Rehadapt Pilippe Ferreira Cleaning and Disinfection User Guide

Pilippe Ferreira Cleaning and Disinfection

Rehadapt Mounts:
Cleaning and disinfection Guidelines
10 December 2018

Definitions

Noncritical Medical Device: Devices that either touch only intact skin (but not mucous membranes) or do not directly touch the client/patient/resident. Reprocessing of noncritical devices involves cleaning and may also require low-level disinfection (e.g., blood  pressure cuffs, stethoscopes) [1. 2].
Cleaning: The physical removal of foreign material (e.g. dust, soil) and organic material (e.g. blood, secretions, excretions, microorganisms). Cleaning physically removes rather than kills microorganisms.
It is accomplished with water, detergents and mechanical action. Cleaning must be performed before disinfection or sterilization [I] Disinfection: A process that kills most disease-producing microorganisms. Disinfection does not destroy all bacterial spores. Medical devices must be cleaned thoroughly before effective disinfection can take place [1] Low-Level Disinfection (LLD): A process capable of killing most vegetative bacteria. enveloped (lipid) viruses, and some fungi. This class of disinfection does not kill mycobacteria, including Mycobacterium tuberculosis, or bacterial spores. LLD is used for  noncritical medical devices and some environmental surfaces [I]

Instructions

2.1. Considerations

• All Rehadapt devices fall into the noncritical device category according to Spaulding classification system [2]. This is due to the fact that they are only meant to be in contact with intact skin but not mucous membranes.

• As Rehadapt products are noncritical devices. cleaning is usually acceptable. However.
  when disinfection is required Low-Level Disinfection (LLD) is sufficient [1, 3].

• The device must always be cleaned prior to disinfection.

• The instructions for cleaning are defined in Section 2.2.

• The instructions for disinfecting are defined in Section 2.3.

• The recommended products used for cleaning and disinfecting are listed in Section 3.

• Rehadapt products must not be submersed as many components are hollow(e.g. tubes) and liquids can be trapped inside. Therefore. manual cleaning is preferred over mechanical cleaning.

2.2. Cleaning/Decontamination

1. Disassembling. Disassemble the device following the assembly instructions in reverse order.
2. Pre-cleaning. If gross soil is visible. wipe the surfaces with a cloth damped with tap water and remove the gross soil using tools such as brushes and cloths.
3. Cleaning. Spray every part with a detergent solution.
4. Rinsing. Rinse the surfaces thoroughly with water. Rinsing removes the residues that might react with the disinfectant.
5. Drying. The device should be dried by hand with a clean, lint-free towel (disposable paper towels are recommended). Drying removes the residual water and prevents the dilution of the disinfectantl.
6. Reassembling. Reassemble the device if disinfection is not required.

2.3. Disinfection
LLD consists in the following procedure:

1. Pre-cleaning. Clean the device according to the instructions set in Section 2.2.
2. Dilution and application. Apply a Low-Level Disinfectant for hard surfaces (see Section 3.2). Follow the product label in regard to dilution°.
3. Exposure time. The surfaces should remain wet for the exposure time included on the product label.
4. Wiping. Wipe dry with paper towels or disposable cloths. Air drying is not recommended when the disinfectant is not a alcohol solution.
5. Reassembling Reassemble the device according to its assembly instructions.

Recommended products

3.1. Considerations

• Always fallow product labels for use-dilution and time of exposure.

3.2. Cleaning detergent

• Enzymatic cleaners
• Detergents
• 0.5% Accelerated hydrogen peroxide [3]

3.3. Disinfectant
The recommended disinfectant is 70% alcohol wipes far hard surfaces [3]. For hard to reach edges and corners (e.g. wheels) alcohol solutions can be poured and let to air-dry. However. as mentioned in Section 2.2. drying the devices with a paper towel is always  recommended to prevent spotting
Despite the recommendation of alcohol. any Hospital Grade Disinfectant [4] is usually appropriate to disinfect Rehadapt mounts. Other possible disinfectants include:

• 60-90%3 Alcohol (ethanol or isoprapanol) [1. 6. 7]
• 3% Hydrogen peroxide [I] 5% Accelerated hydrogen peroxide [4. l]
• Hypochlorite (1000 ppm) [l]
• Quaternary ammonium compounds – QUATs (e.g. Zephirin, CDO, A-3) [6. l]
• Phenolics (should not be used in nurseries) [6, l]
• Diluted sodium hypochlorite (e.g. bleach) [6, l]

References

1. NHS Wirral, “Cleaning and Disinfection Policy.” NHS, 2001

2. BC Ministry of Health, “Best Practice Guidelines For Cleaning. Disinfection and Sterilization of Critical and Semi-critical Medical Devices,” 2011

3. E. Spaulding. C. Lawrence and S. Block, “Chemical disinfection of medical and surgical materials,” Disinfection, sterilization, and preservation, pp. 517-531, 1968.

4. Diversey. “Oxivir 1 Wipes.” 2018. [Online]. Available: http://solutionsdesignedforhealthcare.com/solutions/products/disinfectants/oxivir-1­wipes.

5. Shore Health System, “Cleaning Environment. Patient Equipment and Medical Devices,”
   University of Maryland Medical System, 2011

6. Environmental Health a Safety – University of Colorado. “Disinfectants and Sterilization Methods,” 2008. [Online]. Available: https://ehs.colorado.edu/resources/disinfectants­and-sterilization-methods/.

7. healthE, “Alcohol as Disinfectants,” healthE, [Online]. Available: http://www.nzhealthe.co.nz/knowledge/alcohol-as-disinfectants.

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