The number and types of microorganisms present on environmental surfaces are influenced by the following factors:
a. number of people in the environment,
b. amount of activity,
c. amount of moisture,
d. presence of material capable of supporting microbial growth,
e. rate at which organisms suspended in the air are removed, and
f. type of surface and orientation [i.e., horizontal or vertical].
Strategies for cleaning and disinfecting surfaces in patient-care areas take into account
a. potential for direct patient contact,
b. degree and frequency of hand contact, and
c. potential contamination of the surface with body substances or environmental sources of microorganisms (e.g., soil, dust, and water).
Cleaning of Medical Equipment
Manufacturers of medical equipment should provide care and maintenance instructions specific to their equipment. These instructions should include information about
a. the equipments’ compatibility with chemical germicides,
b. whether the equipment is water-resistant or can be safely immersed for cleaning, and
c. how the equipment should be decontaminated if servicing is required.
In the absence of manufacturers’ instructions, non-critical medical equipment (e.g., stethoscopes, blood pressure cuffs, dialysis machines, and equipment knobs and controls) usually only require cleansing followed by low- to intermediate-level disinfection, depending on the nature and degree of contamination. Ethyl alcohol or isopropyl alcohol in concentrations of 60%–90% (v/v) is often used to disinfect small surfaces (e.g., rubber stoppers of multiple-dose medication vials, and thermometers) and occasionally external surfaces of equipment (e.g., stethoscopes and ventilators). However, alcohol evaporates rapidly, which makes extended contact times difficult to achieve unless items are immersed, a factor that precludes its practical use as a large-surface disinfectant. Alcohol may cause discoloration, swelling, hardening, and cracking of rubber and certain plastics after prolonged and repeated use and may damage the shellac mounting of lenses in medical equipment.
Barrier protection of surfaces and equipment is useful, especially if these surfaces are
a. touched frequently by gloved hands during the delivery of patient care,
b. likely to become contaminated with body substances, or
c. difficult to clean. Impervious-backed paper, aluminum foil, and plastic or fluid-resistant covers are suitable for use as barrier protection. An example of this approach is the use of plastic wrapping to cover the handle of the operatory light in dental-care settings. Coverings should be removed and discarded while the health-care worker is still gloved. The health-care worker, after ungloving and performing hand hygiene, must cover these surfaces with clean materials before the next patient encounter.
Tuesday, May 17, 2022
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