- Decontamination
- Spaulding classification
- Critical items
- Items that enter sterile tissue eg surgical instruments, cardiac catheters, implants, needles
- Semi-critical items
- Contact mucous membranes eg laryngoscopes, fibre-optic endoscopes. They require high level disinfection
- Non-critical items
- Come in contact with healthy skin eg BP cuff, pulse oximetry
- Terminology
- Cleaning
- Physical removal of foreign material
- Decontamination
- A process destroying contamination such that they cannot reach a susceptible site in sufficient quantities to initiate a harmful response. It is followed by disinfection or decontamination.
- Disinfection
- A process that eliminates many or all pathogens except bacterial spores.
- High-level disinfection
- Chemical which kills bacteria, viruses and spores. Only sporicidal under certain conditions
- Sterilisation
- Renders an object completely free of all viable microbial life
- Sterilisation
- Steam
- Steam at 121 or 134ᵒ for 15 or 3 mins respectively
- Chemical
- Ethylene oxide 29-65ᵒ for 5-12 hrs
- Gluteraldehyde 2% for >10 hrs
- Gas plasma has ionised gas and free radicals capable of inactivating microbes in 75 mins
- Disinfection
- Chemical
- Done using gluteraldehyde, hydrogen peroxide, peracetic acid, alcohol.
- Pasteurisation
- Hot water at 77ᵒ for 30 mins. Spores not killed.
- Endoscopes
- Pseudomonas, klebsiella and mycobacterium can be transmitted. The external surface is washed and rinsed, internal channels are brushed and flushed with detergent. Detachable parts are removed and soaked in detergent. They are pressure tested to determin integrity of seals before immersion to reduce the risk of damage to the head of the scope
- Cleaning
- Involves washing with cool water and detergent (<45ᵒ). Can be done by automated machine (including ultrasound cleaners) or manually. It lowers the bioburden before disinfection/sterilisation
- CEACCP
Link:ceaccp.oxfordjournals.org/content/4/4/103.full.pdf