April 20, 2022 admin
Disinfection of Healthcare Equipment as per CDC.
Learn to classify the healthcare equipment for disinfection:
The equipment used in the healthcare industry needs to be maintained for its hygiene can working capacity. The instruments used in hospitals are classified into three categories based on the severity of disinfection required. The non-critical equipment are those which do not come in contact with the internal parts of the patient. The non-critical instruments come in contact only with the intact skin of the patient which imposes minimum chances of infection. The non-critical instruments are the stethoscopes, thermometers, blood pressure monitors, etc. Our intact skin is the first immunological barrier that protects us from invading pathogens. Therefore, the non-critical instruments require a low level of disinfection. The second class of hospital equipment is the semi-critical equipment that comes in contact with the mucous membranes of the body. These are generally the scopes that enter the colon or rectal parts. These instruments enter the internal parts of the body which gives a high chance of infection. The semi-critical equipment needs high-level disinfection before its reuse. The most important class of equipment is the critical instruments which are also termed surgical instruments. The critical instruments are those that directly come in contact with the blood and sterile tissues of our body. These instruments require sterilization as the chances of transmission of infection through contaminated instruments.
Caring for healthcare equipment with proper disinfection:
The healthcare equipment are generally reprocessed and used multiple times. Therefore, the disinfection of instruments used for patient care is mandatory. The Centre for Disease Control and Prevention (CDC) provides guidelines for disinfection and sterilization of healthcare instruments. According to the guidelines the heat-labile instruments are to be disinfected using the high-level disinfectant chemicals that are recommended for the hospital instrument disinfection. The surgical instruments come in direct contact with the sterile tissues of the patient hence it needs high-level disinfection or sterilization. Pre-cleaning of the instruments before disinfection is necessary to remove the organic contaminants, soils, cellular components, and other debris so that the disinfectant can exhibits its action. Pre-cleaning also reduces a load of microorganisms on the instrument. The factors affecting the cleaning of an instrument are quality of water, type and concentration of detergent, and type of instrument.
The pre-cleaned devices are disinfected by soaking in an aldehyde-based or triamine-based disinfectant. Traditionally, formaldehyde was used for instrument disinfection and endoscope reprocessing. Due to the carcinogenicity of formaldehyde, its use is no longer accepted by the CDC guideline. The CDC recommends 55% ortho-phthaldehyde for endoscope reprocessing as it exhibits antimicrobial activity against a broad spectrum of microorganisms. The commonly reported pathogens that contaminate the surgical instruments or the scopes are Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella, Bacillus species and Mycobacterium tuberculosis. Mycobacterial contamination is the hardest to disinfect. Therefore, these instruments must be disinfected with EPA (Environmental Protection Agency) registered with tuberculocidal claimed disinfectant.
Prerequisites for surgical instrument disinfection:
Most invasive surgical procedures involve medical devices and surgical instruments that come in contact with the sterile tissue of the patient and the possibilities of surgical site infections are the highest. The surgical site infections can be reduced to the negligible opportunity of infection by adherence to stringent disinfection protocols. The CDC has defined prerequisite steps for the disinfection of the surgical instruments. The first step to disinfection is the decontamination or pre-cleaning of the surgical instrument. The pre-cleaning step is mandatory for the removal of soil and reducing the load of microorganisms. For pre-cleaning of instruments detergents or enzymatic cleaners are recommended. The enzymatic cleaner help to reduce the cellular contaminants on the instrument. After precleaning with enzymatic cleaner or disinfectant, the instrument is to be cleaned with water to remove the residual detergent. The instruments are then treated with disinfectant. The instruments are emersed in the disinfectant and given the required contact time. It is followed by rinsing and drying of the instrument. The disinfected instruments are then stored in ambient conditions and sterile facilities to avoid contamination.
IMAEC’s Solutions for healthcare instrument disinfection:
IMAEC MEDNTEK has formulations that are recommended for safe and efficient healthcare equipment disinfection. MEDNTEK ID 50 is the aldehyde free surgical instrument disinfectant with triamine formulation. It is a highly effective instrument cleaner that has a broad spectrum of activity. The antimicrobial spectrum of MEDNTEK ID50 formulation is extended to invade bacteria, fungi, viruses, yeast as well as bacterial spores. It is also an efficient disinfectant for the disinfection of RO membranes. Its 2% solution used with a contact time of 15 minutes works as a pre-cleaner and with a contact time of 60 minutes as a disinfectant. For endoscope reprocessing IMAEC has specified MEDNTEK OPA that has 0.55% ortho-phthaldehyde. It is a high-level disinfectant used for gastrointestinal endoscope reprocessing. IMAEC aims to aid the complete infection control strategies of a healthcare facility.
References:
- Healthcare Equipment | Disinfection & Sterilization Guidelines | Guidelines Library | Infection Control | CDC. (2019, May 24). https://www.cdc.gov/infectioncontrol/guidelines/disinfection/healthcare-equipment.html
- How and When to Sterilize Medical Equipment. (2020, December 10). Mindflow Design. https://www.mindflowdesign.com/insights/medical-equipment-disinfect-sterilize-how-to-guide/
- Rutala, W. A., & Weber, D. J. (2004). Disinfection and Sterilization in Health Care Facilities: What Clinicians Need to Know. Clinical Infectious Diseases, 39(5), 702–709. https://doi.org/10.1086/423182