General Best Practices for Cleaning and Disinfecting Medical and Surgical Instruments and Equipment
- • General Best Practices for medical and surgical instruments and equipment includes extremely thorough and intensive cleaning of all surfaces, interior and exterior, especially those heavily contaminated with blood, other organic materials, lubricants, or inorganic deposits. Complete rinsing of all of the interior and exterior surfaces to remove all cleaning materials should be done before disinfection is accomplished or sterilization is utilized. It is extremely important that the proper time for cleaning and correct concentration of cleaning materials and disinfectants be used. In the case of sterilization by heat, it is extremely important that not only all of the instruments be thoroughly cleaned and all deposits removed but also that the appropriate time and temperature under pressure be utilized.
- • Cleaning, which is the physical removal of all organic material including blood and tissue as well as inorganic salts and various types of soil, is best accomplished by cleaning as soon as possible after use of the equipment and utilizing ultrasonic cleaners, washer disinfectors, and washer sterilizers instead of hand washing which varies in intensity according to the individual performing the work. In some cases where the level of soil is intense, it may be necessary for a person to preclean the instruments and equipment to remove a large amount of the soil prior to using the mechanical equipment for cleaning.
In any case, the proper amount of detergents or enzymatic cleaners that are compatible with the metals or other materials of the medical and surgical instruments must be used according to the manufacturer’s instructions. Time and temperature are of great importance. All equipment must be inspected after cleaning to make sure that there are no breaks or cracks in it.
- • Use disinfectants that are: broad-spectrum antimicrobial agents; fast acting producing a rapid kill; active in the presence of various types of organic matter; non-toxic to people; produce continued killing of microorganisms on surfaces for a period of time; easy-to-use, odorless, soluble in water, good cleaning substances, and stable in the concentrated and diluted forms; not supporting bacterial growth in the cleaning solution; economical; and not damaging to surfaces, water, or the rest of the environment.
- • Take into consideration when sterilizing equipment or medical instruments the following issues: is the cleaning complete and thorough to avoid a higher bioburden and salt concentration; are you dealing potentially with spores; type of pathogens and resistance to sterilization techniques; is there a biofilm on the equipment or medical instruments; the length and diameter of various tubes; is there a restricted flow in the tubes because of sharp bends; the types of materials utilized in the equipment and how this affects sterilization; are there screws or hinges in the equipment that may affect the sterilization technique being utilized.
- • Despite the best cleaning and decontamination procedures utilized on single use medical equipment or instruments, do not reuse them.