1. Title How clean is your house? Decontamination of equipment and the environment Infection Prevention & Control Anita Watson Lead Nurse Infection Prevention and Control NHS North Lancashire

2. Title Decontamination Decontamination of the environment and reusable medical devices is essential to reduce the risk of transmission of infection to staff and residents There must be systems in place to ensure that reusable medical devices have been effectively decontaminated. Equipment MUST always be cleaned prior to maintenance service, repair or return to the manufacturer.

3. Title Decontamination Guidelines Manufacturers’ guidelines must always be checked prior to carrying out decontamination. Protective clothing must be worn to reduce the risk of cross contamination and exposure to chemicals.

4. Title Three processes of decontamination Decontamination is the combination of processes, including cleaning, disinfection and sterilisation used to render a reusable item safe for use on clients or handled by staff.

5. Title The removal of deposits by washing with hot water and a neutral detergent, followed by thorough drying with disposable paper towels. This removes dirt, grease and organic matter. Cleaning must always take place prior to disinfection or sterilisation. Cleaning

6. Title Disinfection Kills or inactivates organisms but not all bacterial spores. A chlorine releasing agent, for example Hypochlorite, is suitable for disinfection.

7. Title Removes all organisms including spores. This is absolute; an item of equipment is either sterile or not sterile. Sterilisation

8. Title Risk Assessment The level of decontamination required is determined by the type of equipment and the risk it poses for transmission of infection. Manufacturers’ guidelines must always be followed.

9. Title

10. Decontamination must take place in a suitable environment. The care home should have a safe environment for the effective decontamination maintenance and storage of equipment which ensures that dirty and clean equipment never come into direct or indirect contact. Decontamination environment

11. Title Separate area - to prevent cross contamination. Double stainless steel sink unit - equipment can be washed and then rinsed. A hand wash sink which must not be used for washing equipment. Alcohol hand gel - quick, easy, convenient method to rapidly disinfect hands if access to hand washing facilities is not available. A drying area must be available Decontamination area

12. Title Storage Area There must be a storage area for clean equipment which has been labelled to show that it has been cleaned. This must be a secure area protecting against the elements, pests and rodents and large enough for the volume of equipment.

13. Title Recliner chairs etc.- prior to purchasing ensure that equipment is able to be cleaned. Soft furnishings

14. Title Check weekly for signs of leakage into the foam no staining must be visible the equipment must be impermeable to fluids. To test - place a paper towel beneath the cover, press down on the mattress or cushion for 10 seconds, pour 50ml of water onto the area, press down for a further 30 seconds. Remove and examine the paper towel for signs of leakage through the cover. Ensure that covers are placed correctly onto the cushion or mattress after cleaning. Mattresses, cushions and seating products

15. Title Enclosed in a wipeable cover - clean with detergent Dry thoroughly with disposable paper towel. Store dry. Specialist beds - take care to avoid “electrics”. Specialist mattresses and cushions - launder cover in washing machine following manufacturers’ instructions. Ensure it is dry prior to replacing on the foam. Check mattress/cushion for signs of staining and also test cover for permeability. Hospital mattress

16. Title Lifting and transfer equipment Examine for signs of wear e.g. chipped or rusted surfaces - the item must be condemned and not reused. Clean as instructed. Use steamer if necessary for intricate areas. Dry with disposable paper towel and store dry. Slings and slide sheets - launder in washing machine following manufacturers’ instructions

17. Title Clean with a neutral detergent and hot water and disposable cloths or disposable detergent wipes. During outbreak follow by disinfection using chlorine releasing agent diluted to a concentration of 1,000 parts per million. Dry with disposable paper towelling. Label with clean indicator tape. Store dry. Cleaning toilets and raisers etc

18. Title Cleaning commodes Do not forget to clean underneath and foot rests. Must be examined for signs of wear for example chipped or rusted surfaces. If found the item must be condemned and not reused

19. Title

20. X

21. Title Cleaning a body fluid spillage Protective clothing Hypochlorite granules 1% hypochlorite solution Orange bag N.B carpets and soft furnishings will have to be steam cleaned. Infection Prevention & Control

22. Title Everyone’s responsibility to ensure safe reuse. Be careful of “single patient use”. Remember careful consideration before purchasing equipment! Single use means single use.

23. Title Any Questions? Anita Watson Anita.watson@northlancs.nhs.uk 01524 519440

24. Title

25. Legionnaire’s disease is a form of lung infection spread through the air via contaminated water droplets/aerosols

26. Title True Legionnaire’s disease is a form of lung infection caused by the bacteria Legionella. Common sources are air conditioning unit, cooling towers, swimming pools and spas.

27. Title Which disease with less severe symptoms is caused by the same bacteria as Legionnaire’s disease?

28. Title Pontiac fever is a mild flu like illness caused by Legionella bacteria. As with Legionnaire’s disease, symptoms can include fever, headaches and muscle aches, but Pontiac fever does not cause pneumonia. Pontiac fever normally clears up without treatment within 2-3 days.

29. Title How is Legionnaire’s disease spread? Person-to-person Airborne from water source Inoculation

30. Title Legionella bacteria grow and multiply within warm moist environments. Breathing in aerosols from a contaminated water system, for example, showers and spa pools is the most likely root of transmission. Person-to-person spread does not occur.

31. Title For at least how many minutes should you run a shower every day to protect yourself and patients from Legionella bacteria? 1 2 3

32. Title Legionella like to colonise and contaminate hot water systems, spa baths and showers. Before using the shower, allow the hot water to run for at least 2 minutes every day before use.

33. Title Cleaning is a process that aims to remove contamination from reusable medical devices and equipment True or false

34. Title True

35. Title What is the essential first step in preparing reusable medical devices for disinfection?

36. Title Cleaning

37. Title What process makes a reusable medical device free from viable microbes including bacterial spores and viruses? Cleaning Disinfection Sterilisation

38. Title Sterilisation

39. Title Disinfection is used to decontaminate what type of items? High risk Medium risk Low risk

40. Title Medium risk

41. Title What types of micro-organisms are part of our essential normal skin flora, but are potentially dangerous during invasive procedures?

42. Title Resident

43. Title Why should wristwatches, rings and jewellery be removed before washing your hands?

44. Title Because they attract micro-organisms that can be transferred to patients/clients and may cause infections.

45. Title Handwashing is the cornerstone for preventing the spread of infection

46. Title True

47. Title What reason do health and social care workers give when challenged for not washing their hands? Not enough time Lack of facilities I wear gloves so my hands don’t need to be washed

48. Title All of the above

49. Title The thumb, fingertips and between the fingers are most frequently missed during hand washing

50. Title True

51. Title What is the key reason for drying hands thoroughly after hand washing?

52. Title You should dry your hands because micro-organisms are more easily transferred on wet or damp surfaces

53. Title What is the most effective method for drying hands after washing?

54. Title Paper towels – paper towels rub away transient micro-organisms and dead skin cells and remove bacteria from deeper layers of the skin by friction

55. Title How many moments are there in The World Health Organization’s (WHO) activity that aims to add value to any hand hygiene improvement strategy?

56. Title 5