infection control policy - NHS Greater Glasgow and Clyde
Contents
1. NHS Sm NHS GREATER GLASGOW amp CLYDE CONTROL OF INFECTION COMMITTEE POLICY Page 1 of 13 Greater Glasgow and Clyde AND SINGLE PATIENT USE ITEMS AN ELEMENT OF STANDARD PRECAUTIONS Effective November From 2011 DECONTAMINATION OF EQUIPMENT AND THE Review November ENVIRONMENT INCLUDING THE USE OF SINGLE USE ee au The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol Policy Objective To provide Healthcare Workers HCWs with details of the actions and responsibilities necessary to ensure that procedures in relation to decontamination do not pose risks to patients or HCWs and comply with current legislation This policy applies to all staff employed by NHS Greater Glasgow amp Clyde and locum staff on fixed term contracts KEY CHANGES FROM THE PREVIOUS VERSION OF THIS POLICY e New category for CJD risk added Document Control Summary Approved by and date Board Infection Control Committee 21 November 2011 Date of Publication 22 November 2011 Developed by Infection Control Policy Sub Group 0141 211 2526 Related Documents NHSGGC Creutzfeldt Jakob Disease CJD Policy NHSGGC Hand Hygiene Policy NHSGGC Standard Precautions Policy NHSGGC SOP Cleaning of Near Patient Healthcare Equipment Distribution Availability NHSGGC Infection Prevention and Control Policy Manual and the Internet w2. eae t From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE USE date l au ersion AND SINGLE PATIENT USE ITEMS AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol 8 8 1 Disinfectants Disinfectants are chemicals that are subject to the Control of Substances Hazard to Health COSHH Regulations 2002 Their use in hospitals or healthcare premises is limited to e Disinfection of body fluid spillages e Disinfection of heat labile equipment such procedures must be approved of by the ICT and take place in a designated central decontamination unit CDU e Terminal or twice daily cleans of source isolation rooms e Terminal clean after outbreaks of infection e Routine cleaning during outbreak of infection 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 this is to ensure that the disinfectant works and does not cause harm to HCWs equipment or the environment The approved procedure is detailed in 8 4 Personal Protective Equipment PPE Protective clothing must be worn in accordance with Body Fluid Spillage Procedure 8 3 and the local COSHH assessment for the disinfectant used
3. Decontamination of Medical Devices 5 oE O D E E E T aan ne 6 5 3 Surgical instruments used on patients with or suspected of having CJD vCJD 6 5 4 Decontaminating equipment ssssessessrseseesesstserestessttsertiesttstttreesttsttsrrestessesetestesseseresees 7 6 General Good Practice Guidelines sseeseeessesesserserssesresstesrrrtestrsterrtestesesernreesseseeesresseeeresens 7 6 1 TAMNA a5 ssisssevs geopesse stusitavesnaccesantannayeseaanasannenesashavensaSeoeas AEREE RA ERE ERG 7 7 Symbols used on medical packaging and their meanings eeeesesseeeresreesesresssserersersrirrreserse 8 DUSUINIS CUA secon ce cet vecstgetincteesdee lean sxc eaii a ne aa i S E S O E E E as 9 8 1 Personal Protective Equipment PPE eeeeseesseereeseesessrssresrersersresressresresrresreeereeressereresees 9 8 2 S Pillages On Carpets eee mere er ee e e eee penn nee ae ee a E N E 9 8 3 Body Fluid Spillage Procedure sssccssssnccssssenciaansagcenssauasasadiunconasizsascaustbatapebeasacdatsunconsaeena 10 8 4 Formulae for disinfectant calculations cccccecessseceesessececeeseeeeeeeeesaeceessaeeeessseeeens 11 9 Adverse Incident Reporting Medical Devices s ssesssssessssssessseressserssressressresseeesseesssees 11 10 Equipment Sent Tor Service OF ROMA ss a5csscntcesssdveennreeesnepnasveveasnsa uaa tasulasasmancmeaseevendssosdaragaen 11 I e S i A T E EEE 12 12 References amp Bibliopraphys oracin a aaia 13 The mo
4. The HCW prior to any procedure must undertake a risk assessment where any chemicals including DISINFECTANTS and DETERGENTS are used 8 2 Spillages on Carpets Please note carpets are not recommended for clinical areas Carpets in healthcare premises should be able to withstand 10 000 ppm available chlorine If there are areas that do not meet this standard discolouration will occur during decontamination Contact ICT if large volume body fluid spillages occur on carpets NB Spillages within community healthcare settings The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS Ven ae Greater Glasgow and Clyde NHS GREATER GLASGOW amp CLYDE Page 10 of 13 CONTROL OF INFECTION COMMITTEE POLICY Hiffective Te From 2011 DECONTAMINATION OF EQUIPMENT AND THE Review November ENVIRONMENT INCLUDING THE USE OF SINGLE USE 22te_ 2014 AND SINGLE PATIENT USE ITEMS Version 4 AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol HCWs cannot use disinfectant to deal with blood and body fluid spillages occurring in the patient s own home because of the possibility of damage to carpeting or furnishings HCWs should wear the appropriate PPE e g gloves and aprons and where possible and remove spillages with paper towels and dispose of in the dome
5. The use of Single Use and Single Patient Use Equipment Prior to use packaging must be checked for single use markings and decontamination instructions Items marked Single Use must be used once on one patient and discarded as clinical waste Items marked Single Patient Use may be decontaminated and only re used on the same patient provided the manufacturer s instructions on decontamination and re use are followed See Section 7 for the Symbol for Single Use 4 Definitions e Decontamination the combination of processes including cleaning disinfection and or sterilisation used to render a re usable item safe for further use e Cleaning is the process which physically removes large numbers of micro organisms and the organic matter on which they thrive e Disinfection is the reduction of the number of viable micro organisms on a device to a level previously specified as appropriate for its intended further handling or use e Sterilisation a process which if specified conditions are met renders a device sterile i e free from all micro organisms and spores The theoretical probability of there being a viable micro organism present on the device shall be equal or less than 1 in a million BS EN 556 2 2003 The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 5 of 13 N H S CONTROL OF INFECTION COMMITTEE
6. instruments should be sent for incineration in the yellow waste stream Consider the use of single use wherever disposable equipment possible The most up to date version of this policy can be viewed at the following website www nhseggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 7 of 13 N H S CONTROL OF INFECTION COMMITTEE POLICY Hiffective sae From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE USE _22 _ 2014 AND SINGLE PATIENT USE ITEMS Version 4 AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol 5 4 Decontaminating equipment Each time a piece of equipment is decontaminated it must be examined by the HCW intending to use it to ensure it remains fit for purpose and does not pose an infection hazard Deteriorated equipment that cannot be decontaminated must be replaced There must be sufficient equipment to allow for effective decontamination between patients Where there is insufficient equipment this must be reported SCN Department Leads have a system to replace re usable equipment that cannot be decontaminated safely and effectively General Good Practice Guidelines Before using any equipment check the manufacturer s instructions regarding reprocess See Section 7 Symb
7. likely contamination and whether the equipment has been appropriately decontaminated e No equipment will be accepted for repair if visibly soiled e No equipment will be accepted for repair if a Certificate of Decontamination has not been completed The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE NHS Sm CONTROL OF INFECTION COMMITTEE POLICY Page 12 of 13 Effective From November 2011 Greater Glasgow and Clyde AND SINGLE PATIENT USE ITEMS DECONTAMINATION OF EQUIPMENT AND THE ENVIRONMENT INCLUDING THE USE OF SINGLE USE AN ELEMENT OF STANDARD PRECAUTIONS Review date November 2014 Version 4 The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol 11 Audit Area being audited Criteria Achieved Not Achieved Not Applicable HCWs are aware of and have access to this policy HCWs if they know of the policy and where it is kept Ask two HCWs are aware of the differences between single use and single patient use equipment Ask two HCWs HCWs understand the symbols used on packages HCWs Ask two HCWs comply with the policy in relation to decontamination of equipment Ask two HCWs what they would do with an item from the minimal e g bed intermedi
8. specialist facility e g into a sterile body area Sterile Services Department Intermediate te s in contact with intact skin Sterilisation or disinfection required i particularly after use on infected patients Decontamination to be undertaken in a Risk or prior to use on immuno compromised specialist facility e g Sterile Services patients or items in contact with mucous Department or ICT Approved Area membranes or body fluids Low Risk Items in contact with healthy skin or not Decontamination may be undertaken in contact with patient in the clinical area The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS a Greater Glasgow and Clyde NHS GREATER GLASGOW amp CLYDE Page 6 of 13 CONTROL OF INFECTION COMMITTEE POLICY Hiffective saree From 2011 DECONTAMINATION OF EQUIPMENT AND THE Review November ENVIRONMENT INCLUDING THE USE OF SINGLE USE 22te_ 2014 AND SINGLE PATIENT USE ITEMS Version 4 AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol 5 2 CJD There are Technical Requirements for Decontamination for specific instruments in relation to CJD The rationale for additional precautions in the decontamination of equipment for instruments potentially contaminated with CJD is that normal sterilise
9. POLICY e E t From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE USE date 2014 AND SINGLE PATIENT USE ITEMS Version 4 AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol Re usable Medical Devices Re usable devices are NEVER marked single use A medical device is any piece of equipment that is used on a patient It includes all equipment e g tourniquets 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 This necessitates a risk assessment before reprocessing begins There are three categories of risk to be considered for the equipment the procedure and the patient They are explained in e Risk Categorisation for the Decontamination of Medical Devices See 5 1 e Surgical instruments used on patients with or suspected of having CJD vCJD See 5 3 5 1 Risk Categorisation for the Decontamination of Medical Devices Risk Category Description Recommendation Hi gh Risk Items in close contact with a break in the Sterilisation Decontamination to be skin or mucous membrane or introduced undertaken in a
10. ate e g laryngoscope blade and high risk categories e g surgical instruments Disinfectants are stored in a locked cupboard Information on how to decontaminate spillages is accessible and in close proximity to the disinfectant There is a notice on the cupboard on how to decontaminate spillages HCWs know why they must not put chlorine releasing granules on urine Ask two HCWs HCWs follow advice with regard to the precautions necessary prior to sending equipment for service or repair Ask two HCWs There is a supply of labels certificates for decontamination of equipment Totals General comment on performance Agreed action plan Date Signed Manager Copy of audit to Signed ICN The most up to date version of this policy can be viewed at the following website www nhseggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 13 of 13 N H S CONTROL OF INFECTION COMMITTEE POLICY Effective November t pout From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE USE ee au AND SINGLE PATIENT USE ITEMS AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol 12 References amp Bibliography Advisory Committee on Dangerous Pathogens Transm
11. bsite www nhsggc org uk infectioncontrol 7 Symbols used on medical packaging and their meanings 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 2008 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 for an explanation BATCH CODE DATE OF MANUFACTURE DO N OT REUSE ABC 1234 wy pynonyme or this are 1999 12 Synonyms for this are e Lot number e Single use e Batch number e Use only once USE BY DATE SERIAL NUMBER ATTENTION SEE INSTRUCTIONS FOR USE SN ABC123 CATALOGUE NUMBER 2002 06 30 REF ABC123 STERILE STERILE The CE mark indicates STERILE Sterilized by Ethylene Oxide that the device complies with the essential requirements for the STERILE R Sterilized by Irradiation performance and safety of medical devices supplied or sold in the UK under UK and EU laws STERILE Sterilized by Steam or Dry Heat Items sold as Sterile will have a number under the CE mark The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 9 of 13 NHS CONTROL OF INFECTION COMMITTEE POLICY
12. curement Managers e Liaise with the ICTs on matters relating to decontamination e Seek the advice of ICTs before purchasing new items that require reprocessing and cannot be autoclaved Medical Physics Technicians e Report adverse incidents to appropriate authorities The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 4 of 13 N H S CONTROL OF INFECTION COMMITTEE POLICY Hiffective see From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE Us 22te_ 2014 AND SINGLE PATIENT USE ITEMS Version 4 AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol 2 Introduction This policy details the actions necessary for the safe use of medical devices and appropriate use of disinfectants in NHS Greater Glasgow amp Clyde to minimise the risk of healthcare associated infection HAI 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 All HCWs involved in the use of medical devices must be aware of their role and responsibilities towards patient safety and infection control 3
13. elines HSG 93 Decontamination of equipment prior to inspection service or repair Medical Devices Agency Reporting Adverse Incidents and Disseminating Medical Device Alerts 2008 001 Medical Devices Agency DB2000 04 Single use Medical Devices Implications and Consequences of Reuse National Institute for Health and Clinical Excellence patient safety and reduction of risk of transmission of Creutzfeldt Jakob disease CJD via interventional procedures November 2006 Guidance endorsed by NHS QIS for implementation by NHS Scotland Siegel J D Rhinehart E Jackson M Chiarello L The Healthcare Infection Control Practices Advisory Committee Guidelines for Isolation Precautions Preventing Transmission of Infectious Agents in healthcare Settings CDC 2007 Websites http www dh gov uk ab ACDP TSEguidance index htm http www hps scot nhs uk haiic ic guidelines aspx http www cjd ed ac uk The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol
14. issible Spongiform Encephalopathy Agents Safe Working and the Prevention of Infection 2003 http www dh gov uk ab ACDP TSEguidance index htm Ayliffe G A J Fraise A P Geddes A M amp Mitchel K 4 ed Control of Hospital Infection A Practical Handbook Chapman amp Hall Bloomfield S F Smith Burchnell C A Dalgleish A G 1990 Evaluation of hypochlorite releasing disinfectants against the human immunodeficiency virus HIV Journal of Hospital Infection 15 3 273 278 Brady R R Kalima P Damani N N Wilson R G Dunlop M G 2007 Bacterial contamination of hospital bed control handsets in a surgical setting a potential marker of contamination of the healthcare environment Annals of the Royal College of Surgeons of England 89 656 60 Chitnis V Chitnis S Patil S Chitnis D 2004 Practical limitation of disinfection of body fluid spills with 10 000ppm sodium hypochlorite American Journal of Infection Control 32 5 306 308 Control of Substances Hazardous to Health Departments of Health 2002 HPS Endoscopy Reprocessing Guidance on the requirements for decontamination equipment facilities and Management Interim Guidance 2007 http www documents hps scot nhs uk hai decontamination publications end 001 01 vl 1 pdf HPS Model Policies 2009 Management of Care Equipment Policy and Procedure HPS Model Policies 2009 Management of Blood and Other Body Fluid Spillages Policy and Procedure Health Service Guid
15. ols on medical packaging and their meaning e Decontaminate your hands before using any equipment e Check the wrapper and identify the markings on the medical device See Section 7 e When cleaning medical devices or the environment follow the manufacturer s instructions for volume of detergent to water If wrapped e Check the expiry date has not passed If beyond the expiry date DO NOT USE e Check the wrapping is intact If not intact DO NOT USE e Check there is no staining on the wrapper or indication that it has been wet after sterilisation If staining present DO NOT USE e All new equipment must be CE marked See Section 7 for Symbols 6 1 Training Managers must ensure that all HCWs are appropriately trained and have access to detailed instruction illustrating the correct procedure taking into account the manufacturer s instructions Seek the advice of the ICT when necessary The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 8 of 13 N HS CONTROL OF INFECTION COMMITTEE POLICY Hiffective EET 7 From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Oye ENVIRONMENT INCLUDING THE USE OF SINGLE UsE 42te_ 2014 AND SINGLE PATIENT USE ITEMS Version 4 AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following we
16. p if available or envelop spillage in paper towels and discard into a clinical waste bag Pour enough of the solution over spillage to saturate the paper towels and leave for 5 minutes Still wearing protective clothing pick up the paper towels and place in a clinical waste bag Still wearing protective clothing pick up the paper towels and place in a clinical waste bag Wipe over area with chlorine based detergent Dispose of any paper towels as clinical waste Clean spillage area with General Purpose Neutral Detergent Clean spillage area with General Purpose Neutral Detergent If still required clean spillage area with General Purpose Neutral Detergent Dry the area thoroughly Remove gloves decontaminate hand replace gloves and discard the remaining disinfectant rinse the container leave to dry and return to the disinfectant cupboard Remove gloves and apron and wash hands thoroughly The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 11 of 13 N H S CONTROL OF INFECTION COMMITTEE POLICY Effective November t From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE USE date l au AND SINGLE PATIENT USE ITEMS cad AN ELEMENT OF STANDARD PRECAUTIONS The mos
17. r temperatures do not inactivate the prion which is thought to cause CJD For further information please refer to the NHSGGC CJD Policy http www nhsggc org uk content default asp page s708_3 5 3 Surgical instruments used on patients with or suspected of having CJD vCJD Risk Category Action Comment Patient suspected of having CJD Quarantine instruments in See designated box CJD Policy Consider the use of single use disposable equipment wherever possible Patient in high risk group i See e patients with antithrombin deficiency haemophilia or If possible decontaminate and CJD Policy other familial bleeding disorders retain for the use of the named e recipients of growth hormones or gonadotrophin treatment Patient e g endoscopes before 1986 in the UK or at any time whilst abroad il otherinstr mentesh uid ie ec pients of human dura cad grafts be sent for incineration in the patients with a family history of familial CJD yellow waste stream e patients who have been contacted by public health and told that they are at risk of CJD Consider the use of single use e patients who have had multiple transfusions more than wherever disposable 50 units of blood or blood components or received blood equipment possible or blood components on more than 20 occasions Patient diagnosed as having CJD If possible decontaminate and See retain for the use of the named CJD Policy patient e g endoscopes All other
18. st up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 3 of 13 N H S CONTROL OF INFECTION COMMITTEE POLICY ae ee t From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE USE de au AND SINGLE PATIENT USE ITEMS AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol 1 Responsibilities Healthcare Workers HCW e Follow this policy e Attend appropriate training e Report to supervisor manager when they are unable to follow the policy or if they think there is a problem issue with equipment Clinical Managers Senior Charge Nurses SCN e Ensure HCWs involved in implementing this policy are trained to do so e Ensure HCWs have access to and follow this policy e Seek advice from ICT regarding the correct method of decontamination of equipment if required Managers e Support Clinical Managers SCNs in implementing this policy Infection Control Team ICT e Provide teaching opportunities on the implementation of this policy e Act as a resource for guidance with regards to decontamination of blood and body fluid spills e Keep this policy up to date Sterile Services Department SSD Manager Estates Manager Pro
19. stic waste stream If required spillage area should be cleaned with detergent water and paper towels Gloves and aprons should be removed and disposed of in the domestic waste stream and hands thoroughly washed 8 3 Body Fluid Spillage Procedure As part of the Standard Precautions Policy spillages of blood and body fluids must be decontaminated as follows WET BLOOD SPILLAGES DRIED BLOOD SPILLAGES ALL OTHER BODY FLUID SPILLAGES Get someone to guard the area whilst you collect the necessary equipment Put on protective clothing gloves apron and eye protection if necessary Apply Chlorine releasing granules e g ACTICHLOR Granules Leave granules over spillage for a minimum of 3 minutes The spillage should no longer have a fluid consistency If the spillage is still liquid apply more granules and leave for a further 3 minutes Put paper towels over the spillage Make up 10 000ppm available chlorine disinfectant by putting a 1 7gm tablet of ACTICHLOR PLUS into 100mls of cold lukewarm tap water safely securing the lid of the container and leave for 3 minutes Then invert the container to ensure the tablets are dissolved Using paper towels or incopad if necessary remove spillage contents and discard into clinical waste bag Make up a solution of a chlorine based detergent ACTICHLOR PLUS 1 7gm tablet in 1 litre of cold lukewarm tap water Remove spillage with a scoo
20. t up to date version of this policy can be viewed at the following website www nhseggc org uk infectioncontrol 8 4 Formulae for disinfectant calculations ACTICHLOR Granules ACTICHLOR Comment Suitable for Use PLUS Tablets 10 000ppm N A 1 7gm tablet in 100mls of Disinfection of available chlorine cold lukewarm tap water dried blood spills 10 000ppm Yes N A Disinfection of wet available chlorine blood spills 1 000ppm available N A 1 7gm tablet in 1 litre of General chlorine in detergent cold lukewarm tap water environmental disinfection 9 Adverse Incident Reporting Medical Devices An adverse incident is an event which causes or has the potential to cause unexpected or unwanted effects involving the safety of patients users or other persons Any adverse incident involving a medical device should be reported following the local Incident Reporting System See http www show scot nhs uk shs hazards_safety hazardsp3 HTM for how to report incidents 10 Equipment Sent for Service or Repair e Before equipment is presented for repair it must be appropriately decontaminated Single use items that are in use and are found to be faulty should be decontaminated before being sent back to the manufacturers or to pharmacy seek advice from ICT e In addition to the repair slip a Certificate of Decontamination Label must be completed and attached to the item for repair by a suitably trained HCW aware of the
21. ww nhsggc org uk infectioncontrol Implications of Race Equality and other diversity duties for this document This policy must be implemented fairly and without prejudice whether on the grounds of race gender sexual orientation or religion Equality amp Diversity Impact Assessment Completed November 2011 Lead Lead Infection Control Nurse North East Responsible Director Manager Board Infection Control Manager The most up to date version of this policy can be viewed at the following website www nhseggc org uk infectioncontrol NHS GREATER GLASGOW amp CLYDE Page 2 of 13 N H S CONTROL OF INFECTION COMMITTEE POLICY ae aks t From 2011 Greater Glasgow DECONTAMINATION OF EQUIPMENT AND THE Review November and Clyde ENVIRONMENT INCLUDING THE USE OF SINGLE USE date 2014 AND SINGLE PATIENT USE ITEMS Version 4 AN ELEMENT OF STANDARD PRECAUTIONS The most up to date version of this policy can be viewed at the following website www nhsggc org uk infectioncontrol Contents l PR SOS Sassi tecets Mace taatencatsactencee sae E e a A R E a ES 3 2o MORO GUCUIOT sennen E A E E a a aa 4 3 The use of Single Use and Single Patient Use Equipment sseeseseeeseereeseereesresrrerresrrsserrresee 4 4 Petitions ise a RE E EE E AE AA 4 5 Re usable Medical Devices Re usable devices are NEVER marked single use 5 5 1 Risk Categorisation for the
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