Reusable Medical Device Decontamination (PDF)

Sorting and Disassembly of Contaminated RMD As mentioned in module 4, to be effective, reusable medical device decontamination must be carried out in a timely manner. Sorting, disassembly and cleaning facilitates timely cleaning and in a way that minimizes risk to you, the decontamination specialist...

Sorting and Disassembly of Contaminated RMD As mentioned in module 4, to be effective, reusable medical device decontamination must be carried out in a timely manner. Sorting, disassembly and cleaning facilitates timely cleaning and in a way that minimizes risk to you, the decontamination specialist. Once the containers are received and unloaded from the transport carts you learned about in module 4, the reusable medical devices are sorted—usually according to whether they need a manual or an automated cleaning process. Policies and/ or procedures should be developed for the handling, sorting and disassembly of all devices used within the facility, and for handling specialized items if required. The manufacturer’s instructions for cleaning are followed in order to ensure the device is not damaged and is cleaned adequately. Disassembly of RMD Complete the following activities to facilitate Arrange medical devices in an effective cleaning: orderly fashion in mesh trays so that all surfaces are exposed to Open all reusable medical device the cleaning action when using an box locks, hinges etc. automated cleaner (Figure M5–3c). Place the medical devices in a Place each jointed medical device mesh basket in a way that ensures in the open position in the mesh effective cleaning of the device. Do basket. If extra mesh baskets are not place reusable medical devices required for cleaning a device set, a on top of one another. Overloaded marker is placed in the extra baskets baskets will result in ineffective to identify the set name and number. cleaning Place heavy retractors and other heavy medical devices on the bottom or in a separate tray. Secure small and light items with a hold down screen or by other means, to ensure they are not free to move around during the cleaning Figure M5–3a Overloaded baskets result in ineffective cleaning process. Place scissors, light-weight medical devices, and microsurgical devices next (Figure M5–4). Receivers and gallipots (bowl- shaped items) must not be placed New-M5-3b Poor Arrangement WD New-M5-3c Better Arrangement WD  over any other reusable medical Open ratcheted devices for cleaning devices, as they may cause to ensure the box joints and jaws are shadowing and interfere with the being cleaned thoroughly and all cleaning process. debris removed. Separate all sharp devices from Dismantle any devices with valves, general devices. This is to ensure ports or multiple parts as far as ease of identification for personnel possible for cleaning, following assembling the devices after manufacturer’s instructions (Figure cleaning, in order to prevent sharps M5–6). injury. Open, flush and brush taps that do For medical devices with one or not come apart, before mechanically more lumens (tubes), connect each cleaning. lumen to the appropriate flushing Stylets are used to unblock devices system provided for that purpose during use. Remove them, and (Figure M5–5). flush and brush the devices prior to Ensure the tips of devices align mechanical cleaning (Figure M5–7). and meet at the tip, and are not Stylets need to be checked for hooked or snagged—items that are correct fit and function. misaligned, damaged or worn need to be sent for repair. Figure M5–4 Hold-down screen for small or light items Figure M5–6 Flush tubes for Lumens Figure M5–7 Cleaninglumens Automated Cleaning (including pre-cleaning) As we have learned, cleaning is an essential prerequisite for all effective disinfection and sterilization processes, as organic residue may prevent the disinfectant or sterilants from contacting the surfaces of the item being processed and may also bind and inactivate chemical disinfectants. In other words—if the item can’t be cleaned, it can’t be disinfected or sterilized. Twenty years ago, decontamination experts focused on the sterilizer, while today it is globally accepted that cleaning is the initial and most crucial step in breaking the chain of disease transmission. The use of mechanical cleaners such as washer-disinfectors (Figure M5–8) and ultrasonic cleaners (Figure M5–16 to 12) is preferred to the manual cleaning of items. The advantage of using automated cleaning equipment is that it provides an efficient, validated, reproducible process which is more easily controlled than manual methods. A simple example of this is the temperature of the water at