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SELF-STUDY SERIES


treated water) which could include a carbon bed, softening, deion- ized (DI), or reverse osmosis (RO). While tap water can be used for rinsing to ensure a large volume of water is used to remove loosened debris and detergents, the final rinse should be performed with treated water that does not contribute to staining or contamination of the instrument.


While utility water may be used for general reprocessing, it is critical that device manufacturer’s instructions be followed for appropriate rinse water recommendations. It is also critical to en- sure you are following manufacturer’s instructions for equipment water recommendations e.g., washer decontaminators, automated endoscope reprocessors (AERs), etc., which may require the use of critical water for appropriate cleaning and rinsing.


Importance of rinsing


While decontamination in the Central Sterile Processing Depart- ment is considered the centralized area to perform cleaning and rinsing functions, it is important to identify all areas in the facility, including outpatient and clinic areas that perform these functions in your facility, to ensure there is a standardized process and that the same standards that are adhered to in the CSPD are adhered to in the outlying areas.


While there may be awareness in the CSPD of the importance of appropriate rinsing, we may need to provide education to other areas that perform clean- ing tasks. As a component of a facility Quality Management System (QMS), a review of processes for standardization should include not only appro- priate cleaning per manufac- turer’s written instructions, but also appropriate rinsing.


Mechanical Washing


At point of use the staff should be keeping devices free of gross There are multiple points in the process that require rinsing:


Point of Use Care & Handling


After High-Level Disinfection


debris and flushing lumens to prevent the formation of biofilm by allowing bioburden to dry on the devices. One of the challenges at the point of use is the type of solution that is used, saline is often the only solution opened onto the sterile field during a procedure. Staff need to be educated that saline is corrosive to the instruments and that sterile water should be the only solution used for point of use care and handling. Decontamination of devices/instruments should be taking place in a room separate from the clean processes, or have spatial sepa- ration. Although decontamination is a dirty area, it is important to have a designated flow from dirty to clean to prevent cross contamination. Rinsing in the decontamination sink is a point of possible cross contamination; frequent cleaning and disinfection between cleaning of devices should be a routine process. In the past it was common and probably still today to perform high-level disinfection, either manual or automated in the decon- tamination area. The challenge then becomes how do you remove and rinse the device without recontamination? When removing a device from manual high-level disinfection the device must be rinsed prior to patient-use and storage, if the high-level disinfec- tion takes place in the decontamination area where do you rinse the device? If you rinse in the decontamination sink you have re- contaminated the device, if you use a separate soak basin in the decon- tamination area, is the basin covered and the lid disinfected to prevent cross contamination through aero- solization? While most automated reprocessors have a rinse cycle, there is still a risk of recontamination if removing the device in the decon- tamination area.


Decontamination After Manual Cleaning Page 28 hpnonline.com • HEALTHCARE PURCHASING NEWS • January 2016 27


Self-Study Test Answers: 1. C, 2. D, 3. D, 4. A, 5. D, 6. D, 7. D, 8. B, 9. D, 10. A


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