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DECONTAMINATION
Understanding decontamination
Infection prevention specialist, Nanosonics, recently held an ultrasound probe decontamination event, in which independent speakers presented delegates with talks relating to the latest decontamination developments in an ultrasound environment.
The Decontamination of Ultrasound Probes Study Day took place on Friday 10 May at Ardencote Resort and Spa in Warwick, and was chaired by Claire Jones-Manning, decontamination lead, University Hospitals of Leicester (UHL) NHS Trust. Among the highlights, was Karren Staniforth, clinical scientist, infection prevention and control at Nottingham University Hospitals (NUH), who opened proceedings by providing an overview of decontamination to set the scene for the day. “Decontamination is the entire process required to remove or destroy contamination, including micro-organisms, thereby preventing these contaminants from reaching a susceptible site in sufficient numbers to initiate infection or some other harmful response,” she said.
Karren explained that the decontamination processes for a specific item may include cleaning, disinfection and sterilisation, based on the likelihood of transmitting infection and the degree of potential harm. She continued: “The choice of decontamination method may depend on a number of factors, such as a patient’s susceptibility to infection. device compatibility - tolerance to heat, chemicals, pressure and, moisture – and the nature of the contamination. Additional challenges include the limited time available for processing, risks to processing staff, the cost of processing, and the availability of processing equipment. Earle H Spaulding summarised the risk back in 1939 in the Spaulding Classification.” The Spaulding Classification states that
Pictured at the Warwick event venue, the UK expert speakers (left to right) Wayne Spencer, authorising engineer decontamination, Spencer Nickson; Karren Staniforth, clinical scientist, infection prevention & control, Nottingham University Hospitals; Claire Jones-Manning; Bryn Tudor-Owen, Nanosonics country manager, UK and Ireland; Dr Peter Cantin, consultant sonographer, University Hospitals Plymouth NHS Trust; and Liz Collins, clinical lead infection prevention, University Hospitals of Leicester NHS Trust.
non-critical (low risk) items in contact with intact skin, a detergent clean or disinfectant wipe is sufficient. For semi-critical (intermediate risk) items in contact with broken skin or intact mucous membranes, sterilisation or high level disinfection is required. For critical (high risk) items in close contact with breaks in the skin or mucous membranes - or introduced into a sterile body cavity – sterilisation is required.
Sterilisation is defined as the complete destruction or removal of all microorganisms, including bacterial spores. Cleaning removes 80% of potentially infectious microorganisms, as well as organic material on which they thrive. Karren Staniforth, Nottingham University Hospitals
SEPTEMBER 2019
Karren continued: “Sterilisation is defined as the complete destruction or removal of all microorganisms, including bacterial spores. Cleaning removes 80% of potentially infectious microorganisms, as well as organic material on which they thrive. Soil is also removed, which can protect microorganisms and inactivate chemical disinfectants. Cleaning also removes some prions, which can transmit CJD, even after sterilisation, disinfection, mechanical action and dilution. A good standard of cleaning is a prerequisite to effective disinfection and sterilisation.” Defining disinfection as the destruction of microorganisms – but not necessarily bacterial spores - Karren explained: “The process does not necessarily kill all microorganisms, but reduces them to a level which is not harmful to health – around 4 or 5LOG
.
“Thermal washer disinfectors and steam sterilisation are preferred as there are a number of advantages. They provide robust and fully automated programmable cycles,
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