OR Manager - June 2020 - 22

Device safety depends on routine cleaning, maintenance
Sterilization & infection prevention
outine cleaning and maintenance
of the equipment used to process
medical devices is important
to prevent contamination of medical
devices. This article will discuss the
required cleaning and maintenance in a
sterile processing department (SPD) as
well as the guidelines and regulations
that inform these practices.
R
Environmental issues
Recommendations for cleaning and disinfecting
surfaces in an SPD are based
on manufacturers' instructions for use
(IFU), government regulations, and standards
and guidelines. SPDs should have
policies and procedures that specify
standards for cleaning, disinfection, and
routine maintenance. An interdisciplinary
team with staff from the SPD, environmental
services, perioperative nursing,
and infection prevention should work together
to determine cleaning procedures
and frequency based on the IFU, best
practices, and regulations.
This interdisciplinary team should
identify high-touch areas to be cleaned
and disinfected. Evidence has shown that
high-touch areas such as control panels,
switches, knobs, and handles can harbor
contamination and should be cleaned
and disinfected on a routine basis to prevent
the spread of contamination.
To ensure the department is being
properly cleaned, establish a method
for evaluating the effectiveness of the
cleaning process. Either a qualitative
method, such as visual inspection and/
or fluorescent marking, or quantitative
methods, using cultures or adenosine
triphosphate (ATP) monitoring, may be
used. The testing time intervals should
be based on recommendations from
the interdisciplinary team. Results
from quantitative methods should be
recorded and can be used to provide
measurable, objective data to help drive
process improvement, encourage compliance,
educate personnel, and verify
personnel competency.
To avoid the risk of any missed surface
or equipment cleaning, responsibility
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OR Manager | June 2020
for cleaning should be assigned. In most
facilities, environmental services staff
are responsible for cleaning floors, walls,
ceilings, and vents. The rest of the SPD
environment and processing equipment
is the responsibility of SP technicians.
Have a written plan to specify who is
responsible for each surface and piece of
equipment so that nothing is overlooked.
The equipment and work surfaces used
in medical device processing should be
cleaned on a routine basis as prescribed
in the policies and procedures.
Develop checklists specifying the
equipment or surface to be cleaned,
and the cleaning and maintenance
schedules. Checklists are a means to
standardize procedures, prevent missing
surfaces or equipment, and demonstrate
compliance with policies and
best practices.
Routine cleaning
These are areas that should be considered
for routine cleaning and/or disinfection
in an SPD:
* Ventilation ducts, including air vents
and grills and the filter, should be
cleaned and changed on a routine
basis. The manufacturer's IFU
should provide this information.
* Walls, floors, and ceilings should be
routinely inspected for debris and
staining. Any defective areas should
be replaced or repaired.
* High-touch areas that cannot withstand
disinfection should be protected
with a barrier covering to prevent
the surfaces from becoming
a reservoir for microorganisms. For
example, a protective covering for
a computer keyboard should be removed
or disinfected per the IFU.
* High-touch areas, such as doorknobs,
control panels, cart handles,
and switches, should be cleaned
routinely.
* All floors should be cleaned and disinfected
with a damp mop each day
they are in use.
* Sinks should be cleaned and disinfected
at least daily.
* Emergency eye/shower stations
should be cleaned and disinfected
on a routine basis. This equipment
requires weekly testing to ensure
its safe operation according to the
Occupational Safety and Health Administration's
Eye and Face Protection
Standard (29 CFR 1910.133).
Both the shower (if available) and eye
wash station should be activated for
a period long enough to verify operation
and ensure that the flushing
solution is available. Water temperature
should be monitored to ensure it
stays between 60° and 100 °F. There
should be a record of this weekly test.
* Countertops should be cleaned and
disinfected at least daily.
* Workstations should be cleaned and
disinfected at the end of each shift
and whenever they are soiled.
* The service area behind the sterilizers
should be routinely cleaned
(with areas in need of cleaning identified).
The cleaning schedule should
be based on the recommendations
from the interdisciplinary team.
* Staff changing areas should be
cleaned daily, and staff should clean
their lockers regularly.
Routine maintenance
It is imperative that staff follow the IFU
for SPD equipment. The IFU should
specify the types of cleaning and disinfectant
chemicals to use, routine maintenance
requirements, replacement
parts (including tubing and filters), inspection,
and other maintenance necessities.
These also should be included
in a checklist, and verification testing
should be recorded.
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OR Manager - June 2020

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