APPENDIX J Decontamination of Medical Equipment, Fittings and Rooms A Z

APPENDIX J Decontamination of Medical Equipment, Fittings and Rooms A Z Accidental / Environmental spillages or soiling by blood etc Ambu bag Anaesthetic equipment Antibacterial hand soap washing dispensers Laryngeal masks Baby scales Bottles, baby feeding Bottle brushes Baths, showers, wash basins Bed pans Pans commodes Bed frames Bedpan carriers Bedpan washer/disinfector Bedpan macerator machines Bowls - Wash Vomit Brushes - Surgical Nail Kitchen Tooth Hairbrushes and combs WC Buckets Carpets Ceilings Cleaning Equipment Mops for floor cleaning Mops dish Curtains Cleaning Cloths Crockery and Cutlery Chairs Easy / Upright Chairs Wheelchairs Wheelchairs for Hydro use Chairs Fabric finish Commodes Cots and cot sides Cradles bed Crutches / Zimmer frames Cuffs (recording blood pressure) Cuff Insert Cystoscopes rigid and flexible Drainage Equipment Suction jars Jar liners Suction catheters Suction tubing Suction wall mounted apparatus Underwater seal drainage equipment Wound drainage systems Duvets Ear phones / head sets Ear pieces Auriscope Hearing aids Stethoscopes Endoscopes ECG leads and machines Feeding pumps Floors dry cleaning Wet cleaning Flower vases Fridges Furniture

Gloves heavy duty rubber Hands Hoists (see manual handling equipment) Humidifiers Incubators (Infant) Infusion pumps Instruments Surgical Ward Intravenous infusion stand Laryngeal Masks Laryngoscope Laryngoscope blades Linen Linen Special infected Linen bag holders Lockers bedside Manual Handling Equipment Mattresses / Pillows / Propad cushions Mattresses (contaminated) Mattresses (pressure relieving types) Mops Dish Pro pads Medical Physics Equipment Medicus Mattress Sacs Medicine pots Monitors Blood pressure Oxygen cylinders and carriers Patients Own Clothing Razors Scrubbing Machines and Wet Suction Machines Sigmoidoscopes (non Proctoscopes Dispos) Peak Flow Meters Sigmoidoscopes / Protoscope leads and light source Soap Liquid Soap Liquid Dispenser Specula Stethoscope Syringes metal cartridge Syringe Drivers Telephones Thermometers digital Toilet Seats Toilet Pan Tooth Mugs Toys Tracheotomy Tubes Trolleys Dressing Trolleys Medicine Trolleys Other e.g. food, transporting patients, telephones etc Tubing (Anaesthetic / Ventilator) Urinals Ventilators Ventilator external circuits Walking Aids Walls Walls (spot cleaning only) X Ray Equipment

Ambu Bag Anaesthetic equipment (airways & endotrachael tubes) Baby Scales Baths / Showers and Wash Basins Note; Legionella Policy for low usage areas Disposable single use. Non-disposable wash with detergent and hot water, and dry. 1) Single use, then dispose. 2) Autoclave if possible this is preferable to other methods or 3) Heat disinfectant if possible. Wash with a solution of General Purpose Detergent and hot water, rinse and dry well with disposable paper towels. Renew disposable paper. 1) staff clean daily with General Purpose Detergent. 2) Nursing staff clean between each patient with General Purpose Detergent. For INFECTED PATIENTS disinfect with Actichlor and rinse thoroughly. For patients with TB use disposable or heat sterilise. Any scale build up must be removed as this can be a reservoir for bacteria. Note: Legionella Policy for Ward/department staff re low use flushing and ETS / PFI maintenance of shower heads & TMVs protecting outlets / Theatre Practitioner Physiotherapist Theatre Practitioner / Midwife Bedpans and Commode Pans Bedpan Holders for Pulp Products Bedpan Washer and/or Macerator Machines Disinfection in a bedpan washer with a heat disinfection cycle which must reach a temperature of 80 degrees centigrade for one minute during this cycle. Wash with hot water and detergent and dry. For infective case, wipe with Actichlor. Wipe all external areas and ledges with a solution of detergent and hot water daily. These machines will receive appropriate PPM and validation as described in HTM 01 Bottle Brushes After use, rinse under hot running water, shake well and store dry. / Midwife Bowls Surgical Send to SDU for decontamination. DSU Bowls Vomit Disposable pulp products. Bowls Wash Individual wash bowls should be preferably be kept for each patient. Wash thoroughly with a solution of detergent and hot water, rinse and dry. Store inverted and separated. Brushes Hair and Combs Individual brushes and combs must be used for each patient. Clean with detergent if necessary. Single patient use only. Brushes Kitchen Nylon type recommended. Store dry. Catering Brushes Nail Send to SDU for decontamination. A sterile nailbrush must be used for all Theatre use only clinical procedures. DO NOT LEAVE soaking in any solution. Brushes Tooth Single patient use only. Brushes WC Rinse in flushing water, shake in pan, store dry in dedicated container. Clean holder with hot water and detergent only.

Buckets Carpets Wash daily with a solution of detergent and warm water, store DRY. Do not leave full of water. Vacuum daily. Clean periodically by warm water extraction. For known contaminated spillage, contact the Department and Infection Prevention & Control Team for advice. See Appendix E Ceilings The cleaning of ceilings should be carried out sufficiently often to prevent the accumulation of visible dirt. except where specialist access is required - then ETS Chairs (fabric finish) Clean with hot water and detergent, leave to dry. May not be totally effective. Cleaning after Infected Wear appropriate clothing as per Infection Control Policy. Wipe Cases furniture, bed etc with detergent and hot water then wipe immediately with Artichor. Leave to dry. Cleaning Cloths Rinse, leave dry. See appendix C / Cleaning Equipment Change daily and send to the laundry. Mops (for floor cleaning) Commodes Crockery and Cutlery (if not returned to central wash up on main kitchen) Crockery. Some Infectious Cases (e.g. enteric infections or TB) Curtains around bed space Cytoscopes (rigid and flexible) Wash after each use with a solution of detergent and warm water, store dry and tape with indicator tape. Machine wash and rinse in temperature above 80 degrees centigrade where possible OR hand wash with detergent and hot water, rinse and dry in air or with disposable paper towel/roll. The crockery and cutlery from some cases will require that a dish washing machine or disposables should be used. If in any doubt contact the Infection Prevention & Control Team. Should be laundered at least once every 6 months or when visibly soiled or following contact with certain infections Refer to manufacturer guidelines first for decontamination advice. Wash and decontaminate before autoclaving. Autoclave if autoclavable OR automated endoscopes reprocessors (EWD) are recommended OR Gigasept solution. NB If this used, they should be placed in a vertical position to allow air bubbles to escape and the disinfectant fluid to penetrate to all parts of the instrument. They must be rinsed well before use with sterile distilled water. If in any doubt contact the Infection Prevention & Control Team or Consultant Medical Microbiologist for decontamination exposure times. Indicator tape to be attached across pan and removed just before use with patient For patient with open TB or enteric infections, if possible heat disinfect or use disposable. Curtain rails must be cleaned before clean curtains are hung. See MDA decontamination of Endoscopes MDA 2002 (05) July 2002 and HMT 2030. Must be performed in well ventilated rooms or preferable in a sealed unit. Drainage Equipment After use, empty carefully, wash with a solution of detergent and hot Clinical users and SDU

Suction Jars if none disposable Duvets Ear Pieces / Auriscopes /Hearing Aids / Stethoscopes water rinse and dry thoroughly. Change if in use for longer than 24 hours. Water-impermeable cover: wash with detergent and hot water solution and dry. Use a fine brush to clean narrow lumen, wash with a solution of detergent and hot water, rinse then wipe with an alcohol wipe. If contaminated contact the Laundry Service for advice. Auriscope specula use disposable if possible. Laundry Team / Medical Staff Ear Specula Send to Sterile Services Dept. DSU ECG Leads and Machine Wipe with a solution of detergent and hot water and dry. / Practitioner Electrical Equipment Wipe with detergent and hot water, and dry. / Practitioner Endoscopes Rigid and Flexi Feeding Bottles for babies Scopes are to be sent to the centralised facility in SDU All patients about to undergo any endoscopy procedure should be asked if they have been notified as at increased risk of CJD or vcjd. See CJD Policy Disposable (pre-packaged) Rinse with water then discard into appropriate receptacle after use Non-Disposable Sterilise by autoclaving or wash thoroughly with a solution of detergent and hot water, rinse thoroughly and place bottles in fresh disinfectant solution in small tanks. They should be completely immersed with removal of air bubbles and left for the recommended time. Send to SDU in designated container. For instruments / scopes used on a patient/s with suspected or proven CJD, contact the Infection Prevention & Control Team. Chemical methods should only be used where other methods are not available. / Practitioner / SDU / Midwife Feeding Pumps Wipe with detergent and hot water, and dry. / Practitioner Floors (dry cleaning) 1) Vacuum clean. Do not use brooms. Dust extraction with velmop. Floors (wet cleaning) Wash with domestic cleaning agent (a neutral detergent). Dry naturally. Flower Vases (if used within area or department) Fridges (kitchen/drug/specimen) Empty and change water regularly, and clean thoroughly with detergent and hot water. Do not clean in designated hand washing sink. Invert and wipe dry between uses. 1) Defrost weekly. Clean with General Purpose Detergent and hot water. 2) Temperature of fridge s must be checked and recorded as per policy. 3) Food stored in kitchen fridge s must be dated and labelled. No food to be stored in drug or specimen fridges. Do not use disinfectant on floors daily, unless infected area. Voluntary Staff / Ward Staff Furniture Bed frames, Wipe with hot water and detergent. If used by infected patient, All furniture brought for

lockers, desks, stools, chairs etc. Gloves Heavy Duty Rubber Household Type wipe with Actichlor. clinical areas must be wipeable. Wash in a solution of detergent and hot water. Hang to dry. Should not be kept in pockets. Porters ETS Hands As per Trust Hand Hygiene/Decontamination Policy. All employees. Humidifiers Infant Incubators Infected Linen Infusion pump Instruments Surgical Procedures And Ward Instruments SINGLE PATIENT USE a) MASK wash every 24 hours in warm water and detergent. Dry. b) TUBING change every 24 hours. c) ADAPTER change weekly. BOTTLE disposable. In Use Change weekly (if possible), dismantle, wash incubator with a solution of detergent and hot water, rinse and dry with disposable paper towel. Leave plugged in and switched on for one hour prior to use. Between Babies As above. Following a significant infection 70% alcohol wipes with 125 PPM NaDCC disinfectant solution in a well ventilated room. The incubator must be properly aired before reuse. 2) *If in any doubt contact the Medical Microbiologist or Infection Prevention & Control Team. Water-soluble inner bags to contain linen, tied securely at the top and placed inside an outer red bag, again tied securely at the top. Unplug from the mains, wipe with detergent and hot water. Dry with a lint free cloth. Washed and then autoclaved in Sterilisation and Disinfection Unit. They must not be left soaking in solution. All patients about to undergo any surgical procedure should be asked if they have been notified as at increased risk of CJD or vcjd. See CJD Policy Treat cold and heater humidifier systems the same. Manufacturer instructions should be followed. See also separate guidelines for cleaning and disinfection of neonatal equipment. Send to SDU in designation container. All instruments are treated as infected. However, SDU to be notified of patients known to have blood born virus infections. For instruments used on a patient/s with suspected or proven CJD, contact the Infection Prevention & Control Team. Intravenous Infusion Stand Wipe with a solution of detergent and hot water and dry thoroughly. Clinical staff SDU

Intubation Laryngoscope Wipe with a solution of detergent and hot water, rinse and store dry. Following an infection it may be necessary to disinfect. Contact the Medical Microbiologist or Infection Prevention & Control Team if in doubt. Jugs Single use only, disposable after use. Theatre or Anaesthetic Practitioner Laryngeal Masks a) Sterilisation and Disinfection Unit for decontamination. Limited Use Items. SDU Laryngoscope Blades Disposable preferably, if not autoclave in SDU. Theatre Practitioner Linen Bag Holder Clean weekly with a solution of detergent and hot water and dry. Linen Used See Trust colour coding/segregation chart for used linen. Appendix E Manual Handling Wash at recommended temperature. Use disposable for infected Laundry Equipment patients. Slings Mattresses / Pillow / Propad Cushions Wipe with a solution of detergent and hot water, rinse and dry thoroughly. Mattresses / Pillow / Propad Cushions (if contaminated) Pressure mattresses can be sent to MDMC Mattresses Pressure relieving types e.g. Alphaxcell Clean with a solution of detergent and water, then, disinfect with Tech-care solution, rinse and dry. MDMC Procedures Switch off the pump and disconnect the power source. Ensure the air sacs under covers are thoroughly cleaned. Wipe over pump and tubing, hanging bracket and mains lead. Remember to clean mattress sides as well as cover using a detergent and hot water solution. Then return to Medical Device Management Centre for subsequent processing by the laundry. DO NOT disinfect unnecessarily as this could damage cover. For all special mattresses and beds see manufacturers instructions. It is important to ensure that the mattresses are thoroughly dried after cleaning especially the air sacs and inside covers to prevent bacterial growth. MDMC MDMC Staff Medical Physics Equipment Wipe down with hot water and detergent and dry on return from the Clinical Scientist patient, prior to reuse on another patient. Monitor (blood pressure) Clean the pump with alcohol spray and a yellow cloth. Clean the display window with a soft lint free cloth sprayed with alcohol free glass cleaner. Mops Vel Mops Single use only. Only to be used when unable to vacuum. Nebulizer Chambers Dismantle and wash in hot water with detergent, rinse, reconnect and blow air thoroughly to dry. Store in plastic bag. Single patient use.

Oxygen Cylinders and Carriers Wipe surfaces with a solution of detergent and water. Dry thoroughly. Oxygen Masks Single patient use only. For same patient comfort, it can be cleaned by wiping with warm water and detergent, and dried. Oxygen Tubing Single patient use only. Patientline Equipment (units, earphones and head sets) Wipe units with a solution of detergent and hot water followed by a wipe with a 70% alcohol wipe between patients. Head sets and earphones are disposable (single patient use) and to be changed between patients. Patientline/ Patients Own Clothing Peak Flow Meters Razors Scrubbing Machines and wet Suction Machines Sigmoidoscopes (non Proctoscopes Dispos) Sigmoidoscopes / Protoscope leads and light source Soap Liquid Dispenser Soap Liquid Specula Stethoscope Remove any solid matter. Place in clean plastic bag and label with patient details. Mouthpiece disposable. Meter immerse in detergent and wipe with Actichlor and dry. Single patient use only. Drain reservoir and allow to dry after use. Wash and dry cleaning pads thoroughly. Either send home to be washed or contact Patients Clothing Dept in Laundry. Do not take cleaning pads from one area to another to avoid cross infection. Autoclave in SDU. Mechanical washing recommended. Sterilise in autoclavable. SDU Wipe with a solution of detergent and hot water and dry. Wipe over regularly with a solution of detergent and hot water, leave to dry before inserting new bag. This should consist of an inner bag of liquid soap complete with dispensing nozzle which should be disposable when soap used, then replace with a fresh bag. Single patient use: b) Reusable: return to SDU for autoclave. Disposable: discard in yellow clinical waste bag. Wipe with hot water and detergent to remove any debris then wipe with 70% alcohol wipe or spray. Filters are recommended on bellows. Patient Clothing / Laundry / SDU / SDU Doctors Practitioner Suction Catheter Single use only. Suction Lines Disposable. Clean canister which holds suction lines with disposable cloth rinsed with detergent and hot water. Suction Tubing Disposable. If in constant use, change tubing daily. Change between

single patient use. Suction Wall Mounted Apparatus Replace filter frequently also if wet or discoloured and when the collector is full and float valve is not working. Wash and dry the float valve and collector in a solution of detergent and hot water. Syringe drivers Wipe over with detergent and hot water. Syringes metal cartridge Autoclave in SDU. SDU Telephones Wipe over with detergent and water. Doctor Thermometers digital a) Tempadot single use only. b) Mechanical wipe with 70% alcohol. Practitioner Toilet Pan Daily lift seat, clean with sanitary cleaning agent, clean using designated brush and clean water. Rinse with fresh water (flush a couple of times). Damp dust cistern top, ledges and handles etc using sanitary cleaning agent. See appendix A Toilet Seats Using gloves (disposable) and disposable cloth, wash with a solution See appendix A of detergent and hot water and dry with a disposable paper towel at least once daily. Use Actichlor in addition if grossly contaminated (e.g. faecal contamination). RINSE and dry. Tooth Mugs Disposable single patient use only. Toys Wipe with detergent and hot water. Remove any soft toys from Clinical. Tracheotomy Tubes Single patient use or autoclave if non disposable (wash first and send Trolleys designated for Dressings metal ones to SDU). Clean thoroughly daily with detergent and hot water. Between dressings, spray with 70% alcohol. / Medical Staff Trolleys Medicine Trolleys other e.g. Food, Transporting of patients, Telephone etc Tubing (Anaesthetic / Ventilator) Under Water Seal Drainage Equipment Urinals Wash inside and out with a solution of detergent and hot water. Dry. Remember to include wheels in cleaning. Wash regularly with a solution of detergent and hot water. Dry. Remember to include wheels in cleaning. Disposable. Single patient use only. Disinfection in bedpan washer machine with a heat disinfection cycle which must reach a temperature of 80 degrees centigrade for one minute during this cycle. See also Anaesthetic Equipment. / / ODO s / Porters / Theatre Practitioner Theatre Practitioner

Ventilators in ITU Ventilators in Theatres Ventilator external circuits In Use Change external circuit every week as recommended (or between patients if the lesser time). Single use micro filters to be in place. Change circuits if there is visible or perceived contamination. Between Patients Wipe over outer surface of ventilator and filters. Manufacturer instructions should be followed. Disconnect before cleaning. Theatre / Anaesthetic Practitioner For advice re specific infections e.g. Tuberculosis, contact the Infection Prevention & Control Team. In line single use filters to be disposed of. Wheelchairs Wash with a solution of General Purpose Detergent and hot water and dry thoroughly after each patient use. The Spinal Unit has a designated decontamination area for wheel chairs /AHP/Portering Staff Walking Aids Wipe with hot water and detergent and dry thoroughly. Therapy Staff Recycling Unit Walls Walls (Spot cleaning only) The cleaning of walls should be carried out sufficiently often to prevent the accumulation of visible dirt. Wash with a solution of detergent and hot water. Use disinfectant only in cases of frank contamination (e.g. splashes of blood, urine etc). When spot cleaning walls, the surface should be left as dry as possible Damaged wall surfaces should be promptly repaired. staff will only clean accessible walls. Contact Estates Department for ceilings and high level cleaning. ETS ETS X Ray Equipment Switch off. Wipe over with a detergent and hot water solution. Do not over wet. Allow to dry before use. Follow manufacturers instructions X Ray Staff