What is the Cleaning Medical Equipment Procedure?
Cleaning medical equipment is a process in healthcare to remove contaminants, such as organic matter, blood, and microorganisms, from medical instruments and devices to make them ready for reuse. The primary purpose is to prevent infections and ensure the safety of both patients and healthcare workers. Proper medical equipment cleaning is essential to maintaining healthcare standards and complying with regulatory guidelines.
Common medical equipment requiring specific cleaning procedures and validation includes the following:
- Surgical instruments
- Endoscopes
- Diagnostic medical devices
- Patient care equipment
Importance
Efficient and proper medical equipment is essential for the following reasons:
- Prevention of Infections: The most critical reason for cleaning medical equipment is to prevent infections. Proper cleaning is a fundamental step in infection control and in reducing the risk of Healthcare-Associated Infections (HAIs).
- Minimizing Equipment Downtime: Accumulated dirt and debris can impair instruments’ functionality, leading to malfunctions. Cleaning can act as a part of preventive maintenance as it helps preserve the equipment’s longevity and enhances its operational efficiency.
- Meeting Regulatory Standards and Compliance: Effective cleaning requires following established guidelines. Medical facilities are required to comply with regulatory guidelines to ensure not only patient safety, but also healthcare workers safety.
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What is Involved in Cleaning Medical Equipment?
The process of cleaning medical equipment involves several steps:
1. Pre-Cleaning
Beginning with pre-cleaning, the first step is eliminating visible debris and organic matter from the equipment. This stage sets the foundation for the subsequent cleaning and disinfection processes. The tools and methods involve using water, detergents, or enzymatic solutions to break down organic materials.
2. Cleaning
General cleaning involves using appropriate cleaning agents and methods (manual or automated) to remove all contaminants. Methods may include thorough washing, rinsing, ultrasonic cleaning, and equipment drying. This will depend on the type of medical device used and the level of contamination.
3. Disinfection
The third step is disinfection, eliminating harmful microorganisms on the equipment’s surface. The choice of disinfectant depends on the medical device’s nature and intended use. The US Centers for Disease Control and Prevention (CDC)’s guidance on Disinfection and Sterilization in Healthcare Facilities generally provides evidence-based recommendations for the disinfection and sterilization of medical instruments and devices in healthcare settings.
CDC classifies disinfection methods based on the risk level of using medical devices. These categories align with the Spaulding classification system and include three main types of disinfection as follows:
| Category | Definition | Required Disinfection Level | Methods/ Disinfectants |
| Critical | Contacts sterile tissue or vascular system | Sterilization | steam sterilization, ethylene oxide gas, or hydrogen peroxide gas plasma |
| Semicritical | Contacts mucous membranes or non-intact skin | High-level disinfection (HLD) | This can be accomplished using chemical disinfectants such as glutaraldehyde, ortho-phthalaldehyde (OPA), or hydrogen peroxide, or through heat-based methods like pasteurization. |
| Noncritical | Contacts only intact skin | Low-level disinfection (LLD) | typically involves the use of EPA-registered hospital disinfectants that can destroy vegetative bacteria and some viruses and fungi but do not kill spores. |
These classifications help healthcare facilities determine the appropriate cleaning and disinfection protocols needed.
4. Sterilization (If Applicable)
Sterilization is needed when medical equipment or instruments are classified as “critical,” as mentioned in the table above. Instruments that penetrate tissues or contact sterile body areas must be sterilized. Various methods exist for sterilizing medical equipment, including steam autoclaving, ethylene oxide gas (EtO), or hydrogen peroxide gas plasma.
5. Inspection and Maintenance
Regular maintenance ensures equipment integrity after cleaning. This includes a visual inspection to check for cleanliness and damage, applying lubrication if necessary, and testing the equipment for functionality.
6. Documentation
Lastly, the medical facility must document each cleaning process step to ensure compliance with regulatory guidelines. Cleaning validation, which proves that cleaning procedures are done, requires proper documentation. Since it is a requirement of regulatory bodies such as the US Food and Drug Administration (FDA) and the Joint Commission, proper documentation helps facilities meet compliance regulations.
Regulatory Framework
Cleaning medical equipment is regulated by laws to ensure safety and compliance in healthcare. These rules vary by country and are usually enforced by health agencies. Here are key aspects of this legal framework:
Regulatory Agencies
In the US, the FDA is the primary overseer of medical devices. They require manufacturers to follow Good Manufacturing Practices (GMP) for cleaning and disinfection.
Following this, the CDC offers guidelines for infection control, including cleaning medical equipment to prevent HAIs. In addition to manufacturers, healthcare facilities are also required to followed these as part of their daily operations.
Standards and Guidelines
Some of the most well-known standards healthcare facilities comply with for cleaning medical equipment are the following:
- American National Standards Institute (ANSI): ANSI develops standards for cleaning and sterilizing medical devices. It has several standards for cleaning medical equipment, including ANSI/AAMI ST108 and ANSI/AAMI ST79.
- Association for the Advancement of Medical Instrumentation (AAMI): AAMI publishes guidelines on the cleaning, disinfection, and sterilizing of medical equipment, which ANSI accredits.
- International Organization for Standardization (ISO): ISO publishes medical equipment and devices standards for healthcare facilities. Some of its standards for cleaning and disinfection include ISO 17664 and ISO 8250.
Environmental Factors
Regulatory guidelines are also established because the environment in healthcare settings plays a critical role in maintaining the safety and effectiveness of medical equipment. Environmental conditions can impact the cleaning process, such as:
- Temperature: Ensures effective sterilization, particularly during heat-based cleaning methods.
- Air Quality: Minimizes airborne contaminants that could re-contaminate equipment.
- Humidity: Prevents microbial growth in storage and drying processes.
Since environmental factors can affect the efficacy of cleaning and disinfection, healthcare facilities must monitor and control these conditions to maintain the highest standards of cleanliness. Utilizing environmental monitoring tools, such as Internet-of-Things (IoT) sensors and data loggers, can help facilities maintain optimal environmental conditions for cleaning medical equipment.
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Role of Sensors
Sensors are an increasingly essential part of the healthcare industry. In cleaning medical equipment specifically, sensors can be used for the following:
- Environmental Monitoring: Sensors can monitor conditions like temperature and humidity. Monitoring these conditions and surface cleanliness helps prevent pathogen growth that can lead to HAIs.
- Complying with Regulations: Regulatory bodies like the CDC and FDA require healthcare facilities to maintain certain environmental conditions to ensure patient safety.
- Monitoring Cleaning Processes: Sensors can be used to ensure that cleaning procedures are followed correctly, reducing human error and maintaining compliance.
- Detecting Residual Contaminants: Sensors can detect the presence of residual contaminants on different sources and equipment and identify their levels, ensuring thorough cleaning and disinfection.
- Tracking Equipment Usage: Sensors, such as Radio Frequency Identification (RFID) tags, can track equipment usage and alert staff when it requires cleaning. This helps facilities maintain proper cleaning schedules, manage equipment usage, and avoid any potential safety hazards.
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