8 Questions
What is the recommended number of sinks to use for cleaning RMD?
Three sinks
Why should you avoid using household soap for manual cleaning of RMD?
It is not effective
What is the purpose of using an enzymatic detergent for cleaning devices with channels or complex parts?
To facilitate cleaning by breaking down biological material
Why should you immerse the item carefully in the cleaning solution?
To displace trapped air
How should stubborn staining on devices be removed?
By scrubbing with a non-abrasive scouring pad
What is the final step after flushing lumened devices with a jet-gun?
Rinsing in warm-to-hot water
Why should you avoid splashing and aerosols during the discharge process while flushing lumened devices?
To prevent infectious aerosols spreading
What is the pH range preferred for manual cleaning detergents?
$8.0 -11.5$
Study Notes
Decontamination Process
- All RMDs that come into contact with the patient or surgical field should be systematically decontaminated after each surgical procedure to prevent infection.
- Decontamination processes must be validated and reusable medical devices reprocessed to a level appropriate for their intended use.
- The appropriate level of decontamination depends on the body sites where the device will be used and the risk associated with a particular procedure.
Spaulding Classification
- The Spaulding classification system categorizes RMDs into three risk categories: non-critical, semi-critical, and critical.
- Non-critical devices require cleaning and/or low/intermediate level disinfection, e.g., stethoscope.
- Semi-critical devices require high-level disinfection, e.g., Parkes retractor.
- Critical devices require sterilization, e.g., Travers retractor.
Decontamination Steps
- Pre-preparation (wiping and keeping moist) in the OR or SPD dirty side.
- Manual cleaning or ultrasonic cleaning (if necessary).
- Automated washer disinfection.
- Instrument care and sterilization.
Reprocessing Methods
- Critical site: devices must be sterile at the time of use, either through steam sterilization, low-temperature sterilization, or single-use.
- Semi-critical site: devices are either single-use or sterilized after each use, or high-level disinfection is used.
- Non-critical site: cleaning alone is generally sufficient, but intermediate or low-level disinfection may be used in specific circumstances.
Sorting and Disassembly of Contaminated RMDs
- Sorting and disassembly facilitate timely cleaning and minimize risk to the decontamination specialist.
- Policies and procedures should be developed for handling, sorting, and disassembly of all devices.
- Manufacturer's instructions for cleaning should be followed to ensure the device is not damaged and is cleaned adequately.
Manual Cleaning
- Manual cleaning is necessary for delicate or complex devices that cannot be immersed in water or are susceptible to mechanical damage.
- Use a mild detergent (pH range 8.0–11.5) specifically designed for RMD cleaning.
- Immerse the item in the solution, displacing trapped air, to ensure all surfaces are cleaned.
- Remove all visible soiling, including lumens and valves, and flush all lumened devices with a jet-gun.
Test your knowledge on the equipment and processes required for thorough cleaning in the decontamination zone. Learn about the importance of decontaminating reusable medical devices after each surgical procedure to prevent infections.
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