Healthcare Hygiene magazine September 2020 September 2020 | Page 33
unattended in hallways or public areas. The top of the case carts
and container handles should be wiped with a disinfecting wipe
before transport to prevent cross contamination.
●Prevent. Remove gloves and perform hand hygiene before
transporting the case cart to the designated area. Contaminated
gloves are a source of transmission when touching other surfaces
along the way like the doorknobs, elevator buttons, and push
open plates.
Meticulous Procedures in the Decontamination Area
Cleaning operating instruments and tools requires meticulous
processes and unyielding attention; there is no room for error
when you are eradicating infectious microorganisms and bioburden
from lifesaving instruments. In the SPD, technicians must be
laser-focused while:
●Sorting. Determining the category instruments fall into:
are they delicate? Can they be submersed? Do they need to be
disassembled? Are there even more specific cleaning procedures
for the device? It’s crucial to separate sharp items before they
pierce PPE. Case carts also need to be emptied and processed for
cleaning after each use.
●Preparing to manually clean instruments. Prep the
right detergents, at the right dilutions and temperatures, to
manually clean instruments and tools. Thorough hand-cleaning
and disinfection is performed on items that cannot go through
mechanical washing.
●Inspecting. All items processed in the decontamination area
must be inspected to ensure the cleaning process was successful.
Use visual and chemical aides to detect bioburden. If bioburden
is detected, clean the items again.
●Mechanically cleaning. All multiple-level trays must be
separated, and instruments must be disassembled to ensure that
the cleaning action of the mechanical washer and sonification
process touches every instrument surface. Disassembly must take
place for a thorough clean.
Preventing Cross Contamination in the Decontamination
Area
The decontamination area will become soiled and contaminated
over the course of a day as instruments and tools are brought
through for processing. As such, we must follow the appropriate
procedures to disinfect the decontamination area in between
processes. It is significantly important to understand the conditions
in which microorganisms live and although we cannot see them with
the naked eye, they are present on the contaminated instruments,
equipment, and surfaces.
Our role in the decontamination area is to destroy microorganisms
regardless of their type or lethality. The steps must
be consistently followed during the cleaning process, items
disassembled and rinsed after cleaning. Rinsing will remove lose
debris and bioburden from the device allowing the next steps in
the cleaning process to take place.
●Disinfect sinks after each tray is cleaned to limit the transfer
of loose bioburden/contamination to the next item. All cleaning
tools such as brushes, cleaning sponges and cloths should be
cleaned after each use following the manufacturer’s instructions
for use. Disposable tools should be discarded.
●Change linen between processing and dispose of soiled linen
in the appropriate receptacles.
●Keep Separate “clean” and “dirty” spaces so there is no cross
contamination after processing.
●Clean surfaces regularly with hospital-approved disinfectant.
Clean surfaces when they become visibly soiled.
●Housekeeping procedures for cleaning floors, walls, and vents
must be on a regular schedule to minimize microbial growth in
the environment.
●Wipe water faucets and handles, doorknobs, phones,
equipment panels, tables, and case carts after each use.
●Mechanical equipment must also go through a disinfection
process. Thoroughly clean the outside of the equipment and ensure
the strainers are not clogged as it may prevent water circulation
and can create conditions in which bacteria can grow.
● Don and doff PPE in the proper order, if uncertain become
familiar with the facility donning and doffing procedures to ensure
the proper steps are followed.
●Perform proper handwashing procedures before and after
removing PPE.
Infectious diseases such as COVID-19 are of a great concern
not only for healthcare workers but for the population in general.
Consistent procedures, performance expectations, process
audits, collaborative teams, and open communication, create
a culture of safety and minimizes the risk to harm patients and
healthcare workers.
Mary Olivera, MHA, CRCST, CHL, FCS, has actively participated
in the monitoring, surveying and training interdepartmental
staff in the proper cleaning, decontamination and sterilization
practices and has been highly committed to the standardization
of interdepartmental processes. Currently, she is the president
and CEO for OSPECS Consulting, LLC. a company dedicated to
facilitating process re-engineering in healthcare organizations.
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stakeholders from all aspects of prevention and control (including IP/
healthcare epidemiology, healthcare value analysis, quality/safety/
risk management, surgical services, sterile processing, environmental
services, biomedical engineering and scientific research) to submit
science-driven, best practice-based articles for consideration for
publication. Please, no public relations pitches or articles with
commercial overtones. Send your queries to
Kelly Pyrek at: [email protected]
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