manual washing and cleaning

Question 1

cleaning removes

Answer 1

bodily fluids and organic matter that has adhered to the surface of the instrumentation, during the procedure that it was used for

Question 2

importance of cleaning stage

Answer 2

we remove ‘proteins’ or ‘prion’ (vCJD)

Prion is only removed during the washing process. It is not deactivated during sterilisation and can survive higher temperatures than our standard process achieves

Question 3

PPE needed for cleaning

Answer 3

Apron or gown to cover our person

A face shield to protect from splashing our face and eyes

Rubber gloves and heavy duty rubber gloves on our hand (thick rubber gloves with nitrile gloves underneath)

Question 4

set points needed for successfully manually cleaning

3

Answer 4

dedicated sink for the purpose of manually washing and also another separate sink for rinsing.
- These cannot be the same sink used for hand washing

can use standard potable water for this process
- must not exceed 35 degrees Celsius
As this might cause proteins to coagulate making them more difficult to remove

use a chemical detergent during this process,
- Generally enzymatic or pH neutral, to improve the cleaning process and help remove any contamination present

Question 5

recommendations for manual cleaning to follow

4

Answer 5

chemicals must be dosed based upon the Manufacturers Instructions (MI), for the correct concentration.

• This is generally in ml/L (e.g. 5 millilitres per 1 Litre of water)
  e. g. sink filled with 12L of water at a temperature no greater than 35 degrees Celsius, need to dose 60ml of chemical for the correct concentration (5 x 12 = 60)

essential we do not exceed the recommended temperature as this may damage to efficacy of the chemical, especially if we are using Enzymatic, as this is temperature sensitive.

manually scrub the instruments to remove contamination, this must take place below the surface of the water.

generally use a long handled, soft bristled, non-metallic brush, that can be processed through a thermal washing cycle, for this purpose.

Question 6

reasons to scrub below water surface (3)

Answer 6

1. We need contact with the water and detergent
2. While carrying out the process we want to minimise splashing
3. Scrubbing above the water causes aerosols to be produced

Question 7

after manual washing

Answer 7

use ultrasonic bath to process

Question 8

physical scrubbing removes

Answer 8

gross contamination from the surface of instruments

Question 9

ultrasonic cleaning…

Answer 9

bolsters the process by getting right into the textured surfaces and joints of the instruments.

ferocious process that uses soundwaves, at a very high frequency, to produce bubbles that implode and have a scouring effect against the hard surface of the instruments.

Question 10

ultrasonic cleaning science

Answer 10

As the sound waves pass through the water they cause micro bubbles to be formed.

The fluctuation in pressures the sound waves induce, causes the bubbles to rapidly expand and then collapse

process is referred to as cavitation

Question 11

set points for ultrasonic machine

4

Answer 11

The operating temperature is set between 20 – 30 Degrees Celsius

The machine can be filled with potable water to the required volume which is marked on the chamber

Chemical must be added to the water in the chamber, at the concentration recommended by the chemical manufacturer

The cycle must be ran for a specified period of time that has been established to effectively remove contamination

Question 12

recordings needed for ultrasonic cleaning

Answer 12

audited on it, in practice

recorded info in our equipment log-book record keeping is an essential part of our decontamination process.

Date = 21.07.2020
Cycle number = 2346
Detergent added 	= YES
Temperature	= 27.6 C
Time = 20 minutes 36 seconds 

20 mins sufficient time for decontamination

Question 13

after washing and ultrasonic cleaning, instruments need

Answer 13

rinsed in a separate ‘rinse’ sink to remove any remaining residue from previous stages

Question 14

first stage in cleaning cycle

Answer 14

use of washer-disinfector

manual washing and ultrasonic cleaning are basic steps before cleaning cycle - in decontamination cycle

Question 15

reasons for manual and ultrasonic cleaning (3)

Answer 15

Manually scrubbing with a brush exerts a greater force than the Washer-Disinfector is capable of producing

Some pieces of equipment must only be manually washed, in-line with manufacturers recommendations

Ultrasonic baths have a ferocious process that is very good at removing contamination

Question 16

reasons against manual and ultrasonic cleaning

Answer 16

A member of staff is required to be present for the entire process

There is a risk of aerosol production

There is a risk of contaminating the surrounding environment

There is the potential for inconsistency in the process due to human error

There is a high risk of sharps injuries for members of staff carrying out the process

Ultrasonics have a ferocious process which has the potential to damage some equipment

There are no automatic water changes in an Ultrasonic bath

Question 17

when might manual washing and ultrasonic cleaning be of key use

Answer 17

very stubborn, dried in contamination

should be combined with the use of a Washer-Disinfector due to the disinfection stage and reproducibility of the cycle

Question 18

decontamination

Answer 18

reduces the microbial contamination of materials or surfaces and is accomplished through the use of a chemical disinfectant

Question 19

disinfection

Answer 19

accomplished through the use of chemical disinfectants.