Cleaning, Disinfection, and Sterilization for Patient Care Equipment in Outpatient Healthcare Settings

1. Module G Application of Cleaning, Disinfection and Sterilization Principles to Patient Care Equipment in Outpatient Healthcare Settings

2. Objective • Discuss principals of disinfection and sterilization for medical devices used in outpatient facilities

3. Physical therapy • High risk patients (wounds, burns, trauma) • If on contact precautions ideally seen at end of day

4. Hydrotherapy Head rest, slings, etc. wiped with EPA-registered disinfectant detergent after each patient use

5. Infection Control in Gym/Activities Room • Splinting tanks emptied and cleaned weekly • The hot pack hydrocollator emptied, cleaned every 2 weeks. Assure water temp >160°F • ColPac is cleaned biannually, temperature monitored daily (10-21° F)

6. Infection Control in Gym/Activities Room • Frequently used items (hand weights, parallel bars, stair rails, and canes) cleaned after each use, and weekly. • Wheelchairs, cuff weights, and mats wiped down with a EPA-registered disinfectant weekly or when visibly soiled. • Patients using PT or rehab areas with shared equipment should perform hand hygiene upon entry and exit

7. Cleaning Toys • Toys should be non-porous and able to withstand mechanical cleaning • Toys should be: • Inspected for damage • Cleaned/disinfected

8. Pharmacy - Infection Control • Perform hand hygiene with antimicrobial soap or alcohol-based hand rub at these times: • Upon arrival at work • After eating, drinking or handling food • After using the toilet • Prior to preparing IV medications • When repackaging and handling medications • When returning from outside pharmacy area

9. Stock-clip.com

10. Medication Preparation and Storage • Must be a clean, dedicated area • > 3 feet from sink • Free of clutter • Cleaned after each shift and with any medication spills • No food, drink or specimens stored in refrigerators/freezers with pharmaceuticals • Medication refrigerators/freezers should be continuously monitored to ensure temperature within proper range

11. Phlebotomy station

12. Thermometers Electronic thermometers - rectal (red) or oral (blue) • New disposable hard plastic sheath for each patient • Cord, probe, and unit cleansed daily and when visibly soiled with alcohol single-use pledget • Do not place unit on surfaces in patient/exam room Alternatives for ambulatory care are disposable thermometers

13. Ear and Temporal Scan Thermometers Ear and Temporal Scan Thermometers • New plastic cover each use • Unit (especially end of probe membrane) wiped daily and when visibly soiled with 70-90% alcohol, or per manufacturer’s recommendations

14. Ear, nose and throat (ENT) Equipment Reusable ear specula and curettes • Washed with detergent and water and autoclave. Reusable nasal specula • Clean and autoclave after each patient use Non disposable tips on audioscopes/tympanometers • Washed with detergent and water, • Soak in alcohol 5-10 m

15. Eye Equipment • Applanation tonometer • Soaked in bleach (1:10) dilution for a minimum of 5 minutes - then flushed with tap water for 15-20 seconds and allowed to dry • Tonopens • Thoroughly disinfected with 70% alcohol after each use • A new tip cover is placed for each patient use • Gonio Lenses • Disinfect between each patient by immersion in a 1:10 bleach solution for 10 minutes • Thoroughly rinse through three cycles, and allow to dry prior to storage

16. Eye equipment and drops Slit lamps • Head rests, chin rests, and handles wiped with a 1:100 sodium hypochlorite solution or 70-90% alcohol between patient uses. Eye Drops • Read label (single vs multi patient use) • If multi-patient, take steps to prevent contamination

17. Electrocardiogram (ECG) Cables and Leads • Cables and leads wiped with EPA-registered disinfectant after each use • Clean machine at least weekly and when visibly soiled

18. Blood Pressure Cuffs • Cleaned with EPA-registered disinfectant or 70-90% alcohol • Routinely (e.g., between patients, daily), and when visibly soiled

19. Vaginal specula • Should be cleaned with detergent and water • Steam Sterilization or high-level disinfection • Each specula should be individually wrapped prior to sterilization • Stored in a manner that prevents contamination

20. Diaphragm Fitting rings • Clean with enzymatic or non-enzymatic detergent and rinse • Immersed in high-level disinfectant or steam sterilization • Follow manufacturer's recommendations

21. Cryosurgical Probes • Cleaned with soap and water or enzymatic cleaner • Immersed in high-level disinfectant • Wrapped in high-level disinfectant soaked cloths • Follow manufacturer’s instructions

22. Vaginal Ultrasound Probes

23. Prostate Biopsy Probe • Fully disposable prostate biopsy equipment is preferred. If reusable do the following: • Disassemble the probe (remove the needle guide) • Clean with an enzymatic or instrument detergent taking care to flush all lumens, and rinse with tap water prior to HLD • After cleaning the ultrasound probe and needle guide shall be exposed to a complete HLD cycle per the facility policy. BE SURE that Lumen of the needle guide and probe channel are flushed with the HLD chemical • Following HLD probe and lumens should be rinsed thoroughly with sterile water and air-dried • Tap water followed by an alcohol rinse may be used rather than sterile water • Flushing air through the lumens will facilitate the drying process • The probe must be dry prior to storage

24. Infrared Coagulation Unit

25. Congratulations on completing the modules!