Decontamination Advice Guidance of A-Z Equipment Used within Care Homes in Leeds

Transcription

1 Decontamination Advice Guidance of A-Z Equipment Used within Care Homes in Leeds Author: Jennifer Featherstone Infection Prevention and Control Nurse Specialist Leeds Community Healthcare NHS Trust

2 A-Z of Decontamination of Equipment EQUIPMENT OR SITE ROUTINE OR PREFERRED ACCEPTABLE ALTERNATIVE OR Ambubags / Ambumasks Consider: 1. Disposable, single use or Detergent wipes ensure kept and appropriately stored. 2. Single patient (resident) use Baths, Showers (shower chairs) & Bidets After each resident use, wash using Consider purchasing a combined disposable cloths and hand hot water Detergent / disinfectant product. N.B. For hydrotherapy and general-purpose detergent. and Jacuzzi type baths Rinse well and allow to dry. For residents with open wounds ensure Refer to manufacturers surfaces of bath is cleaned and Instructions disinfected before and after use. Bath mats The use of bath / shower mats is not Disposable paper bath mats be used (for use outside the bath) advocated but if they are, they should instead of bath mat. be cleaned after use and be single resident use. Bed frames and cradles Between residents, wash with hand If contaminated with blood clean with (metal) hot general-purpose detergent hand hot water and general-purpose solution and dry. detergent, rinse and dry. Wipe with 10,000 ppm (1%) hypochlorite solution, rinse and dry. Bedpans, Urinals & Residents to have their own If no Bed-pan washer disinfector/ Commode pans individual (preferably labelled) macerator in home OR machine is Bedpan / urinal / commode pan. out of order empty contents of bedpans/urinals/commode pans into Use: sluice hopper or toilet (avoiding splashes) then: 1. Bed-pan washer disinfectant or 1. Place disposables in a yellow/orange 2. Place single-use disposables and plastic bag for incineration or their contents into macerator registered landfill. 2. Clean re-usable bedpan N.B. Operate equipment according holders/urinals/commode pans with To the manufacturer s hand hot water and generalrecommendations. purpose detergent, rinse and dry. Return to resident s room. Residents with diarrhoea and vomiting to have their own bedpan/urinal/ commode pan: 1. Clean with hand hot water and general purpose detergent, rinse and dry. 2. Disinfect surfaces by wiping with 1,000 ppm (0.1%) hypochlorite solution, rinse and allow to air dry.

3 Bedpan Washer Clean outer casing of machines with Engineer to check machine and seals Disinfector/Macerator hand hot water and general-purpose annually and a logbook kept. detergent on a weekly basis and immediately when visibly soiled. Bowls - Washing If bowls are necessary for the bedbound, they must be labelled with the resident s name. After use, wash with hand hot water and generalpurpose detergent, rinse and dry. Store inverted in the resident s own room. Bins (domestic and Wash weekly and when visibly soiled If contaminated with blood, wash with clinical) with hand hot water and general- hand hot water and general purpose purpose detergent in designated detergent followed by disinfecting with area. 10,000 ppm (1%) hypochlorite solution rinse and dry. Blood Pressure Refer to manufacturer s cleaning Sphygmanometer & Cuff instructions. Single resident use (disposable) cuffs are available. BRUSHES: Lavatory brushes After every use, rinse in running water (in toilet pan), and store dry. Disinfect and replace on a regular Basis or sooner if visibly contaminated. Nail brushes Do not use routinely. Single use, disposable nail brushes are available for aseptic procedures Shaving Brush Single resident use only. Use brushless cream or shaving foam. Tooth Brushes Carpets and Rugs Single resident use only. Vacuum daily. Wash periodically using carpet compatible detergent solution and hot water extraction. For contaminated spills clean with carpet compatible detergent solution and water extraction system. Disinfect carpet only if capable of withstanding disinfection. Alternatively, consider steam cleaning. Alternative floor coverings are available instead of carpets for use in areas where frequent spillage anticipated. Some carpets are available which are compatible with use of hypochlorite.

4 Cleaning equipment Use correct colour coded cleaning equipment for different areas in home e.g. CLOTHS: Toilet areas. Kitchen areas. General use. Barrier nursing. Disposable Non disposable Discard at the end of each shift and when otherwise indicated. Wash after use with hot water and general-purpose detergent. Send to laundry for heat disinfection in washing machine at the end of each shift. Commode Frames Clean after each use with a general purposes detergent solution, rinse well and dry. Wash frame and seat with hot water and general purpose detergent solution when visibly soiled and on a daily basis. After use by infectious residents always clean surfaces with general-purpose detergent solution, rinse and dry. For infectious residents disinfect surfaces by wiping with 1,000 ppm (0.1%) hypochlorite solution rinse and dry. Crockery and cutlery, Wash (and heat disinfect) in If no dishwasher available: water-jugs and glasses dishwasher suitable for commercial Wash using hand hot water and purposes. Allow to dry in general- purpose detergent, rinse and dishwasher. allow to air dry using racking system or dry using disposable paper towels / kitchen roll. Avoid the use of tea towels Curtains Launder or dry clean at least annually and or more frequently if resident has had known infection. Always change after episodes of isolation (isolation nursing), for example after MRSA; C diff; and following Norovirus outbreak THERMOMETERS: Electronic Clinical Thermometers Tympanic thermometers Single-use disposable thermometers Duvets Use disposable sleeve. Disinfect unit with 70% alcohol swab after use. Individual disposable earpiece. Single-use disposable thermometers. Launder duvet and cover in the same way as other bed linen: Follow manufacturer s instructions

5 Floors (dry) (1) Vacuum clean daily Do not use brooms in resident areas. Floors (wet cleaning of Wash daily or as appropriate with hot For known contaminated area wash first hard floors) general purpose detergent solution. with general-purpose detergent Disinfection is not routinely required. solution, followed by disinfecting with 1,000 ppm (0.1%) hypochlorite solution. Allow to dry. Flower vases When changing water/flowers, Perform thorough hand dispose of water into sluice hopper or decontamination after dealing with toilet, wash vases with general- flowers. purpose detergent solution before refilling with clean water. After use, wash vases with generalpurpose detergent solution and store dry and inverted Furniture and fittings Damp dusting with hand hot water and general purpose detergent. Hair combs Single resident use only. Wash regularly. Hair curlers Wash after use with hand hot water Residents with scalp conditions should and general-purpose detergent and have their own hair curlers. allow to air dry. Hoists Wash daily when in use and when Pay particular attention to connecting visibly soiled with hand hot water and parts. general purpose detergent. Allow to dry. Hoist slings (material) Single resident slings to be sent to Refer to manufacturer s instructions laundry when visibly soiled and on a weekly basis.. Disposable slings are available.

6 Undertake regular mattress audits Mattresses and Mattress Covers N.B. For pressure relieving mattresses always refer to manufacturer s instructions. To have fluid impermeable(i.e. waterproof) covers on mattresses. Covers to be: Washed with general-purpose detergent solution and dried using disposable cloths or paper towels Check condition and integrity of mattresses on a weekly basis. Mattresses that become soiled or damaged should be replaced. Always refer to manufacturer s instructions. N.B. Do not use disinfectant unnecessarily as this damages the mattress cover. MOPS: Establish if single use or re-useable Wet Mops Wash with hot general-purpose If disinfection is required either heat detergent solution, rinse, wring and disinfect (laundry) OR soak in 1,000 store dry and inverted between uses. ppm (0.1%) hypochlorite solution rinse well and dry. Mop bucket Medicine Pots Nebulisers Wash with hot water and generalpurpose detergent. Store dry in inverted position at the end of each shift. Treat as Crockery and Cutlery (above). Always check for single use symbol underneath. If single use dispose of after use. See Manufacturers guidance for Nebulisers Oxygen masks and tubing Single resident use only (dispose of Follow manufacturer s instructions. after each resident). Wash masks in Retain in manufacturer s wrapping until hand hot water and general-purpose required. detergent on a weekly basis and when visibly soiled. Pillows (Waterproof covers) Launder pillow and cover in the same way as other bed linen: Follow manufacturer s instructions for laundering. RAZORS: Wet Shaving Single resident use. Rinse in hot N.B. No sharing of razors. water after use. Electric Single resident use.

7 Rooms Daily cleaning of resident s room. Use hand hot water and generalpurpose detergent and allow to dry Receivers (Non-sterile, reusable) Scissors (non-sterile) Soap Dishes Wash with hand hot water and general-purpose detergent and dry with paper towel. If not single use should be cleaned with hand hot general-purpose detergent solution, dried and wiped with 70% alcohol wipe. Do not use in staff areas. Residents own should be washed and dried on a daily basis. Spenco, Kelly s, sheepskin, foam 1. Single resident use. pads 2. Send to laundry between. each resident use or if soiled. 3. Discard if damaged. Stands for drips, PEG Wash with general-purpose detergent If contaminated with blood, wash with feeds etc. and hot water between resident use hand hot water and general-purpose and when soiled. detergent followed by disinfecting with 10,000 ppm (1%) hypochlorite solution rinse well and allow to dry. Stethoscopes Follow manufacturer s instructions. Wipe with detergent wipe. Ear pieces/bell N.B. Staff with ear infections should not use stethoscopes. Suction Equipment (Respiratory) Refer to manufacturer guidance for Cleaning and Storage of Suction Equipment Toilet seats Wash with hand hot water and If grossly contaminated, hand hot water general-purpose detergent and dry and general-purpose detergent, dry daily and or when visibly soiled. Increase frequency to twice / three times daily if toilet is regularly used. using disposable cloths or paper towels followed by wiping with hypochlorite 1,000 ppm Av Cl (0.1% solution). Rinse well and dry. Toys used for activity sessions Wash weekly or when visibly soiled When grossly contaminated, wash with with hand hot water and general- hand hot water and general-purpose purpose detergent. Use washing detergent, dry using disposable paper machine for soft toys. towels followed by wiping with 1,000 ppm (0.1%) hypochlorite solution or 70% alcohol wipe. Rinse well and dry. N.B. Heavily contaminated soft toys may have to be destroyed.

8 Trolleys Wash shelves and frame with hand hot water and general-purpose detergent and dry before and after use. Uniform In the event of a laundry system It is recommended that a spare uniform (clothing) not being available in the work is available to staff at all times. setting: Wash separately on 65ºC for not less than 10 minutes or 71ºC for not less than 3 minutes in domestic washing machine, followed by drying and ironing with as hot an iron as possible. Vacutainer Barrels Vacuum cleaners Walking Aids (Zimmer frames, walking stick etc) Wash Hand Basins Single-use, disposable Cleaned and maintained in Accordance with manufacturer s instructions. Between residents and when visibly soiled, wash with hand hot water and general purpose detergent and dry. Clean with general-purpose detergent or cream cleaner on a daily basis. Disinfection not normally required. Decontamination of health care equipment prior to repair, service or investigation Equipment that has been contaminated with blood and other body fluids, or exposed to service users with a known infectious disease, should not be sent to third parties without being correctly decontaminated first. Before dispatching the item it should be labelled with a declaration of its decontamination status that states the method of decontamination used. Anyone who inspects, services, maintains or transports healthcare equipment has a right to expect that the equipment has been appropriately decontaminated to remove or reduce the risk of infection, for example, equipment being returned to Leeds Community Equipment Stores, (Medicines and Healthcare products Regulatory Authority).

9 References: British Institute of Cleaning Science (BICS) Department of Health (2006) Infection Control Guidance for Care Homes. London, Department of Health. Health and Safety At Work Act 1974 ICNA Audit Tools for Monitoring Infection Control Standards. The Infection Control Nurses Association in partnership with the Department of Health Infection Control Guidacne for Care Homes Department of Health June 2006 Lawrence, J. & May, D. (2003) Infection Control in the Community, London, Churchill Livingstone. Management of Health and Safety At the Work Regulations Medical Devices Agency (2003) management of medical devices prior to repair, service and investigation DH National Institute for Clinical Excellence (2010) Infection control: prevention of healthcare associated infection in primary and community care. NPSA National Specifications for Cleanliness: Guidance on Setting and Measuring Performance Outcomes in Care Homes (2010) Standards for Environmental Cleanliness in Hospital. NHS Estates and the Association of Domestic management, The Stationary Office 2000 The Health and Social Care Act 2008: Code of Practice for Health and adult social care on the prevention and control of infections and relating guidance. Department of Health The Revised Healthcare Cleaning manual NPSA 2009 Wilson J. (2001) Infection Control in Clinical Practice (2 nd ed.), London, Balliere Tindall.