contents urinal into lavatory or sluice then place bedpan urinal into clinical waste bag for disposal Inserts
15. ction Prevention and Control Department for further details 01502 719534 All wards and departments are required to maintain a inventory of equipment with a cleaning schedule and proof of compliance that will be checked at the departments annual infection control audit 14 Spillages Procedure for Dealing with Body Fluid Spill on Hard Surface e All spillages should be considered potentially infectious regardless of the patient s condition Blood and body fluids may carry infectious micro organisms e Clinical staff are responsible for cleaning and disinfection of blood and body fluid spillages and should do so promptly wearing the correct personal protective equipment PPE see standard precautions policy following one of the two methods described below e All waste materials generated when mopping up body fluid spills should be treated as Hazardous and disposed of accordingly e Hands must be washed following removal of PPE Method 1 e Sprinkle absorbent disinfectant granules over the spillage and allow them to absorb the liquid for about 2 minutes e Remove waste and dispose of in a yellow orange waste bag Hazardous waste e The area must then be cleaned thoroughly using detergent and water and dried Page 22 of 24 Method 2 e The spillage should be covered with disposable paper towel to soak up excess These should then be gathered up and placed in a yellow orange waste bag Hazardous waste e The area must th
16. d be vacuum cleaned or with a dust attracting dry mop Vacuum cleaners need to comply with standards set in BS5415 Flower Vases Wash with hot water and detergent and dry thoroughly Store clean and dry and keep dust free when not in use NOT IN THE SLUICE Foam Wedges At hospital sites Clean on patient discharge or when visibly soiled Clean with hot water and detergent detergent wipes and dry thoroughly If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent In patients own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue Use only if covered with a plastic waterproof cover Glucometer Clean machine with hot water and detergent detergent wipes weekly unless contaminated with blood or body fluids then clean immediately Test strips single use only Gym Equipment used by physio Clean all equipment with either hot water and detergent or detergent wipes between patient uses If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent for dilution Page 16 of 24 Item Recommended Method Comments see page 8
17. d to the sterile services removers department Instrument Once emptied the container can be placed through a washer transport container disinfector if available If washer disinfector not available dental and clean with detergent and water followed by disinfection using podiatry a chlorine releasing agent and dry thoroughly Interferential pads Refer to manufacturer s guidance Jugs non sterile procedures i e those used measure urine Disposable urinals should be used for emptying catheter bags Jugs used for the measurement of urine are single use disposable and must not be left in the sluice Kidney Dishes Disposable single use Discard into macerator if available if not available dispose of empty receptacle in yellow orange clinical waste bag Kidney dishes should not be used as vomit bowls Laryngoscopes Blades disposable single use Handles wipe with hot water and detergent If contaminated with blood or body fluids clean with detergent and hot water followed by disinfection using a chlorine releasing agent and dry thoroughly Lavatories At Hospital sites If these items show signs of including raised lavatory seats Cleaning should be undertaken daily and when soiled Clean both sides of the seat with detergent and hot water If patients using facilities suffering from diarrhoea clean with detergent and water followed by disinfection using a chlorine releasing and dry thoroughly In patients
18. disposal tourniquets should be available for individual patients and disposed of on discharge If the above unavailable wipable material tourniquets should be used and cleaned between patient use with detergent wipes If contaminated with blood or body fluids these should be disposed of Fabric Tourniquets are not recommended as they are impractical to clean Toys Toys must be cleaned with hot water and detergent detergent wipes at least weekly and when soiled Soft toys and those made of wood are not recommended as they are impractical to clean Toy cleaning schedule should be available and records kept Urinals At Hospital sites Disposable disposed of into macerator In the event of machine failure inform works Department immediately and dispose of bedpan contents urinal into a lavatory or sluice then place bedpan urinal into clinical waste bag for disposable In patients own homes It is the user s responsibility to empty contents down a toilet rinse thoroughly and dry Store to keep dust free When no longer required these should be returned to central equipment stores for cleaning prior to re issue Ultrasound probes To be used only on intact skin For Leg Doppler Remove gel from probe after each use with disposable paper towel Then wipe the probe with a detergent wipe Abdominal Bladder Scans Remove gel from probe after each use with disposable paper towel Then wipe the probe with a
19. diswab prior to injection unless otherwise contra indicated by the manufacturers Swab the intended site with a swab containing 70 alcohol and allow to dry Swab the intended site with a swab containing 70 isopropyl and 2 chlorhexidine gluconate and allow to dry see guidelines in Saving Lives VIP scoring must be documented Wound Cleaning Wounds with minimal to moderate discharge can be cleaned with warm normal saline 0 9 sterile solution Tap water of drinking quality can be used to irrigate wounds and to soak leg ulcers prior to dressings Page 10 of 24 13 Cleaning Disinfection Chart A Z Item Recommended Method Comments Acupuncture Single use Discard into sharps needles container conforming to British or United Nations current standards Airways Single use Ambu bag re breathing bags Dispose of filter and mask between uses and use disposable ambu bags Ampoules No preparation required Discard into sharps container conforming to British or United Nations current standards Auroscopes Detachable earpieces single use item Baby changing Cover with disposable paper roll and change between each If the plastic cover becomes mats baby Clean with hot water and detergent at the end of the torn or damaged the mat session or use a detergent wipe If contaminated with body must be discarded fluids mop up excess soiling with paper towels clean as above then wipe with 70 isopropyl a
20. e clean with warm water and detergent washing up liquid Mattress At Hospital sites Mattress must have plastic Wash with detergent and hot water detergent wipes and dry Cleaning required if soiled and on patient discharge If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly In patients own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue waterproof cover In the event of the outer plastic cover becoming damaged split the item should be disposed of as clinical waste Specialist mattresses should be cleaned according to manufacturers instructions Medicine pots spoons These are single use items only Monkey poles See bed frame cleaning Mop heads See Cleaning Equipment Nebulisers mask Single patient use between use wash chamber and mask Clean the machine as per and tubing thoroughly with hot water and detergent rinse and dry manufacturers instructions thoroughly Replace weekly or if heavily soiled When patient discharged discard single patient use item Needles Single use only Oxygen tubing and mask Single patient use Each patient must have their own mask and tubing masks which s
21. en be cleaned thoroughly using detergent and hot water and dried e The area must then be disinfected using a chlorine releasing agent Urine and vomit spillages e Chlorine releasing agents must never be poured directly onto urine or vomit as this causes chlorine gas to be released e For urine and vomit spillages follow method 2 Spills on soft furnishings e Clean spills immediately e Cover with disposable paper towel to soak up excess These should then be gathered up and placed in a yellow waste bag Hazardous waste e The area must then be cleaned thoroughly using detergent and hot water e A steam clean should then be carried out by contract cleaners this will need to be requested Page 23 of 24 15 References Applying the principles of infection control to wound care 2000 Parker L British Journal of Nursing Vol 9 No 7 p 394 404 Common problems in wound care wound cleansing 1995 Young T British Journal of Nursing Vol 4 No 5 p286 289 Department of Health 2010 The Health and Social Care Act 2008 DoH London403423 Essential Steps to Safe Clean Care Enteral Feeding 2006 Department of Health Guidelines for Enteral Tube Feeding in the Acute Setting reducing the risk of microbial contamination Norfolk and Norwich University hospital NHS Trust amp James Paget Healthcare NHS Trust Guidelines for the Control of Infection and Communicable Disease in Nurseries and other institutional early year s
22. f plastic bag lining splits clean with detergent and water followed by disinfection using a chlorine releasing agent for dilution see Page 8 and dry thoroughly Store clean and dry Car seats Follow manufacturers guidance replace when visibly contaminated with blood or body fluids Carpets Vacuum daily Vacuum cleaners need to comply with CARPETS ARE NOT standards set in BS5415 Carpets in clinical area requirea6 RECOMMENED FOR monthly carpet shampoo Clean spills immediately The CLINICAL AREAS as they area should be immediately shampooed are impractical to clean Alternative types of flooring must be considered when replacing Catheter bag In Hospital settings If using metal plastic coated holders Clean with hot water and detergent detergent wipes catheter stands the plastic between patients and at least weekly If contaminated with should be intact blood or body fluids immediately clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly In patients own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue Cervical Single patient use only diaphragms and caps practice caps Cleaning equipment 1 Wet mops 2 Mop buckets Disposable items Clean wit
23. h hot water and detergent after each use and dry thoroughly store inverted Chairs At hospital sites and PCT health centres Fabric chairs are Clean with detergent and hot water rinse or use detergent unsuitable for clinical areas wipes and dry thoroughly daily if soiled or if patient as they are impractical to discharged or at the end of each clinic clean All chairs must be In patients own homes made of a fire retardant It is the users responsibility to keep equipment dust free If material visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue Combs Patients must have their own individual comb When visibly soiled clean with hot water and detergent and dry thoroughly Commodes At Hospital sites Disassemble and clean Clean all surfaces with hot water and detergent and dry commode thoroughly at Page 13 of 24 Item Recommended Method Comments thoroughly between each use If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly In patients own homes It is the responsibility of the user s to ensure the commode pot is emptied into a lavatory then rinsed and dried thoroughly The pot should be stored in the commode It is the user s responsibility to keep equipment dus
24. hould be cleaned with hot water and detergent as required if soiled and change at least weekly Discard on discharge from hospital O2 machine Follow manufacturer s instructions damp dust daily clean filters weekly when in use or after each patient use Peak flow Use single use disposable mouthpieces Wherever possible allocate machines patients their own machine Pillows Examination couches pillows should be cleaned with hot Pillows must have plastic water and detergent at the end of the day cover In the event of the outer Inpatient Services clean with hot water and detergent on plastic cover becoming patient discharge and when soiled damaged the item should be disposed of as clinical waste If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly If contamination has leaked onto the fabric then the pillow must be disposed of as Clinical waste Podiatry chair Clean with hot water and detergent and dry before and after each session Use paper couch roll for each patient Podiatry Clean entire trolley with hot water and detergent at the Ensure no items are left on workstation trolley beginning of the session and when visibly soiled Wipe with detergent wipes between each use the trolley when not in use Pulse oximeter Clean with detergent wipes between patients and at least weekly Pressure relieving aids
25. ibly soiled please clean with warm water and detergent washing up liquid At both sites Syringes these are single patient use and may be re used for a specified patient and that patient only for a period of no longer than 24 hours Separate syringes should be used for medication flushing feeding and aspiration All syringes should be cleaned thoroughly after each use with warm water mild detergent and then allowed to air dry Syringes should be stored covered When no longer required these should be returned to central equipment stores for cleaning prior to re issue Examination couches Please see couches Examination lamps Wipe with damp cloth with hot water and detergent detergent wipe daily and when visibly soiled Ensure that electrical supply is turned off before cleaning do not use large amounts of water Enuresis mats Single patient use wash with detergent and water follow manufacturers instructions Enuresis Alarms As per manufacturers instructions Fans Need to be kept dust free The outside and guard can be cleaned with detergent wipes when not operating To clean the blades fan must first be dismantled by an appropriately trained person When purchasing new or replacing existing fans please contact Infection Prevention and Control for advice Floors wet Floors dry Should be cleaned with a detergent solution Disinfection is not normally required Shoul
26. l 2009 NPSA Department of Health The Need for Skin Preparation Prior to Injection point counterpoint 2005 Pratt Ru Hoffman PN Robb FF British Journal of Infection control Vol 6 no 4 p18 20 The Principles of Decontamination 2000 Booth C Nursing Times Plus Vol 96 no 38 p2 The Primary Ear Care Centre 2006 http www earcarecentre com cleaning htm Revised guidelines on contracting for cleaning 2004 NHS Estates Department of Health Using a non sterile technique in wound care 1998 Hollinworth H Kingston J Professional Nurse Vol 13 No 4 p 226 229 16 Author Infection Prevention and Control Team Page 24 of 24
27. lcohol wipe Baby Scales Line with disposable paper roll and change this between each baby Clean with hot water and detergent at the end of each session or detergent wipe If contaminated with body fluids mop up excess soiling with paper towels clean as above then wipe with 70 isopropyl alcohol wipe Baths bath hoists and seats wash basins shower chairs and seats Clean with hot water and detergent or cream cleaner after each patient Baby feeding bottles and teats Baby feeding equipment must be disinfected between use by either a cold sterilising unit or a steam steriliser following manufacturers guidelines Wherever possible encourage parents to bring in pre made up bottles that once used are rinsed and returned to the parent for cleaning at home Bed Cradles In hospital setting In hospital setting Wash with detergent and water and dry thoroughly Following use discharge of In patients own homes a patients with a known It is the user s responsibility to keep equipment dust free If infection or when visibly soiled please clean with warm water and detergent contaminated with blood or washing up liquid body fluids clean with When no longer required these should be returned to central detergent and water equipment stores for cleaning prior to re issue followed by disinfection using a chlorine releasing agent dilute as per instructions Bed frames In Hospital setting In hospital setting Bed sides Daily w
28. le use only Tubing Single patient use flush through after each use and change every seven days unless copious amounts of secretions are present if this is the case change daily Also see Drainage amp Suction Jars Page 20 of 24 Item Recommended Method Comments Machine It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid Filter changes and maintenance carried out by central equipment services on long term loans as necessary When no longer required these should be returned to central equipment stores for cleaning prior to re issue Tens machine Pads should be disposable single use items Leads and machine wipe with detergent wipe between uses by different patients at least weekly or if dirty If contaminated with blood or body fluids refer to manufactures instruction Telephones Keep dust free Phones should be wiped with detergent wipes and then dried It is expected that clinical staff take responsibility for the cleaning of this equipment Tomometer Heads Follow manufacturers guidance Thermometers Use disposable thermometers or those with a disposable Mercury thermometers are sleeve Digital use a new sleeve cover for each use NOT recommended Wipe thermometer with alcohol wipe between patients Toothbrushes Single patient use only Tourniquets Ideally
29. lood pressure cuffs ers Stethoscopes Wipe the bell and diaphragm the ends with Steret between Infection Control patient contact Earpieces should be removed and cleaned with detergent and hot water detergent wipes recommends that each member of staff has their own Stethoscope Sticks frames and crutches At Hospital sites and clinics Clean with hot water and detergent detergent wipe In patients own homes It is the user s responsibility to keep equipment dust free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue Suction equipment All new suction machines purchased must be of a type with disposable collection bottle liners At Hospital sites Change liner daily when in use Accessories Suction catheters single use Use once and discard Filters disposable change every three months or when wet or visibly soiled or as otherwise instructed by manufacturers Tubing must be single patient use Machines wipe weekly or when soiled with hot water and detergent detergent wipes Dry thoroughly In patients own homes Bottles If disposable available change liner daily If non disposable collection jars used the contents should be emptied down a lavatory and then cleaned with hot water and detergent and dried thoroughly Suction catheters sing
30. or Doppler Cuffs please follow manufacturer s instructions Ideally patients in isolation should have their own blood pressure cuff When purchasing new products avoid cloth where possible to improve the ability to clean the equipment Breast pumps Only electric breast pumps should be loaned a supply of disposable milk collection sets should also be provided Advice to mother is that the pump is cleaned with detergent and hot water then dry thoroughly daily Advice to staff on return of pump clean as per manufacturers instructions Hand breast pumps should not be loaned out as no disposable milk collection sets are available Bowls washing Patients must have own individual wash bowl They must be cleaned with detergent and hot water rinsed and stored dry in or behind the patient locker not on the floor Spare bowls must be stored dried separately stacked upside down in pyramid formation off the floor in a clean area Buckets Wash with hot water and detergent rinse and store dry Page 12 of 24 Item Recommended Method Comments Following contact with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly Buckets for Leg Ulcers Line with a plastic bag with only one opening and no holes After each use dispose of the bag clean the bucket with hot water and detergent and rinse and dry thoroughly I
31. other contaminants reaching a susceptible site in sufficient numbers to initiate infection or any other harmful response It includes the processes of e Cleaning e Disinfection e Sterilisation 9 1 Cleaning Cleaning is a process that physically removes extraneous matter from devices but does not destroy all micro organisms 9 1 1 Manual Cleaning This can be achieved manually with detergent and hot water prepared in clean container and with the use of a disposable cloth Drying is essential to prevent any remaining bacteria from multiplying 9 1 2 Mechanical cleaning these are not currently by used in NHS GY amp W community services staff There are two main types of mechanical cleaning e An Instrument Washing Machine will wash and dry devices This machine should be used strictly to manufacturer s instructions e The preferred method of mechanical cleaning is by Ultrasonic apparatus This dislodges organic and other matter from surfaces 9 2 Disinfection Disinfection is the removal or destruction of micro organisms but not necessarily bacterial spores and or some viruses e Disinfection does not sterilise e Disinfection of medical devices must be carried out by properly trained and competent staff e Disinfection should be carried out to a written procedure based on a risk assessment and in accordance with manufacturer s instructions e Disinfection can be achieved by heat or by chemical means and must always be preceded
32. r be re used A European standard symbol is used on packaging for all medical devices intended for single use only All staff involved in the decontamination process should be aware of and understand this symbol and its meaning Single Patient use The medical device can be used more than once on one patient only The device may need to be decontaminated between each use Re usable The medical device can be used for repeated episodes on different patients but requires appropriate decontamination between each use The following leaflets are produced by the Medicines and Healthcare products Regulatory Agency MHRA and are a useful source of relevant information and explanation Page 5 of 24 Single use Medical Devices How do I know if a device is for single use It will have this symbol on the packaging or the device What does single use mean Do not reuse A single use device is used on an individual patient during a single procedure and then discarded It is not intended to be reprocessed and used again even on the same patient Is single patient use the same as single use No Single patient use means the medical device may be used for more than one episode of use on one patient only the device may undergo some form of reprocessing between each use Crown copyright except single use symbol reproduced with permission from BSI 389 Chiswick High Rd London W4 4AL N Why shouldn t they be reu
33. sed N The MHRA is aware of serious incidents relating to reuse of single use devices ie Reuse can be unsafe because of risk of cross infection inability to clean and decontaminate due to design endotoxin reaction excessive bacterial breakdown products which cannot be adequately removed by cleaning patient injury device failure from reprocessing or reuse because of fatigue material alteration and embrittlement e chemical burns or sensitisation residues from chemical decontamination agents on materials that can absorb adsorb chemicals Also if you reuse a single use device you may be legally liable for the safe performance of the device Can sterilise a single use device A few single use devices are marketed as non sterile These may require processing in line with the manufacturer s instructions to make them sterile and ready for use You must not resterilise them Page 6 of 24 October 2006 website version 8 Further examples of symbols commonly used on health care devices and their packaging These 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 If further clarification is required please refer to the product instructions or user manual Page 7 of 24 9 Decontamination Decontamination is a process that removes or destroys contamination and thereby prevents micro organisms or
34. t free If visibly soiled please clean with warm water and detergent washing up liquid When no longer required these should be returned to central equipment stores for cleaning prior to re issue least daily At the end of each shift is recommended A record of cleaning must be maintained If used for patient suffering from diarrhoea disinfect commode following cleaning with 1000ppm chlorine releasing agent Computers and other IT equipment in clinical areas Keep dust free If possible cover keyboard with plastic cover the keyboard should be wiped with a detergent wipe and then dried It is expected that individual staff clinical staff take responsibility for the cleaning of this equipment Decontaminate hands after touching the keyboard either by washing or use of sanitising gel Ensure that electrical supply is turned off before cleaning do not use large amounts of water Cold hot pad Must have a plastic covering to aid cleaning after each use Do not store in drug or food with hot water and detergent or detergent wipes then dry fridge thoroughly Community Clean by wiping over the bag with damp cloth containing If bag machine washable equipment bags including those used by District Nurses detergent and water detergent wipe This should be undertaken at least weekly follow manufacturers instructions regarding temperatures and wash weekly Couches examination Clean with detergent
35. then rinse the system through with tap water before use At the end of the day disinfect as above Rinse the machine through with running sterile water and dry thoroughly Jet tip Applicators Single use disposable to be used Jobson Horne Probe Return to appropriate sterile services Speculum for Otoscope Disposable single use item Nootes Ear Tank Return to appropriate sterile services Earphones Wipe with a dilute detergent solution or detergent wipe between patients Where possible use single patient earphones for disposal on discharge To include earphones used for audit testing ECG Equipment machine and leads Wipe with a dilute detergent solution or detergent wipe Wipe at least weekly and if soiled Electrodes must be disposable Store clean and dry and keep dust free when not in use Eye testing glasses and vision eye patches Wipe with a dilute detergent solution or detergent wipe between patients and store clean and dry Eye patches should be made of a wipeable material Endotracheal tubes Single use only Enteral feeding Follow manufactures instructions for each product Page 15 of 24 Item Recommended Method Comments equipment At hospital sites The pump must be kept clean and dust free wipe daily with detergent and water detergent wipe In patients own homes It is the user s responsibility to keep equipment dust free If vis
36. tment or central should be laundered on discharge from hospital equipment stores Sliding sheets In patients own homes Patients should have their own sliding sheet When no longer required these should be returned to central equipment stores for cleaning prior to re issue Humidifiers Free Standing Room Humidifiers During use empty and clean reservoir daily using detergent Store clean and dry and and water and dry thoroughly Refill with sterile water only keep dust free when not in Between patients and weekly when in use clean with use detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly Individual patient oxygen humidification systems Disposable units and tubing must be used Use sterile water and change at least daily Infusion pumps At Hospital sites Store clean and dry and The pump must be kept clean and dust free wipe daily with keep dust free when not in detergent and hot water detergent wipe use If contaminated with blood or body fluids clean with detergent and water followed by disinfection using a chlorine releasing agent and dry thoroughly In patients own homes It remains the responsibility of the nursing staff setting up the Page 17 of 24 Item Recommended Method Comments infusion pump as at hospital sites Instruments e g Single use items must be disposed of after use forceps clip Reusable items to be returne
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