Infection Control and Cleanliness: Decontamination of Reusable Equipment and Devices in Care Homes Policy

Policy Statement

This policy describes the procedures used in {{org_field_name}} to ensure the cleanliness of its facilities and equipment to prevent infection and cross-infection. It is produced in line with statutory requirements for care services to maintain high standards of cleanliness of facilities and equipment and health and safety laws.

All equipment and devices employed for the care and treatment of people who use the service must be used and reused properly in line with best practice guidance and statutory requirements. This is to make sure that people who use the service are protected and cared for effectively.

The cleaning and decontamination of each item of equipment and device that is re-used must also comply with the manufacturer’s instructions and statutory guidance in order to ensure safe reuse. The home is aware that all medical devices are subject to the Medical Devices Regulations 2002.

Legal Considerations

This care service must comply with all relevant national health and care standards, health and safety laws and regulations and guidance produced by public health, NHS bodies and the National Institute for Clinical and Health Excellence (NICE).

In brief, the standards require:

where applicable, premises must be cleaned or decontaminated in line with current legislation and guidance, and equipment must be cleaned, decontaminated and/or sterilised in line with current legislation and guidance and manufacturers’ instructions
equipment must be cleaned or decontaminated after each use and between use by different people who use the service
multiple use equipment and devices must be cleaned or decontaminated between use
single use and single person devices must not be re-used or shared
all staff must understand the risk to people who use services if they do not adhere to these requirements.

Under the above legislation, and associated codes of practice, {{org_field_name}} understands its legal and moral duty to ensure the health and safety of both staff and people who use the service, and to protect them, wherever practicable, from dangerous substances in the workplace, including the risk of transmission of infections.

The home understands “reusable medical devices” to refer to equipment that can be used more than once, “reuse” implying some form of reprocessing between use, ranging from a simple washing of the item to a full cleaning and sterilisation process.

This policy should be read and used in relation to other cleanliness and infection control policies.

Applicable best practice infection control guidance includes:

NICE CG139: Healthcare-associated Infections: Prevention and Control in Primary and Community Care (2017), NICE
NICE PH36: Healthcare-associated Infections: Prevention and Control (2011), NICE
HSE HSG220 Health and Safety in Care Homes (2nd edition) (2014), HSE.

Specialist advice and support will be obtained from the local public health protection team and from relevant primary healthcare teams.

Background

“Medical devices” refers to equipment that is usually used for providing healthcare interventions, such as:

equipment used in diagnosis or healthcare monitoring, such as thermometers and blood pressure monitors, blood sugar meters and lancing devices
sterile equipment used in wound care, such as forceps, surgical scissors, pots, dressings, etc
equipment used in the provision of therapy or treatment, such as syringes, needles, infusion pumps, catheters, etc
bed rails, hoists and slings.

Decontamination: a Definition

The home uses a recognised definition of “decontamination” as a range of processes which remove or destroy contamination, preventing micro-organisms or other contaminants reaching a susceptible site in sufficient quantities to cause infection or other harmful response.

The processes include effective cleaning, disinfection and/or sterilisation, used to render reusable equipment and medical devices safe for further use. (See also the Decontamination, Disinfection and Sterilisation policy.)

Scope of Decontamination Processes

Using this definition, the home has developed decontamination procedures of its reusable equipment and medical devices in line with the Hygiene Code, as follows.

All non-invasive equipment used by a people who use the service, eg beds, chairs, commodes, mattresses, hoists, slings, bed linen, duvets, etc are subject to routine cleaning, disinfecting and sterilisation (in line with their specific instructions and requirements) and decontamination where required, eg as a result of infectious illnesses.
Decontamination of reusable medical equipment and devices takes place in appropriate facilities designed to minimise the risks that are present (eg see policies on Autoclaves and Decontamination, Disinfection and Sterilisation).
The home has developed appropriate procedures for the acquisition, maintenance and validation of decontamination equipment, which are the responsibility of the Infection Control Lead.
Staff are trained in cleaning and decontamination processes and hold appropriate competencies for their role, which is carried out from induction onwards with specialist training for those with specific decontamination responsibilities.
The home has developed a record-keeping system to make sure that decontamination procedures are carried out to the required standard in respect of every piece of equipment or item.
It has in line with its approach to quality assurance and clinical governance a system for monitoring and auditing that all required decontamination procedures and protocols are being followed.

Through the implementation of its decontamination policy and procedures the home is then able to demonstrate that its reusable equipment and medical devices are always safe for reuse by being:

sterile (at point of use)
sterilised (ie having been through the sterilisation process)
clean (ie free of visible contamination).

{{org_field_name}} recognises that different items will be made subject to full decontamination procedures (as opposed to routine cleaning and disinfection) in some circumstances, eg during and after outbreaks of infection. The home adopts a rigorous approach to such situations and will always carry out full decontamination procedures where indicated from its own risk assessments and external advice from the relevant health protection agencies.

Safe Disposal

The policy applies to all reusable medical equipment and devices used by the home as long as they remain fit for purpose. When no longer fit for purpose, such equipment and devices are safely decommissioned and disposed of in line with safe disposal practice requirements for the particular device. Some single-use medical devices and equipment are subject to decontamination procedures as part of their safe disposal.

Implementation

All staff are responsible for the implementation of this policy and for making sure that reusable equipment and devices are always fit for use following decontamination.
The Infection Control Lead for the home has overall responsibility for making sure that all required procedures and protocols for the decontamination of defined reusable equipment and devices are developed, implemented, monitored and reviewed. The Lead also provides advice and guidance to staff on the procedure to be followed.
The Lead is routinely involved in the procurement of the relevant devices in order to consider the necessary decontamination methods, safety and infection risks involved.
In consultation with other staff, particularly nursing staff, the Lead is responsible for drawing up a list of the reusable equipment and medical devices that are subject (or might be made subject to) decontamination procedures and for developing the procedures and protocols for their decontamination.
The Lead works closely with and reports to the registered manager/nursing manager to ensure that all decontamination policies are effectively implemented, monitored, audited and reviewed.

Training

All staff will be trained in basic infection prevention and control measures in line with the home’s policies and procedures.

Staff who are required to work on the decontamination of reusable equipment and devices are appropriately trained, qualified and competent to do so by being provided with the appropriate specialised and refresher training.

All new staff will be expected to complete induction training which includes health and safety procedures.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next Review Date: {{next_review_date}}

WCH148. Infection Control and Cleanliness: Decontamination of Reusable Equipment and Devices in Care Homes