Patient safety is paramount in healthcare settings, and one critical aspect of maintaining a safe environment is ensuring proper disinfection and sterilization of medical devices and equipment. This not only protects patients from potential infections but also contributes to overall disease control. Let’s explore the essential safety protocols for handling disinfectants in sterile processing, which promote patient safety and minimize healthcare-associated infections.
Understanding Disinfectants and Their Role in Sterile Processing
Disinfectants serve a vital role in stopping the spread of pathogens in healthcare settings. They are regulated by organizations such as the Environmental Protection Agency (EPA) to ensure their effectiveness and safe usage. The Centers for Disease Control and Prevention (CDC) has developed guidelines for disinfection and sterilization in healthcare facilities, outlining various categories and methods for achieving sterilization, high-level disinfection, and low-level disinfection.
However, research on prions, viruses, mycobacteria, and protozoa has posed challenges to the current definitions and expectations of high-level disinfection (HLD) and low-level disinfection, particularly when it comes to respiratory therapy equipment. Patient safety and disease control hinge on adherence to recommended disinfection practices and understanding the compatibility between disinfectants and medical devices.
Following the local cleaning and disinfection policy or procedure, which specifies the disinfectant to use, is of paramount importance in healthcare settings. The CDC recommends high- or intermediate-level disinfection for noncritical patient care equipment. When other methods are not ideal, the following options can be used to treat heat-sensitive objects:
- Ethylene oxide (ETO)
- Hydrogen peroxide (HP) gas plasma
- Vaporized HP
- HP vapor (HPV) plus ozone
- Liquid chemical sterilants
These options help to achieve successful sterilization.
Actively perfusing the device while immersed in the high-level disinfectant is also recommended. Furthermore, the manufacturer’s instructions for the recommended quality of water to be used for dilution (if dilution is required) must be followed, as water purity is an important factor. To avoid damaging equipment and compromising patient safety, confirm the material compatibility between disinfectants and medical devices.
Personal Protective Equipment (PPE) for Handling Disinfectants
Healthcare personnel handling disinfectants must wear appropriate personal protective equipment (PPE). This protection guards against exposure to hazardous chemicals and potential infections from contaminated equipment, contributing to disease control. Personnel should use appropriate PPE during the disassembly and cleaning process, ensuring their safety while handling medical devices.
To comply with the Occupational Safety and Health Administration’s (OSHA) Personal Protective Equipment Standard, 29 CFR Part 1910 Subpart I, healthcare workers must wear the necessary PPE when handling disinfectants to protect their intact skin and other body parts from exposure to harmful chemicals. Engineering and work practice controls should be utilized in accordance with the hierarchy of controls outlined in 29 CFR 1910.134, supplemented by the appropriate PPE.
One example of an alternative sterilization method that can be used in sterile processing to minimize exposure to hazardous chemicals is hydrogen peroxide gas plasma. This method is less toxic and has fewer safety risks associated with it compared to ethylene oxide sterilization. Moreover, ETO cartridges should be stored in a flammable liquid storage cabinet to minimize the risk of fires and other hazards.
Cleaning and Preparing Medical Devices for Disinfection
The efficacy of the disinfection process relies on the proper cleaning and preparation of medical instruments beforehand. A thorough cleaning of environmental surfaces in healthcare settings requires a neutral detergent and water. The purpose of cleaning with warm water and detergent is to eliminate visible dirt and contamination from surgical devices and other medical equipment.
It is advised to rinse and dry the area after disinfectant cleaning with a hypochlorite solution, especially when dealing with critical devices that require a high level of disinfection. When utilizing cleaning agents for surgical instruments, it is imperative to adhere to the equipment manufacturer’s processing instructions and the detergent manufacturer’s instructions for concentration and other aspects of use.
It is recommended to clean the environment at least daily. Routine cleaning should be improved during an infection outbreak or when the frequency of a certain organism increases unusually. This helps in preventing any further spread of the disease.
Disinfection Process: Best Practices and Safety Protocols
Adherence to best practices and safety protocols during the disinfection process primarily ensures patient safety and reduces the risk of healthcare-associated infections. Remember, a disinfectant used for other purposes in SPD or on a nursing unit might not be suitable for disinfecting patient care equipment. It is important not to make any assumptions in this regard. Some facilities and organizations utilize other technologies, such as steam or vaporized hydrogen peroxide, when performing terminal cleans.
The cleaning schedule for the facility should list which staff member is responsible for ensuring each area of the room or areas within the terminal clean are cleaned. They should also specify who is in charge of completing the terminal clean-up. A terminal clean should be discussed and agreed upon between the Infection Prevention & Control Team and the nurse or manager in charge of the ward or unit. Ethylene oxide (ETO) sterilization, although effective, has potential risks associated with its use. EO is a dangerous chemical; it’s toxic, a known carcinogen, and highly flammable. Exposure should be avoided at all costs.
For the safety and effectiveness of the disinfection process in healthcare settings, adherence to EPA regulations is necessary. EPA-registered hospital disinfectants should be used, and healthcare personnel should be trained in the proper handling and storage of these chemicals.
Monitoring and Quality Control in Sterile Processing
In sterile processing, quality control is crucial to ensure the proper performance of all equipment, whether owned, leased, or rented by the facility, and to minimize potential harm to patients. Equipment critical to patient care should be part of a preventive maintenance program. This program should be conducted by qualified personnel according to the manufacturer’s recommendations, risk levels and past documented experience with the equipment..
Preventive maintenance records should be retained as outlined in the facility’s medical equipment management plan. This responsibility lies with either the SPD, the HTM department, or the repair service. The frequency of routine inspections in sterile processing should adhere to industry standards and guidelines, which may vary depending on the specific processes and equipment being utilized.
It is suggested to follow manufacturer instructions and guidelines such as ANSI/AAMI ST58 for sterilization monitoring and ANSI/AAMI ST79 for routine care and cleaning. Regular monitoring and quality control measures, including preventive maintenance programs, ongoing audits, and routine inspections, help maintain the safety and effectiveness of medical devices in sterile processing.
Ensuring patient safety in sterile processing is of utmost importance in healthcare settings. This requires a comprehensive understanding of disinfectants and their role in disease control, the proper use of personal protective equipment, meticulous cleaning and preparation of medical devices, adherence to best practices and safety protocols during the disinfection process, regular monitoring and quality control measures, and ongoing training and education for healthcare personnel.
By following these essential protocols and best practices, healthcare facilities can minimize the risk of healthcare-associated infections and maintain a safe environment for both patients and staff. Let’s all strive to uphold the highest standards of patient safety and infection control in our healthcare settings.
Frequently Asked Questions
What are 11 safety tips you should remember when using disinfectants?
Remember to always read the label carefully before using any disinfectant, have a safety data sheet on hand, avoid contact with skin and eyes, don’t mix chemicals, ensure good ventilation, wear gloves and safety glasses, wash and dry your hands after use, use the correct amount and dilution, keep Material Safety Data Sheets (MSDS) on hand, and keep away from children.
What are the CDC guidelines for disinfecting clinical contact surfaces?
The CDC recommends cleaning contaminated surfaces with an EPA-registered intermediate-level disinfectant at the beginning of the day, after each patient and at the end of the day; with a label contact time of 10 minutes. Soiled surfaces must be cleaned prior to disinfecting.
What type of personal protective equipment (PPE) should personnel use during the disassembly and cleaning process?
Personnel should wear appropriate protective equipment, such as gloves, respirators, goggles, and overalls, when disassembling and cleaning to protect against hazardous chemicals and infections.
How often should healthcare personnel receive training on handling disinfectants and sterile processing?
Healthcare personnel should receive training on handling disinfectants and sterile processing on an annual basis to ensure they are following the most current protocols and best practices.