DECONTAMINATION
Cleaning impact on medical devices
Tautvydas Karitonas discusses the impact of increased use of disinfection and cleaning products on medical devices in the wake of the pandemic. He highlights the potential risks of environmental stress cracking, along with the implications for patient safety, and calls for a better understanding of cleaning processes and compatibility.
The COVID-19 pandemic has sparked a significant increase in the use of sanitising and disinfectant cleaning solutions such as wipes, gels and sprays, and the levels of hospital surface cleaning to minimise the risks of acquiring the infection. This has been urged by the World Health Organization (WHO), as well as the National Health Service (NHS), in combined efforts to reduce COVID-19 transmission from air and surfaces. Being advised to act and putting that advice into practice are often two different things, as is the case with healthcare cleaning. Any change in behaviour, particularly in environments that have a direct impact on people’s health, must be analysed to minimise risks and maximise any opportunities.
Environmental stress cracking (ESC) and material incompatibility are potential issues caused by increased biocidal and mechanical cleaning (discussed in this article) and are ultimately a cause of medical device failure and must be routinely considered as part of an efficient cleaning process. We must ask where the responsibility sits; is it at the end user part of the product lifecycle, or is it much further in advance at the product development phase? While WHO has advised healthcare organisations to ‘do more cleaning’, there’s a case to be made to the manufacturers to say ‘do more research; listen to the problems’ and ensure that the products manufactured are truly fit for purpose in the healthcare environments for which they’re intended. There’s a worthwhile discussion to be had between the two parties to bring a better understanding of cleaning processes and compatibility to the table, to create medical devices that really stand the test of time and pandemics.
A result of the pandemic has been increased healthcare staff burnout, with
SEPTEMBER 2021
many working for longer periods of time. Time constraints and pressures of their daily routines may not allow appropriate time for necessary or additional manual cleaning, as this risks time being taken from other responsibilities; allowances must be made in considering increased application of mechanical or automated cleaning processes.
Accurate policies and instructions should be in place ahead of medical devices reaching the area of use to ensure that adequate training and cleaning requirements are in place to avoid negative impacts on time management. Healthcare would also benefit financially from efficient cleaning practices, as less devices and equipment requiring maintenance or replacement would take less from the budget.
The increased use of disinfection and
cleaning products on medical devices (especially the ones made from plastic) have already been linked with unexpected incidents where these devices failed or became damaged – making an existing problem even bigger and possessing a higher risk for the safety of patients and healthcare staff. These cleaning products are made to remove, kill or inactivate bacteria and viruses.
However, they are not necessarily formulated to be compatible with plastics, and many medical devices are made of different types of plastics. Device failures that cause serious harm or death have become an ongoing healthcare crisis. Around 409.5 million1
medical device units were recalled
by the FDA in 2016-2017, with an average of 58.19 million units per quarter. In 2018 and the first half of 2019, that average rose
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