Cleaning and Disinfecting Patient Care Equipment 
 

Policy 
 

The Medical Center is dedicated to minimizing the risk of nosocomial infection by establishing guidelines for the cleaning and disinfection of shared equipment. This policy provides guidelines for the recognition of clean or soiled equipment and guidelines for storage or treatment after use.  The following procedures define and establish standards for assuring that non-critical (defined by the Centers for Disease Control (CDC) as items that come into contact with intact skin but not mucous membranes), shared patient care equipment is clean before use and that all used or contaminated equipment is appropriately cleaned before reuse.

General Information

A. Defining Terms

1. Cleaning is the removal of organic and inorganic material from objects and surfaces. This is normally accomplished by using detergents or enzymatic products. Thorough cleaning is necessary before disinfection and sterilization because organic and inorganic materials that remain on the surface of instruments interfere with the effectiveness of these processes. 
 

2.  Decontamination is the use of physical or chemical means to remove, inactivate, or destroy   microorganisms on a surface or item so they are no infectious and the surface or item is rendered safe for handling, use, or disposal. The selection and use of cleaning equipment, chemicals and exposure times suggested by the device manufacturer should Generally be followed to prevent damage to the items.  

3. Disinfection is a process that reduces the number of microorganisms (with the exception of bacterial spores) on inanimate objects. This is done most often by use of an approved hospital detergent/disinfectant or chemical sterilant.  
 

a. High-level disinfection includes pasteurization or use of gluteraldehyde.  All microbial life (except spores) is destroyed.  Items that touch mucous membranes should receive high-level disinfection i.e. flexible endoscopes, laryngoscopes and other similar instruments. (Semi–critical items)

b. Intermediate-level disinfection utilizes hospital-grade disinfectant, an EPA-approved tuberculocidal cleaner/disinfectant.  Items that touch mucous membranes or skin that is not intact should receive intermediate-level disinfection i.e. thermometers, hydrotherapy tanks

c. Low-level disinfection: a disinfection process that will inactivate most vegetative bacteria, some fungi, and some viruses, but cannot be relied upon to inactivate resistant microorganisms (e.g., mycobacteria or bacterial spores) and is used for items that touch intact skin i.e. stethoscopes  beds, whirlpools, and equipment that is NON-INVASIVE to patients.  (Non-critical items) 

4. Antisepsis inhibits the growth of microorganisms on living tissue (e.g. skin preparation before vascular line insertion or other invasive procedure).  Alcohol, chlorhexidine gluconate, and Iodophors, i.e., betadine are the most frequently used solution for antisepsis.  Germicidal chemicals used for antisepsis are not Generally adequate for decontaminating environmental surfaces. 
 

5.  Sterilization is the complete destruction of all microbial life. It is accomplished by either a physical or chemical process such as steam under pressure, dry heat, ETO gas, and liquid chemicals.  All items that enter sterile tissue or the vascular system must be sterile, i.e. implants, scalpels, needles, surgical instruments etc. (Critical items) 
 

B.  Only clean equipment is stored in the clean equipment area.  Equipment that is in continuous use and cleaned daily (Procedure Section A) may also be stored here.  Equipment will not be stored on or immediately around the sink to avoid contamination. All other equipment that is not clean or cannot be cleaned immediately after use shall be labeled to indicate that it is ready for reprocessing and placed in the dirty equipment area or sent to Materiel Services (Procedure Section B).

C. Only soiled equipment is stored in the soiled or “dirty” area and shall be labeled to indicate that it is ready for reprocessing. 
 

D. High-touch surfaces and equipment in patient rooms in acute and critical care areas are cleaned at regular intervals, at least daily and upon discharge or transfer of the patient, as directed in the Patient Support Assistant Room Cleaning Procedure and the Environmental Services Policy and Procedure Manual.

E. Cribs are sent to Materiel Services for cleaning between patients; isolettes are sent to Materiel Services for clean