Decontamination Zone and Spaulding Classifications

Decontamination Zone Overview

• This zone details decontamination zone and equipment required for thorough cleaning.
• All reusable medical devices (RMDs) must be decontaminated after use.
• Decontamination processes need validating and reprocessing for appropriate intended use.
• The appropriate level depends on body sites and procedure risk.

Spaulding Classifications

• A classification system for minimum processing levels based on three risk categories.
• Risk categories, using examples, include:
  • Non-critical (stethoscope)
  • Semi-critical (Parkes retractor)
  • Critical (Travers retractor)

Minimum Inactivation Levels

• Skin surface (non-invasive): Non-critical, cleaned and/or low/intermediate level disinfection
• Mucous membranes/non-intact skin: Semi-critical, high-level disinfection, sterile areas
• Critical (blood contact): Sterilization

Surgical Instrument Processing Steps

• Must follow established department protocol.
• Pre-preparation: wiping and keeping moist.
• Cleaning steps. (Cleaning, ultrasonic cleaning, sterilization care and washer).
• Additional steps. (sorting and disassembly)
• Specific actions for all medical device types. (Open locks and hinges, place in mesh basket appropriately).
• Secure small items and heavy items in different places.

Disinfection

• Two types: thermal and chemical
• Thermal disinfection: Achieved in a thermal washer-disinfector by choosing appropriate cycle.
• Chemical disinfection: Achieved using compatible RMD-grade disinfectant.
• Adequate processes are validated microbiologically.
• Disinfection eliminates many or all pathogenic micro-organisms.

Drying Procedures

• Drying minimizes rusting, staining, and recontamination risk
• RMDs should be dried in a sloping position in a drying cabinet
• Use a clean wipe if a cabinet is unavailable
• Take care not to exceed manufacturer's temperature tolerances

Process Chemicals

• Choice of process chemicals must be compatible. (device, equipment, intended use).
• Chemicals should be non-abrasive, low-foaming, free-rinsing, biodegradable, non-toxic, easily dissolving/dispersing soil, and economical.
• Dosage should be determined and validated during commissioning.

Water Quality

• Water quality critical and must meet device and process requirements
• Periodic tests required for washer-disinfectors.
• Daily, weekly, and quarterly tests required for various checks, calibration and other assessments.

Cleaning Efficacy Tests

• Tests ensure the cycle can adequately clean heavily soiled loads.
• Tests must use correct process challenge device (PCD) as recommended by manufacturer
• Tests include (examples): TOSI-protein test, Hemo-check test, Brownes test, Ninhydrin test, and Foil test.

Disposal Procedures

• Important to follow manufacturer instructions for disposal, and proper certification of destruction for disposal.

Explore the essentials of the decontamination zone, including equipment and processes necessary for cleaning reusable medical devices. Learn about the Spaulding classifications and the required minimum inactivation levels based on risk categories. This quiz is crucial for understanding proper surgical instrument processing protocols.