Cleaning and Disinfection Procedure

1 Page 1 of 15 The Newcastle upon Tyne Hospitals NHS Foundation Trust Cleaning and Disinfection Procedure Version No.: Effective From: 23 December 2015 Expiry date: 23 December 2018 Date Ratified: 10th December 2015 Ratified By: IPCC 1. Introduction Healthcare Associated Infections (HCAI) are a major concern both in the acute and community setting. The situation is further worsened by the increasing resistance of microorganisms to common antimicrobial agents. The cost of HCAI is huge and includes both the financial costs to the NHS and the direct effects on the patient and their carers in terms of increased morbidity/mortality and also the psychosocial aspects of some of the HCAI.

2 Not all HCAI can be avoided but a significant proportion can be prevented by the adoption of evidenced-based Infection Prevention and Control (IPC) standards. Using preventative measures that are based on reliable evidence of efficacy is a core component of an effective strategy designed to protect patients from the risk of infection. 2. Scope This Procedure applies to all healthcare professionals working across acute and community services within Newcastle upon Tyne Hospitals NHS Foundation Trust. This includes medical staff, nurses, allied health professionals and students. 3. Aim The aim of this Procedure is to minimize exposure to and transmission of potentially pathogenic microorganisms and clearly defines how to clean and disinfect patient equipment.

3 It should be read in conjunction with Guidelines for the Management of Patients with Blood-borne Viral Infections, the Cleaning and Disinfection of Endoscopes Policy, Waste Management Policy and procedures , Decontamination of healthcare equipment following patient use and prior to service and/or repair, Decontamination of the Patient Environment (including Terminal and Deep Cleaning ) 4. Duties (Roles and Responsibilities) The Chief Executive has overall responsibility for the implementation, monitoring and review of this Procedure This responsibility is delegated to the Director of Infection Prevention and Control (DIPC) Page 2 of 15 The Infection Prevention and Control Committee (IPCC)

4 Will review the Procedure and any new evidence base within the time frame set out in the Procedure It is the responsibility of the Trust to ensure that policies, education, training and procedures are in place to minimize the risk of infection It is the responsibility of the Trust/line managers and service heads to ensure that policies, procedures and access to education and training are made available to all staff It is the responsibility of all staff to ensure that they understand and implement this policy and attend training sessions as specified in their role The responsibility for delegation of decontamination lies with the nurse in charge of the ward/department The nurse in charge must ensure that staff are educated/trained to an appropriate level in their assigned Cleaning tasks Community staff have an individual responsibility to ensure any items of equipment are decontaminated in line with this policy 5.

5 Definitions Infection Prevention and Control (IPC) Director of Infection Prevention and Control (DIPC) Infection Prevention and Control Committee (IPCC) Healthcare Associated Infections (HCAI) Control of Substances Hazardous to Health ( ) Personal Protective Equipment (PPE) Clinical Assurance Tool (CAT) Community Environment Action Team (CEAT) 6. Decontamination Effective Hand Hygiene The most simple and effective way to prevent HCAIs is by undertaking effective hand hygiene. The Trust recommends that hands are decontaminated in accordance with the 5 Moments for Hand Hygiene . (Refer to the Trust Hand Hygiene Policy). Glossary of terms Table 1 DECONTAMINATION The combination of processes (including Cleaning , Disinfection and sterilisation) used to render a re-usable item safe for further use on patients and handling by staff.

6 Effective decontamination is essential in reducing the risk of transmission of infectious agents CONTAMINATION The soiling or pollution of inanimate objects or living material with harmful, potentially infectious or unwanted material Page 3 of 15 Cleaning The process that physically reduces the level of contamination (organic matter, dirt, grease) but does not destroy all organisms Disinfection The partial removal or destruction of organisms except spores STERILISATION The process used to render an object free from all organisms including spores SINGLE PATIENT USE Any device deemed unsuitable for re-processing and so stated by the manufacturers. Equipment so labelled may be used a number of times by the same patient only SINGLE USE/ DISPOSABLE Any device deemed unsuitable for re-processing and so stated by the manufacturers.

7 Dispose of after each use The terms sterilisation and Disinfection are often used incorrectly, for example: it is not correct to refer to the immersion of baby bottles in a hypochlorite solution as sterilisation. In fact, this is a Disinfection Procedure that destroys some but not all organisms present. No new item of equipment intended for Disinfection or sterilisation prior to re-use should be purchased without consulting a member of the Infection Prevention and Control Team before purchase. The conscientious application of decontamination procedures and policies are of utmost importance in the prevention of cross-infection to individual patients and staff. Always refer to the manufacturer s instructions in the first instance.

8 If further advice or clarification is required, then contact a member of the Infection Prevention and Control Team. The thoroughness of Cleaning / Disinfection is as important as the agent used. It is important to emphasise that thorough physical Cleaning must be the first step in decontamination. Failure to achieve this will subsequently render applied methods such as chemical Disinfection ineffective. Heat Disinfection is preferable to chemical Disinfection and therefore should always be considered in the first instance. Control of Substances Hazardous to Health ( 1989) The Regulations require employers to evaluate and control the risks to health for all their employees from exposure to hazardous substances at work.

9 This includes microbiological agents and chemicals hazardous to health. A assessment should be undertaken by a competent person, appropriately trained individual If in doubt about situations not specifically mentioned in this document please contact a member of Health and Safety or Infection Prevention and Control Team. Page 4 of 15 National Categories of Decontamination (Department of Health2004a) Table 2 INDICATION LEVEL OF DECONTAMINATION METHOD HIGH RISK Items that come into contact with or penetrate skin/mucous membranes or enter a sterile body area Sterilisation Autoclave; Ethylene Oxide MEDIUM RISK Items that have contact with mucous membranes or are contaminated with organisms that are easily transmitted Disinfection ; Sterilisation Autoclave; Heat Disinfection .

10 Chemical Disinfection LOW RISK Items used on intact skin Clean Wash with detergent, hot water/universal sanitising wipes Cleaning Standards and Principles for Healthcare Staff Standards Equipment is free from all dirt soiling, smudges, dust, fingerprints and grease Equipment is free of tape/plastic etc., which may compromise Cleaning Equipment legs, wheels and castors are free from mop strings, dust, soiling, etc. Principles Clean hands Risk assess the requirement for PPE for the task to be performed gloves, apron, visor Select correct Cleaning materials (refer to Table 3 or manufacturers guidance) If using Actichlor plus solution dispense into a bowl and only dip clean, unused cloths into the solution once throughout the process ( do not dip used cloths into the solution)