المملكة العربية السعودية وزارة الصحة اإلدارة العامة لمكافحة عدوى المنشئات الصحية

Size: px

Start display at page:

Download "المملكة العربية السعودية وزارة الصحة اإلدارة العامة لمكافحة عدوى المنشئات الصحية"

Julian Bruce
5 years ago
Views:

1. POLICY STATEMENT: Cleaning, decontamination and sterilization method should be done in CSSD service facility not in the end user department side. 2.

1 1. POLICY STATEMENT: Cleaning, decontamination and sterilization method should be done in CSSD service facility not in the end user department side. 2. PURPOSE: To ensure the proper way of collections, decontamination, cleaning and Sterilization of all instruments in CSSD. 3. SCOPE: This policy is applied to all CSSD personnel. 4. DEFINITIONS: 4.1 Cleaning: is the removal of all foreign material (dirt and organic matter) from The object being reprocessed? 4.2 Decontamination: the physical or chemical methods to remove inactive, or destroy microorganisms, rendering them safe for handling. 4.3 Sterilization: is a process which all viable forms of microorganisms (including Spores) are destroyed. 5. RESPONSIBILITIES: The following functions are performed the CSSD Staff. 6. PROCEDURES 6.1 Cleaning Two key components of cleaning are friction to remove foreign matter and fluids to remove or rinse away contamination Thorough cleaning will remove most organisms from a surface and should always precede disinfection and sterilization procedures If instruments and other items have not been cleaned, sterilization and disinfection may not be effective because microorganisms trapped in organic material may survive after sterilization or disinfection Cleaning is normally accomplished the use of water, detergents and mechanical actions via many types of brushes (do select the suitable one ) Detergent is essential to dissolve proteins and oil that can reside on instruments and equipment after use All personnel who clean or reprocess equipment should use appropriate protective Page 1 of 5

2 barriers for the procedure being performed (i.e. gowns, gloves, goggles, masks, etc). This may vary according to the cleaning disinfectant agent or the item being reprocessed Mechanical Cleaning Mechanical cleaning facilitates cleaning and decontamination of some items Washing disinfectors (Common Criteria ) The washing machine gives a cold rinse followed a hot wash at 71 C for 2 minutes. This is followed a 10-second hot water rinse at C and then drying a heater or a fan at C. See ST Ultrasonic cleaner Ultrasonic cleaning removes soil a process called cavitation in which waves of acoustic energy are propagated to disrupt bonds that hold particular matter to surfaces, see ST Manual Cleaning All items requiring disinfection or sterilization should be dismantled before cleaning. Warm water is preferred; it will remove most of the protein materials (blood, sputum, etc.) that would be coagulated heat and would subsequently be difficult to remove. The most simple, cost-effective method is to thoroughly brush the item while keeping the brush below the surface of the water in order to prevent the release of aerosols The brush shall be decontaminated after use and shall be dried. Finally, items shall be rinsed in clean water and then should be dried. Items are then ready for use (non-critical items) or for disinfection (semi-critical items) or for sterilization (critical items) Manual cleaning is necessary when: Mechanical cleaning facilities are not working Delicate instruments have to be cleaned; Complex instruments need to be taken apart to be cleaned; Items with narrow lumens need to be cleaned (endoscopes). 6.5 Manual or hand-cleaning must be done with extreme caution Wear heavy-duty rubber gloves, a plastic apron, eye protection, and mask during cleaning Soak the instruments in normal tab water containing a detergent. Page 2 of 5

3 6.5.3 Scrub instruments and other items vigorously to completely remove all foreign material using a soft brush or special brush, detergent, and water. Hold items under the surface of the water while scrubbing and cleaning to avoid splashing. Disassemble instruments and other items with multiple parts, and be sure to brush in the grooves, teeth, and joints to items where organic material can collect and stick Flush through lumens with an adapted water jet Rinse items thoroughly with clean water to remove all detergent. Any detergent left on the items can reduce the effectiveness of further processing Inspect items to confirm that they are clean Allow items to air dry or dry them with dryer or a clean towel (in case of dryer M/C not available) if chemical disinfection is going to be used. This is to avoid diluting the chemical solutions used after cleaning. Items that will be high- Level disinfected then will be treated boiling or steaming does not need to be dried. 6.6 Recommendations for Packaging Supplies to be Sterilized 6.6.1They must withstand the physical conditions of the sterilization process chosen for the device They must allow for adequate air removal They must be easily penetrated the saturated steam It must be possible to seal them in such a way that tampering will be evident It must be adapted to the size and shape of the item to be packed They must resist tearing and puncturing under ordinary conditions of use They must protect the package contents from physical damage. Page 3 of 5

4 They must allow aseptic removal of the contents External chemical indicators should be placed on the outside of the packaging material. They may be used as a form of closure for the package such as indicator tape. Use the Bowie/Deck test and the Biological Indicator as per the manufacturer recommendation and ISO and ISO standards The appropriate internal chemical indicator should be placed in the center of the package in the center of the tray. If the internal chemical indicator does not indicate that the item has been sterilized, it should be reported with the load control number to the Manager/Director of the Sterile Processing Department and the item(s) should be reprocessed and sterilized before use. 6.7 Sterilization Steps for steam sterilization as following : Arrange all labeled packs, containers, or unwrapped items in the chamber of the autoclave in a way that allows the steam to circulate freely Follow the manufacturer instruction for operating the autoclave. Adjust time, temperature and pressure according to the table If the autoclave is automatic, the heat will shut off and the pressure will begin to fall off once the sterilization cycle is complete If the autoclave is not automatic, turn off the autoclave after achieving the required time Wait until the pressure gauge reads 0 to open the autoclave. Open the lid or door to allow remaining steam to escape. Leave all items in the autoclave until they dry completely. It may take up to 30 minutes Remove packs, containers, or unwrapped items from the autoclave using sterile pick-ups to handle unwrapped items. The packs of equipment should come out of the autoclave dry. Wet packs must be considered non-sterile. Do not store packs, containers or wrapped items until they cool to room temperature. Page 4 of 5

5 7. REVISION AND AUDIT: This Policy will be reviewed every two years or when necessary. 8. REFERENCES: Association for the Advancement of Medical Instrumentation Advanced AAMI 2011, The International Association of Healthcare Central Service Materiel Management IAHCSMM 7 th Edition, CDC Disinfection and sterilization Guide lines 2009, APIC Guidelines 2009 Chapter 55. Policy Number ST-06 Prepared Reviewed Approved Approval Date : Revision Date : Page 5 of 5

THE BASICS OF DECONTAMINATION

THE BASICS OF DECONTAMINATION Objectives Review the basic factors that impact cleaning and decontamination of surgical devices Present the fundamentals of manual and automatic cleaning Review various cleaning