Decontamination of Reusable Medical Devices

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Questions and Answers

What is generally sufficient for non-critical items after each use?

Intermediate cleaning

High-level disinfection

Chemical sterilization

Cleaning alone (correct)

What is a necessary step for effective decontamination of reusable medical devices?

Cleaning devices immediately after use

Storing devices for future cleaning

Sorting and disassembly prior to cleaning (correct)

Using high-pressure steam cleaning only

Which arrangement is recommended for mesh baskets during cleaning?

Overloading baskets to save space

Grouping similar instruments together regardless of type

Placing devices on top of one another

Arranging devices to ensure all surfaces are exposed (correct)

What should be done with heavy medical devices during cleaning?

Arrange them on the bottom or in a separate tray Signup and view all the answers

What is the minimum inactivation level required for non-critical devices?

Cleaning and/or Low/Intermediate Level Disinfection Signup and view all the answers

What is essential to follow to prevent damage to reusable medical devices during cleaning?

Manufacturer’s instructions for cleaning Signup and view all the answers

Which type of site requires devices to be sterile at the time of use?

Critical Signup and view all the answers

What is the minimum acceptable level of reprocessing for semi-critical devices if sterilization is not possible?

High Level Disinfection Signup and view all the answers

What classification system is used to determine the minimum levels of processing for medical devices?

Spaulding Classification Signup and view all the answers

For devices capable of withstanding heat, which method is acceptable for achieving sterility?

Steam Sterilization Signup and view all the answers

What should be done to remove stubborn staining from devices?

Use a non-abrasive scouring pad or soak in an approved stain-removing solution Signup and view all the answers

Which disinfection method is considered the simplest and most cost-effective?

Thermal disinfection achieved through a washer-disinfector Signup and view all the answers

What aspect is NOT critical for ensuring the effectiveness of chemical disinfection?

The color of the disinfectant solution Signup and view all the answers

What type of devices require high-level disinfection?

Semi-critical devices that cannot be sterilized Signup and view all the answers

Which of the following is true regarding microbial validation of chemical disinfection?

It defines concentration, contact time, and temperature requirements Signup and view all the answers

What is thermal disinfection primarily used for?

Inactivating microbes through controlled heat Signup and view all the answers

Low-level disinfection is recommended for which medical devices?

Non-invasive devices for non-critical sites Signup and view all the answers

What is a critical consideration when using a thermal washer-disinfector?

The ability to record temperature and time properly Signup and view all the answers

Which describes a property of effective chemical disinfectants?

Their effectiveness relies on appropriate concentration and contact time Signup and view all the answers

What is the expected outcome of proper disinfection?

Inactivation of infectious agents on inanimate objects Signup and view all the answers

Study Notes

Decontamination Point of Use Preparation and Transport

Decontamination is necessary to prevent infection and is essential for reusable medical devices (RMDs) that come into contact with patients or surgical fields.
Spaulding Classification System: The system categorizes RMDs into three levels based on the risk associated with their use:
- Non-Critical: Devices used on skin surfaces (e.g., stethoscope)
- Semi-Critical: Devices that contact mucous membranes or non-intact skin (e.g., Parkes retractor)
- Critical: Devices used in sterile areas or with blood contact (e.g., Travers retractor)
Cleaning and Disinfection: The appropriate level of reprocessing depends on the device classification. Critical devices require sterilization, while semi-critical devices require high-level disinfection and non-critical devices generally require cleaning.
Reprocessing Steps: These are the steps included in the surgical instrument processing:
- Pre-Preparation (wiping & keeping moist): This occurs in the operating room (OR) or sterile processing department (SPD)
- Manual Cleaning: Performed at the SPD
- Ultrasonic Cleaning: Optional, if needed
- Automated Washer: Performed before instrument care
- Instrument Care:
- Sterilization: The final step
Sorting and Disassembly of Contaminated RMDs: Once RMDs are delivered to SPD, they should be sorted and disassembled efficiently to minimize contamination risk.
Disassembly:
- Open all device components like locks and hinges to facilitate cleaning.
- Place devices in mesh baskets to ensure adequate cleaning and avoid stacking.
- Arrange items in mesh trays for automated cleaning to expose all surfaces.
- Place heavy items on the bottom or in separate trays for stability.
- Secure lighter items to prevent movement during cleaning.
- Flush lumened devices with a jet-gun, rinsing thoroughly with water.
Three sinks: Washing, potable water rinse, and purified water rinse
Disinfection:
- Eliminates pathogenic micro-organisms on inanimate objects (excluding bacterial spores).
- Two types:
  - Thermal Disinfection: Achieved in a thermal washer-disinfector at specific temperatures. Monitoring temperature and time is crucial.
  - Chemical Disinfection: Achieved using an appropriate disinfectant with consideration of concentration, contact time, temperature, and pH.
High-Level Disinfection: Minimum treatment recommended for thermo-labile devices (e.g., endoscopes) used in semi-critical sites
Low-Level Disinfection: Minimum treatment recommended for instruments used in non-critical sites.
Water Quality: Crucial to ensure a successful cleaning process and maintain the integrity of devices. Water purity and compatibility with chemicals, devices, and washers are critical.
Washer-Disinfector Testing: Requires regular testing and quality assurance to ensure it meets standards.
- Daily: Spray arm rotation, nozzle inspection, strainer and filter cleaning
- Weekly: Automatic control test, safety checks, water hardness, conductivity, and cleaning efficacy testing (residual soil detection).
- Quarterly Automatic control test, calibration verification, thermometric test, and cleaning efficacy assessment.
- Annually: Automatic control test, calibration verification, water system, drainage, doors, door interlocks, fault interlocks, water vapor discharge, aerosol discharge, chemical additive dosing, load carriers, air quality, cleaning efficacy, over-temperature cut-out, thermometric tests for thermal disinfection, load dryness test, and process residues.
Tunnel Washers: Provide hands-free reprocessing in a cycle of pre-rinse, washing, ultrasonic, rinse, and drying.
Ultrasonic Cleaners:
- Require regular testing to ensure they operate effectively.
- Daily: Strainers and filters, visual inspection of items for visible soil after cleaning (load rejection if soiled)
- Weekly: Automatic control test, safety checks, cleaning efficacy test.
- Quarterly: Automatic control test, calibration verification, ultrasonic activity, cleaning efficacy test
- Annually: Revalidation of commissioning procedures, additional tests may be needed.

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Description

This quiz covers the essential decontamination processes for reusable medical devices (RMDs) and the Spaulding Classification System. Understand the categorization of devices based on their risk levels and the appropriate cleaning, disinfection, and sterilization methods required. Perfect for healthcare professionals seeking to enhance their knowledge in infection control practices.