Perspective Article - (2021) Volume 0, Issue 0
Ghulam Abbas*
Department of Reusable Medicine, Waseda University, Doha, Qatar
Received Date: September 24, 2021; Accepted Date: October 08, 2021;Published Date: October 15, 2021
Citation: Abbas G (2021) Point-of-Use Cleaning/Pre-Cleaning of Reusable Medical Devices/Instruments. J Biomed Sci Vol. 10 No.S5:002.
Descrip ion
Cleaning is the first step of reprocessing of reusable medical devices; it makes sure that reusable medical devices/ instruments must be cleaned immediate after they are used in any procedure/surgery/surgical procedure.
Point-of-Use Cleaning
The terms are used “Point-of-use Cleaning” refers to the removal of gross soil, substances from a medical device that take place at point of use, with a period during the procedure or immediately after use [1,2].
“Preclearing” refers to all cleaning actions, such as a removal of gross soil throughout the procedure and/or before transporting to CSSD/SPD decontamination area.
Cleaning at Point of Use Perform
The staff member performing the scrub role should use sterile water/distal water to irrigate instruments with lumens and remove gross soil from the instruments by wiping the instruments with asterile water, moistened surgical sponge. With this action it will reduce the risk of biofilm formation. If gross soil and biofilm are not removed, decontamination process, disinfection and sterilization may challenge and rust, pitting on surgical instruments may came as result.
Always follow the manufacturer’s Instructions for Use (IFU) for opening or disassembled the trays or instruments sets.
Don’t use saline on reusable medical devices its lead to damage the chromium layer of the instruments.
Instruments with lumens should be flushed with distal water/ sterile water during procedure.
Technician in theater should follow work flow policy and procedure established by hospital policy team members and management.
Instruments also be organized according to state of use (i.e., in use, used, no longer needed, not used).
Disposable sharp should be immediate discarded in designated disposable containers.
Delicate instruments should be handled with full care and be cleaned thoroughly and keep separate from heavy trays to avoid damage.
Delicate instruments don’t transport with general trays.
Power surgical instruments should be cleaned under running water don’t keep in soaking basin.
Before transporting the instruments, it should make sure that trays are pre cleaned or cover with moistened towel/moistened spray.
Importance Point-of-Use Cleaning
Point of use cleaning helps to prolong the life the medical devices/instruments.
Point of use cleaning safe the time the decontamination process in Central Sterile Services Department and Sterile Processing Department (CSSD/SPD) decontamination area.
Point of use cleaning help the decontamination staff to disassemble the trays easily.
Cleaning at point of use, remove the gross soil, (blood, blood body fluid) for the instruments safety from the rusting and pitting.
Safety for patients, visitors and healthcare workers point of use cleaning safe from cross contamination and the risk of infection Healthcare-Associated Infections (HAI) hospital acquired infection.
The infection control team and Central Sterile Services Department and Sterile Processing Department (CSSD/SPD) management or Sterile Processing Department (SPD’s) technician and end user management team set educational and practical protocol for point of use cleaning to be practiced.
What Happened if Point-of-use Cleaning Not Performed
If point of use cleaning not performed properly the gross soil remain on the surfaces or lumens instruments, these instruments with dried blood transported to Decontamination area of CSSD/SPD, which is challenged to decontamination process.
Pitting and rusting came as a result on the surfaces of instruments that is very harmful for the patient use.
The instruments with dried blood are most difficult to cleaned, disinfected and sterilized and also chances to risk of infection upon the use like this.
The dried blood instruments take extra time for decontamination process.
The life of the instruments reduced due to dried blood trays/ sets transported to decontamination area.
If disposable sharps didn’t discard it will chance to needle stick injury at any time with any staff including theater nurses, scrub staff, housekeeping and Sterile Processing Department (SPD) technician.
Improper handling and improper cleaning of medical devices, the instruments will damage especially delicate instruments.
AMMI Standard
ANS/AMMI ST79:2017 provides guidelines and recommendations for reprocessing medical devices/instruments in healthcare settings. Healthcare facilities base processes and policies on these standards. Section 6 of the standard discusses point of use cleaning of medical devices.
Transport to CSSD/SPD
Before transporting the instruments, theater staff make sure that all instruments are complete according to checklists. Instruments should be prepared for transporting follow the guide lines OSHA (Occupational Safety and Health Administration) and DOT (Department of Transportation).
OSHA requires when instruments transport from point of use to decontamination area there must be used of puncture resistant, leak proof and closeable containers.
The transport container must be label as a biohazard.
If using transportation cart it should be covered or closed to prevent items from falling.
Instruments should cover with yellow bag or container and must be label as biohazard.
Transportation routes should avoid from high traffic area.
Facilitate efficient pickup and delivery to the decontamination area.
Soiled elevator or lifts/carts/trucks should be dedicated to contaminated items and should not be used for clean or sterile items.
All transport containers, carts, trucks must decontaminate after each use or each round up/pickup as (EPA) Environmental Protection Agency standards.
Conclusion
Through all study and research, it is important that point of use cleaning is play a vital role for reprocessing of reusable medical devices/instruments. Nurses and medical technician must be educated and follow the disciplinary team developed workflow. A highly bioburden trays and instruments completely prewash or clean prior to transportation. Follow the manufacturer’s instruction (IFU). Delicate instruments must be carefully cleaned and transport. ANSI/AMMI standard for sterilization of reusable medical devices and point of use cleaning. Department of Transportation (DOT) and Occupational Safety and Health Administration (OSHA) guide line for health safety and transportation. AORN guide line for chemical high level disinfection.
To develop the successful pre cleaning strategy of medical devices the process need to follow as established.
Educated staff and team member developed the workflow and monitoring all the time that staff should be accountable about process. Putting closed attention by scrub staff and team leader to ensure the point of use cleaning is practiced well. This will reduce the risk of patients, visitors, Doctors, Nurses and technicians safe from HAIs.
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