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. SUBMISSIONS WANTED Healthcare Hygiene magazine invites infection prevention 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] Keep up on the latest news headlines, monthly issues and special editions at: www.healthcarehygienemagazine.com healthcarehygienemagazine www.healthcarehygienemagazine.com • september 2020 33