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When purchasing sharps or devices with sharp components that cannot be safely cleaned, single-use devices or components shall be considered. These items should be designated single-use and not be reprocessed and re- used, even if designated as reusable by the manufacturer. If the integrity of the package is compromised, the item can no longer be considered to be sterile and it must be reprocessed again before use. Sterility of sterile items shall be maintained until used. Environmental Requirements for Reprocessing Areas 8.

Policies and Procedures Education and Training Occupational Health and Safety for Reprocessing Disposable sharps shall be disposed of in an appropriate puncture-resistant sharps container at point-of-use, prior to transportation. Selection of Product and Level for Reprocessing Factors Affecting the Efficacy of the Reprocessing Procedure Continued Monitoring and System Failures B Moderate evidence to support a recommendation for use.

C Insufficient evidence to support a recommendation for or against use D Moderate evidence to support a recommendation against use. E Good evidence to support a recommendation against use. Evidence from at least one well-designed clinical trial without randomization, from cohort or case-controlled analytic studies, preferably from more than one II centre, from multiple time series, or from dramatic results in uncontrolled experiments. Evidence from opinions of respected authorities on the basis of clinical III experience, descriptive studies, or reports of expert committees.

NOTE: When a recommendation is based on a regulation, no grading will apply. Disinfection and sterilization: An overview. Access to decontamination areas shall be restricted to authorized personnel as defined by departmental policies.

LITERATURE SEARCH AND SELECTION CRITERIA

Eating, drinking, smoking, applying cosmetics or lip balm, and handling of contact lenses shall not take place in decontamination areas. Storage of food, drink, or personal effects in decontamination areas shall be prohibited. Space Recommendations: 1. There must be clear separations between soiled and clean areas a decontamination work areas should be physically separated from clean and other work areas by walls or partitions to control traffic flow and to contain contaminants generated during the stages of decontamination; b soiled work areas must be physically separated from all other areas of the space; c walls or partitions should be constructed of materials capable of withstanding frequent cleaning with the cleaning and disinfecting products used in the health care setting; d doors to all work areas should be kept closed at all times; self-closing doors are recommended to restrict access and optimize ventilation control; and e in healthcare facilities, doors should be pass-through, to ensure one-way movement by staff from contaminated areas to clean areas.

There must be an area for donning or removing Personal Protective Equipment PPE : If staff interchange is required between clean and contaminated areas, PPE shall be carefully removed and hands thoroughly washed. There must be easy access to hand hygiene facilities a dedicated hand washing sinks must be provided; b hand washing sinks should be conveniently located in or near all decontamination and preparation areas and at all entrances to and exits from the decontamination area; c hand washing facilities should also be located in all personnel support areas e. The reprocessing area is regularly and adequately cleaned9, a There is an area for storage of dedicated housekeeping equipment and supplies; b wet-vacuuming or hand-mopping with a clean mop head and clean, fresh water should be done at least daily; c spills are cleaned up immediately; and d there is an area for waste.

There is adequate storage space: a there is an area for transportation equipment e. In addition to issues of mineral content hardness or softness , piped water supplies can also introduce pathogens and unwanted chemicals to decontamination processes. Water should appear colourless, clean and without sediment. Canadian Standards Association. Audits should be carried out on a regular basis e. Audit results should be reviewed by the sterile processing department and the reprocessing committee. Appropriate departments and Infection Prevention and Control are notified when follow up is required.

Comply with endoscope A. Endoscope is wiped and flushed immediately manufacturer's following procedure. Debris collected in the endoscope is removed cleaning. Debris collected on the endoscope is removed surface cleaning. A leak test is performed E. The endoscope is visually inspected to verify effective operation. Verify that endoscope can A.

Specific steps in reprocessing have been verified with the endoscope manufacturer before reprocessing endoscope in AER. Conflicts between the reprocessing instructions instructions and resolve provided by the AER manufacturer and those conflicts.


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Adhere to endoscope A. Reprocessing protocol A.

All channels of reprocessed endoscopes are incorporates a final drying flushed with alcohol followed by purging with step. Endoscope-specific reprocessing instructions from the AER manufacturer are correctly implemented. Written, device-specific reprocessing instructions for every endoscope model are available to reprocessing staff. Written policies and procedures for the reprocessing system are available to reprocessing staff.

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Disinfection In Healthcare 3Rd Edition

Comprehensive and A. New reprocessing staff receive thorough intensive training is orientation in all procedures. Competency is maintained by periodic annual assigned to reprocessing hands on training with every endoscope model endoscopes. Competency is documented following supervision of skills and expertise with all procedures. Frequent reminders and strict warnings are provided to reprocessing staff regarding adherence to written procedures. There is additional training with documented competency for new endoscope or AER models.

A comprehensive quality A. There are periodic visual inspections e. There is a scheduled and documented endoscope preventive maintenance program. There is a documented preventive maintenance program for AERs. There is a documented preventive maintenance program for all reprocessing system filters. AER process monitors are utilized and logged. Chemical germicide effectiveness level is monitored and recorded in a logbook. There are records documenting the serial of endoscopes leaving the endoscope reprocessing area e.

Staff adhere to Routine A. Correct hand hygiene technique is Practices. There is compliance with procedures for wearing clean, non-sterile gloves. Appropriate PPE is worn during endoscope cleaning and reprocessing. Heavily soiled and wet linen is placed into a waterproof bag prior to depositing in linen hamper F. Procedures are in place to prevent sharps injury. Endoscope reprocessing H. All procedures are in compliance with the policies and physical space Occupational Health and Safety Act, R. It may also be used as a task check list by reprocessing staff. Discard disposable valves. Place reusable valves and irrigation ports and removable parts into enzymatic cleaner.

Fill basin or sink with clean water for leakage testing. Perform leakage testing in the decontamination area, prior to reprocessing each endoscope. Attach the water resistant cap to cover the electrical socket on the scope where applicable. Check that the leakage tester is emitting air and confirm that the connector cap is dry.

Immerse the entire endoscope in the water and observe for 30 sec. Visually inspect for potential leaks. Manipulate the angulation knobs to check for potential leaks. Remove the endoscope from the water and then turn off the air supply. Disconnect the leakage tester from the air supply and allow the endoscope to depressurize. Disconnect the leakage tester from the water resistant cap. Dry the leakage tester connector cap. Completely immerse the entire endoscope in freshly prepared enzymatic cleaner in basin or sink. Verify that instrument is totally immersed during entire cleaning process to prevent splashing or aerosolization.

Verify that the bending section is straight so brushing does not damage endoscope. Clean the exterior of the endoscope with a soft brush or lint free cloth. Clean brush in enzymatic cleaner each time brush is passed through channel. Brush suction valve housing and instrument channel port with channel opening brush until all debris is removed. Attach a 30ml. Brush and flush the valves and removable parts until all debris is removed. Perform the final rinses in clear water followed by air purges using 30 ml.

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Thoroughly dry the exterior of the endoscope and all removable parts using a clean lint free cloth. Inspect the endoscope for residual debris and repeat the manual cleaning process if debris remains. Immerse the entire endoscope, valves, cleaning brush and removable parts in a basin of HLD solution. Using a 30 cc syringe flush the HLD solution to purge air from all channels.

Soak the endoscope in HLD solution for the recommended time and temperature. Flush air through the endoscope channels using adapters suction cleaning adapters. Perform a channel air flush followed by an alcohol and an air purge. Dry the endoscope with a lint free cloth. Manipulate angulation knobs to test scope flexibility. Ensure optical clarity of telescope. Dry for ETO sterilization where required. Send accessories, e. Properly place the endoscope, valves, cleaning brush and removable parts in the chamber Note: Monitor endoscope stacking.

Disinfection In Healthcare, 3Rd Edition

Remove the endoscope promptly after the final cycle has been completed. Sign off that all AER parameters have been met. Record endoscope number in AER logbook with date. Seal, wrap and label package for ETO gas sterilization according to facility protocol. Sterilize according to ETO parameters.

Disinfection and Sterilization Important Information to Know

Store on shelf. Position the control portion upright, especially if the endoscope is placed on a counter. Transport the endoscope using both hands. Ensure the endoscope was dried thoroughly before storage. Remove all valves and removable parts from the endoscope to prevent the retention of moisture. Hang the endoscope with the insertion tube and light guide tube placed vertical support the body. Infect Dis Clin N Am 25 : They are in the process of publishing a number of best practice guidelines. Infection Control Guidelines. Community and Hospital Infection Control Association - Canada National association for infection prevention and control professionals in Canada.

Offers a number of Position Statements and expertise in infection prevention and control. Available for purchase from APIC online store. References 1. Rexdale, Ont. Mississauga, Ont. Report No. Public Health Ontario. Just Clean Your Hands. Ontario's evidence-based hand hygiene program. Released Ministry of Health and Long-Term Care. Health Protection and Promotion Act: R. Toronto, Ontario [cited November 25, ]. Occupational Health and Safety Act.

Needle Safety. Surgical site infections linked to contaminated surgical instruments. J Hosp Infect. Spaulding E, editor. The role of chemical disinfection in the prevention of nosocomial infections. Food and Drugs Act. Transport Canada. Transportation of Dangerous Goods Act, Health Canada. Classic Creutzfeldt-Jakob Disease in Canada. An infection control guideline. Can Commun Dis Rep. Environmental Protection Agency EPA -registered products that have an EPA registration number on the label can make public health claims that can be relied on for reducing or destroying germs.

The EPA registration label will also describe the product as a cleaner , sanitizer , or disinfectant. Use fragrance-free bleach that is EPA-registered as a sanitizing or disinfecting solution 6.


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  • If other products are used for sanitizing or disinfecting, they should also be fragrance-free and EPA-registered 7. All products must be used accordining to manufacturer's instructions. Employers should provide staff with hazard information, including access to and review of the Safety Data Sheets SDS as required by the Occupational Safety and Health Administration OSHA , about the presence of toxic substances such as, cleaning, sanitizing and disinfecting supplies in use in the facility. The SDS explain the risk of exposure to products so that appropriate precautions may be taken.

    Disinfection in Healthcare 3rd Edition

    Answer: BPA, phthalates, and other additives may leach from a plastic toy while being exposed to the heat of a mechanical dishwasher. Hence, the reason standard 5. However, there is no evidence available to either support or refute the use of a mechanical dishwasher to clean, rinse, and sanitize toys. Toys that cannot be cleaned and sanitized should not be used. Toys that children have placed in their mouths or that are otherwise contaminated by body secretion or excretion should be set aside until they are cleaned by hand with water and detergent, rinsed, sanitized, and air-dried or in a mechanical dishwasher that meets the requirements of Standard 4.

    Formulation of Sanitizers and Disinfectants. Control of Staphylococcus aureus and Enterococcal Infections. Control of Legionella. Mycobacterial Disinfection. Chemical Sporicidal and Sporostatic Agents. Principles of Viral Control and Transmission. Disinfection and Control.

    Measures for Disinfection and Control of Viral Hepatitis. Fungistatic and Fungicidal Compounds for Human Pathogens. Antiprotozoan and Anthelmintic Agents. Prevention Control and Removal. Emerging Infectious Diseases. Sterilization by Heat. Sterilization and Preservation by Radiation Sterilization. Medical Device Infections. Infection Control with Endoscopes. Medical Applications of Peracetic Acid.

    Infection Prevention for Skin and Burns. Drinking Water Recreational Water and Wastewater. Sterilization Disinfection and Asepsis in Dentistry. Disinfection and Disease Prevention in Veterinary Medicine. Disinfection of Contact Lenses. Hazard of Infectious Agents in Microbiologic Laboratories.