1. Pre-Purchase Evaluation ............................................................................................................. 411 2. Sterile Processing Area ................................................................................................................ 412 3. Water Quality ............................................................................................................................... 413 4. Cleaning Products and Equipment ............................................................................................. 415 5. Processing Before Use ................................................................................................................. 417 6. Point-of-Use Treatment ............................................................................................................... 419 7. Transport to the Decontamination Area .................................................................................. 421 8. Personal Protective Equipment .................................................................................................... 421
9. Cleaning and Decontamination ................................................................................................. 422 Manufacturers’ instructions for use, manual cleaning, mechanical methods, ultrasonic cleaners 10. Cleaning Verification and Inspection ...................................................................................... 426
ASC – Ambulatory surgery center ASHRAE – American Society of Heating, Refrigerating and Air-Conditioning Engineers
ATP – Adenosine triphosphate CDBAC – Coco alkyl dimethylbenzyl ammonium chloride CDC – Centers for Disease Control and Prevention CHG – Chlorhexidine gluconate CJD – Creutzfeldt-Jakob disease CRE – Carbapenemase-resistant Enterobacteriaceae DI – Deionized EO – Ethylene oxide FDA – US Food and Drug Administration EPA – Environmental Protection Agency HVAC – Heating, ventilation, and air conditioning ICU – Intensive care unit IFU – Instructions for use IUSS – Immediate use steam sterilization NaOH – Sodium hydroxide
OOSS – Ophthalmic Outpatient Surgery Society OR – Operating room OSHA – Occupational Safety and Health Administration OV – Ophthalmic viscoelastic OVD – Ophthalmic viscosurgical device PPE – Personal protective equipment RLU – Relative light units RN – Registered nurse RO – Reverse osmosis SDS – Safety data sheet SHEA – Society for Healthcare Epidemiology of America SSI – Surgical site infection TASS – Toxic anterior segment syndrome TDS – Total dissolved solids TSE – Transmissible spongiform encephalopathy vCJD – Variant Creutzfeldt-Jakob disease WHO – World Health Organization