Manual Washing and Cleaning

Question 1

Why is the manual washing and cleaning stage of the decontamination cycle so important?

Answer 1

-this is when proteins and prions are removed from the instruments -we are removing bodily fluids and organic matter that has adhered to the surface of the instrument -prions are only removed during this stage - it is not deactivated during sterilisation as it can survive higher temps

Question 2

What PPE is required for manual washing and cleaning?

Answer 2

-apron/gown -face shield (protect from splashing face and eyes) -rubber gloves and heavy duty rubber gloves on hands

Question 3

What sinks are required for the manual washing and cleaning stage?

Answer 3

-Must have a dedicated sink for manual washing and cleaning -must have another separate sink for rinsing -these cannot be the same sinks used for hand washing

Question 4

What are the requirements for the water used for manual washing and cleaning?

Answer 4

-Can use standard portable water -mustn’t exceed 35 degrees Celsius

Question 5

Why cant the water exceed 35 degrees Celsius?

Answer 5

above this temp might make the proteins coagulate making them more difficult to remove

Question 6

What chemicals are used during the manual washing and cleaning process?

Answer 6

Chemical detergent which is generally enzymatic or pH neutral

Question 7

What must we follow regarding the chemical used in this process?

Answer 7

Manufacturers instructions

Question 8

When manually scrubbing the instruments, where must this take place and what would you use?

Answer 8

Must take place below the water

Use a long-handled, soft-bristles, non-metallic brush that can be processed through a thermal washin cycle

Question 9

Why do we need to scrub instruments below the surface of the water?

Answer 9

• we need contact with both detergent and water
• want to minimise spashing
• scrubbing above the water causes aerosols to be produced

Question 10

Once we have manual washed the instruments, what step is next?

Answer 10

Put them in the ultrasonic bath

Question 11

How does the ultrasonic bath enhance the cleaning process?

Answer 11

Can clean textured surfaces of intruments and joints

Question 12

How does the ultrasonic bath work?

Answer 12

• It passes soundwaves through the water at a very high frequency which causes micro bubbles to form
• The fluctuation in pressure (caused by soundwaves) causes the bubbles to rapidly expand then contract
• This process is referred to as cavitation
• The bubbles implode and have a scouring effect against the hard surface of the instruments

Question 13

What is the operating temp for the ultrasonic and what type of wateris used?

Answer 13

20-30 degrees Celsius and portable water

Question 14

Apart from portable water, what else is added to the ultrasonic?

Answer 14

Chemicals added to the water in the chamber (at the conc recommened by the chemical manufacturer)

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

Question 15

Where must all the values for chemicals etc in our machines be noted?

Answer 15

In an equipment log book

Record keeping is an essential part of the decontamination process

Question 16

What is the first step in the decontamination process? When are US and manual washing used?

Answer 16

1st = use of the washer disinfector

Might want to use the ultrasonic before it if the instrument has a lot of hinges etc

Manual washin is only used if the instrument states it cant go through the washer disinfector or if the WD fails

Question 17

What are the advantages of manual washing and the ultrasonic?

Answer 17

• Manually scrubbing with a brush exerts a greater force than the Washer-Disinfector is capable of
• Some pieces of equipment must only be manually washed (manufacturer instructions)
• Ultrasonic baths have a ferocious process that is very good at removing contamination

Question 18

What are the disadvantages of using manual washing and the ultrasonics?

Answer 18

• 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