General Principles. Replacement of PN tubing and filters

Policies and Procedures on Infection Control Ministry of Health Malaysia 56

4.7.2 Definitions Cleaning

Removal of blood, secretions and debris from endoscopes and accessories Disinfection Reduction of number of viable micro-organisms on a device to a level that is appropriate to be used safely on a patient where sterilisation of the device is not necessary. Disinfection may also be undertaken as a preliminary step to sterilisation, if necessary. Disinfection should be carried out immediately after cleaning and immediately prior to use. Sterilization Validated process used to render a device free from all forms of viable micro-organisms. Endoscopic accessories All devices used in conjunction with an endoscope to perform diagnosis and therapy, excluding peripheral equipment. Single-use accessories Also called “disposable”, these are provided in a sterile state ready for use. The opening of a sterile package implies immediate use, as is routine in surgery. After a single-use device has been used, all materials should be properly disposed of. Under no circumstances should a single-use device be reused. Reusable accessories All reusable accessories should be sterilised. The sterilisation should be carried out after proper cleaning, as detailed below. Manufacturers provide validated standard reprocessing parameters dilution, temperature and time for cleaning, disinfection and sterilisation.

4.7.3 Cleaning – Rising – Disinfection – Sterilisation Sequence

Non-compliance with guideline is the chief factor compromising the safety of endoscope reprocessing. The consequence of failure to follow recommendation may not be only transmission of pathogens due to pathological material from one patient being produced into the next patient, but also misdiagnosis instrument malfunction, and a shortened instrument lifespan. Preliminary-cleaning Preliminary-cleaning starts before the endoscope is detached from the light sourcevideo- processor and the reprocessing begins as soon as the endoscope is removed from the patient. 1. Wipe down insertion tube with a detergent-soaked gauze 2. Place the distal end of the endoscope into the enzymatic detergent solution which is diluted according to the manufacturer’s instruction.