The manufacturer must provide written information regarding the safe and appropriate reprocessing of the medical equipment/device. 14 Spaulding EH. The Role of chemical disinfection in the prevention of nosocomial infections. In: PS Brachman and TC Eickof (ed). Proceedings of International Conference on Nosocomial Infections, 1970. Chicago, IL: American Hospital Association: 1971: 254-274. Best Practices for Cleaning, Disinfection and Sterilization in Health Authorities March 2007 18 5.5 All medical equipment/devices that will be purchased and will be reprocessed must have written device-specific manufacturer’s cleaning, decontamination, disinfection, wrapping and sterilization instruction. If disassembly or reassembly is required, detailed instructions with pictures must be included. Staff training must be provided on these processes before the medical equipment/device is placed into circulation. 6. Environmental Issues 6.1 There must be a centralized area for reprocessing medical equipment/devices. Reprocessing performed outside the centralized area must be kept to a minimum and must be approved by the reprocessing committee or those accountable for safe reprocessing practices and must conform to the requirements for reprocessing space. Refer to Appendix B for details regarding recommendations for processing space. The environment where cleaning is performed must: a) Have adequate space for the cleaning process and storage of necessary equipment and supplies; b) Be distinctly separate from areas where clean/disinfected/sterile equipment/devices are handled or stored; c) Have easy access to hand hygiene facilities; d) Have surfaces that can be easily cleaned; e) Have restricted access from other areas in the setting and ensure one-way movement by staff; f) Have air changes, temperature and humidity appropriate to the process/product being used (see manufacturer’s recommendations and CSA Standards). Refer to Appendix B; g) In health care settings where there are dedicated central reprocessing areas, negative pressure airflow must be used in soiled areas, and positive pressure airflow must be used in clean areas;15 h) The health care setting should be aware of the quality of its water supply and develop policies to address known problems (refer to Appendix B); i) The health care setting should have written reprocessing contingency plans in place that address loss of potable water, boil water advisories and other situations where the water supply becomes compromised.
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6.2 Wherever chemical disinfection/sterilization is performed, air quality must be monitored when using products that produce toxic vapours. Many products (e.g. glutaraldehyde) have a maximum ceiling exposure value (CEV) as documented in the Worker’s Compensation Act and Occupational Health and Safety Regulation. If reprocessing is not carried out in an appropriately vented space, air sampling may be required to ensure that the CEV has not been exceeded for the chemical being used. 7. Occupational Health and Safety Issues Occupational Health and Safety for the health care setting will review all protocols for reprocessing medical equipment/devices to verify that worker safety measures are followed and in compliance with the Workers Compensation Act RSBC 1996, c.492 and the associated Occupational Health and Safety Regulation 296/97. 7.1 The following aspects of the reprocessing procedure must be reviewed by a representative from the facility’s Occupational Health and Safety Department: a) Sharps are handled appropriately; b) Air handling systems adequately protect the worker from toxic vapours;16 15 Canadian Standards Association. Physical requirements for decontamination facilities.