Canterbury DHB

Volume 10 – Infection Prevention and Control

Decontamination of EquipmentDecontamination of
Equipment

Decontamination of Equipment

The aim of appropriate decontamination of reusable equipment is to prevent

patient to patient transmission of infectious agents. Cleaning the item of
equipment is the first step in the decontamination process and may be
followed by disinfection or sterilisation depending on the use of the
equipment and the risk of transmission of infection by that item.

Only equipment that can be effectively decontaminated must be used in

clinical areas.

1. Classification of equipment according to risk of infection

Critical Items that confer a high risk for infection and must be sterile at the time
of use. This includes any objects entering sterile tissue, site or vascular
system.
Semi-critical Items that come into contact with mucous membrane or non-intact skin
should be single use or sterilised after each use. Where this is not
possible, high level disinfection is the minimum level of reprocessing
acceptable.
Non-critical Items that come into contact with intact skin, not mucous membranes.
Thorough cleaning after individual use or intermediate/low level
disinfection may be appropriate.

2. Cleaning
• Cleaning is the most important step in the decontamination process.
• Cleaning of equipment using detergent and warm water or a detergent
wipe will physically remove contamination, but does not necessarily
destroy the bacteria. Drying is also an important part of the process.
• Cleaning is a pre-requisite before either disinfection or sterilisation.
• Cleaning is adequate for most items which come into contact with
intact healthy skin.

3. Disinfection
• Disinfection is a process which inactivates non spore-producing
infectious agents.
– Thermal disinfection uses heat and water at temperatures that
destroy infectious agents.
– Chemical disinfection is achieved by using an approved chemical
agent e.g. alcohol, sodium hypochlorite.
• There are three levels of disinfection depending on the intended use of
the equipment, low, intermediate and high.
• All disinfection products and processes must be approved by the
IP&C Service.

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Volume 10 – Infection Prevention and Control
Decontamination of Equipment

• Refer Appendix B for Dilution Instructions for chlorine based

disinfectants.

4. Sterilisation
• Sterilisation is a process that destroys all micro-organisms, including
bacterial spores.
• Sterilisation must only be carried out by an approved sterilising
service, e.g. CSSD/TSU by suitably qualified staff.

4.1 Storage of sterile items

• Store sterile items away from direct sunlight in a clean, dust, insect and
vermin free room in a manner which protects the items from damage
or recontamination before reuse.
• Sterile items stored on open shelving must be stored 25cm above floor
level.
• Storage trolleys, bins and cupboards shall be kept clean and free from
dust.
• A system of stock rotation should be in place.

5. Single Use Instruments and Equipment

• Items labelled as ‘single use only’ must not be decontaminated or
reprocessed for re-use on other patients.
• Any exception to this has previously been subjected to review by the
Canterbury DHB Clinical Board. No new items will be submitted.
• For further information refer to Online Manual Volume 11,
Reprocessing of single use medical devices.

6. Specialist Equipment
All specialist reusable equipment must have cleaning and decontamination
processes approved by the IP&C Service.

7. Decontamination of Equipment Prior to Inspection, Service or Repair

Purpose
To ensure all items of medical devices and equipment intended for
inspection, service, repair, or for return to the lending organisation, first
undergo cleaning and disinfection to reduce the risk of infection to any
person who may handle the equipment.

Policy
• All equipment must be emptied of all potentially contaminated
secretions/fluids.
• All disposable components, eg. plastic tubing, must be discarded by
the user.

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Decontamination of Equipment

• All equipment must have all outer surfaces cleaned with detergent and
water.
• If contaminated with blood/body fluids or from an isolation room,
then the cleaning must be followed by disinfection with an approved
disinfectant and left to dry.
• Metal equipment must be rinsed off with water (damp cloth) after ten
minutes and dried immediately.

8. Decontamination of Commonly Used Equipment

• If equipment is contaminated with blood and body fluids, cleaning
must be followed by disinfection.
• Equipment used for a patient in Contact Precautions must be cleaned
and disinfected according to IP&C policy prior to use on another
patient.

Table 1: Decontamination method and frequency for commonly used patient care
equipment
NB: Where detergent and water is referred to in this section, a detergent wipe may be used if available.
Equipment / Item Method Frequency
Ambubag Single use: Dispose of as infectious/medical Single use
waste.
Reusable: Clean as per manufacturer’s Between patient
recommendations. use
Anti-thrombotic hosiery Single patient assigned. Single use
(TED stockings)_and Wash as per manufacturers recommendations.
Anti slip socks
Auroscope Wipe handpiece with detergent and water or After each
approved alcohol based surface wipe. patient use
Use single use heads or sterilise reusable heads
via CSSD/TSU.
Babies bottles and Teats Bottles and teats are single use items and are Single use
not reprocessed.
Breast Pumps Use one immersion tank per mother. Change solution
Clean and rinse breast pump equipment, then daily
soak in diluted Presept (refer to dilution of
disinfectants).
Clean and disinfect breast pump machine with Between patient
an alcohol wipe. use
On discharge: rinse breast pump and send to
CSSD to be packaged and re-sterilised.
Baby Scales Wash with detergent and water. After each
Allow to dry where required, disinfect with an patient use
alcohol-based surface wipe.
Baths Wash with approved cream cleanser. After each
Disinfect as required. patient use

Birthing Pools Refer to Birthing Pool Cleaning policy.

Bed Frames and Wheels Wash with detergent and water. After each

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Decontamination of Equipment

Equipment / Item Method Frequency

(see also mattresses)
Bedpans
Blood Pressure Cuffs (nylon)
patient use
Disinfect in bedpan washer/sanitiser. After each
patient use
Wipe BP cuff, tubing and bulb using a Weekly
dampened cloth with detergent and water or use
a disposable detergent wipe.
Use a cap to cover flexiport hole for cleaning.
DO NOT IMMERSE TUBING OR CUFF.

Isolation –allocate B/P cuff to individual

patients until discharge.
Use disposable wipe with appropriate
disinfectant e.g sodium hypochlorite1,000ppm
(bleach) or alcohol-based surface wipe.

Cloth BP cuffs Where fitted, remove cloth cover and wash

Bowls (washing)
Cleaning Bucket (plastic)
Chairs (fabric covered)
Commodes
CPR Trolley
Crockery and Cutlery
Curtains / Window
Coverings
Change routinely, when visibly
soiled or as part of terminal or
bed space disinfection clean.
Black laundry bag.
Dressing / Procedure trolleys
weekly with detergent and water. Allow to fully
dry before refitting for use. Wipe over cuff
inner/ hose/ bulb or connectors (do not
immerse).
Wash with approved cream cleanser, then After each
disinfect in washer/sanitiser and store dry. patient use
Empty contents down toilet or sluice. Wash
with detergent and water, store dry, positioned
upside down.
Spot clean as required. 6 monthly or if
Hot water extraction clean/steam clean. contamination
with body fluid
NOTE: Impermeable, wipeable fabrics are occurs.
advised for clinical areas.
Clean with detergent and water or spray with After each
toilet sanitiser solution (where available). patient use
If soiled, clean then use an appropriate
disinfectant e.g. sodium hypochlorite 1,000ppm
(bleach) and allow to air dry.
Damp dust using a detergent wipe. Weekly
Wash in approved dishwasher.
Window curtains are sent to laundry. Yearly
Roller blinds are cleaned with detergent and Yearly
water.
Privacy Curtains are sent to laundry. 6 monthly
Shower curtains are sent to laundry. 3 monthly
Venetian blinds are removed for cleaning and 3 monthly
maintenance inspection/repair by specialist
venetian blind service.
(Venetian blinds are not recommended in
clinical areas unless between double glazing)
Use detergent and water. After each

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Decontamination of Equipment

Equipment / Item Method Frequency

Where required, disinfect with an alcohol-based patient use
surface wipe.
Clean wheels regularly Weekly
Duvet inners and covers Clean via laundry service (single patient Between patients
assigned only).
ECG trolley, leads and Ensure the ECG machine is disconnected from
electrodes the power supply before cleaning. Weekly
Wipe with alcohol-based surface wipe including
all leads and electrode buttons.
Endocavity transducers and Requires high-level disinfection or sterilisation.
probes Refer to departmental specific procedure
manuals.
Examination equipment, Wipe with detergent and water or approved After each
eg. Opthalmoscope, reflex alcohol-based surface wipe. patient use
hammer, sonic aid transducer
(Doppler)
Examination Bed/Couches Use a paper cover or sheet to protect bed and Change paper
pillow. between patients.
Change pillow case daily.
If paper cover is unavailable, change linen
between patient use. Weekly
Clean couch bed with detergent and water.
Flower vases Change vase water every two days (do not
discard in handwash basin).
Wash with detergent and water. Between patients
Store dry positioned upside down.
Glucocard Monitor and Wipe monitor with approved alcohol-based After each
Storage Box surface wipe or swab. patient use
Clean box with detergent and water. Weekly
Gumboots Clean with detergent and water. Weekly
If soiled, clean then use an appropriate Following use
disinfectant e.g. sodium hypochlorite 1,000
ppm (bleach) and allow to air dry.
Hair Trimmers / Clippers Use trimmers with single use disposable heads. After each
Disposal via sharps container. patient use
Wipe trimmer handles with detergent and water
Hoist Equipment Refer Appendix A
IV Stands Wash with detergent and water. After each
If contaminated disinfectant with appropriate patient use
disinfectant e.g. alcohol-based surface wipe,
sodium hypochlorite1,000 ppm (bleach).
IV Pumps Wipe with detergent and water. After each
Use an appropriate disinfectant e.g. sodium patient use
hypochlorite 1,000 ppm (bleach), allow to air As required for
dry. terminal clean
Linen Carriers Wash with detergent and water including base Weekly
and wheels.

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Decontamination of Equipment

Equipment / Item Method Frequency

Mattresses Wash with detergent and water. After each
Replace mattress if the cover is torn or damaged patient use
whereby the foam inner of the mattress may
become contaminated.
Dispose of mattress as infectious/medical
waste.
Specifically designed mattresses (such as
airflow mattresses) should be cleaned in
accordance with manufacturer’s
recommendations.
Medicine cup/pill pottles If non-disposable, wash in approved dishwasher After each
or “clean” washer/sanitiser. patient use
Mobility Aides, Walking Wash with detergent and water. After each
Frames, Crutches. patient use
Mop (cotton head for wet Mops heads are laundered by the contracted Daily
use) cleaning or laundry service. Store dry.
Nail Clippers Send to CSSD for reprocessing. After each
patient use
Pillows Treat as for mattresses. After each
patient use
Pulse Oximeter Clean finger probe/ear sensor with alcohol After each
based surface wipe/swab. patient use
Wipe with detergent and water or approved
alcohol- based surface wipe.
Razors Disposable safety razor –dispose in sharps Single-use
container.
Electric – patient’s own only.
Refrigerators Defrost and clean weekly to prevent ice build Weekly
Medication up.
Refer to Food and Water Hygiene section in
Food this manual
Resuscitation Mannikins Refer to manufacturer’s guidelines / CDHB Decontaminate
Resuscitation Training Coordinator for full after each use
cleaning instructions.
Rubbish Bag Stands/Bins Wash with detergent and water. Weekly
Note: Yellow bag bins/stands are cleaned by
ward staff.
Scissors Reusable scissors for sterile use, e.g. dressings, After each
are returned to CSSD for processing. patient use
Designated sluice room scissors - wash with
detergent and water and sanitise in ward Daily
sanitiser.
Sheepskins Send to laundry service; place in black laundry After each
bag. patient use
Shower Chairs / Stools Wash with detergent and water. After each
If soiled, clean then use an appropriate patient use
disinfectant e.g. sodium hypochlorite 1,000

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Decontamination of Equipment

Equipment / Item Method Frequency

ppm (bleach) and allow to air dry.
Sigmoidoscopy Equipment Refer to Sigmoidoscopy Guidelines, Infection
Prevention and Control Intranet site for detailed
instructions.
Slide Sheets/Lifting Belts Refer Appendix A Single patient
assigned.
Stethoscopes Use alcohol-based surface wipe/swab. After each
patient use
Telephone Clean with a detergent or alcohol-based surface Daily
wipe.
Thermometers (oral/axilla) Electronic or Tympanic After each
(Reusable only) Use disposable sleeve or ear piece. patient use
Wipe probe/handpiece with alcohol-based
surface wipe /swab.

Mercury
Single patient assigned thermometers.
Rinse with tepid water and detergent under tap,
dry with paper towel, then wipe with alcohol -
based surface wipe /swab.
On discharge, clean in detergent and cold water
and soaked for one hour in diluted Presept
(140ppm) and store dry.
Tooth Mugs and Bowls Single use: Dispose of as General Waste. After each
Reusable: Rinse and sanitise in patient use
washer/sanitiser.
Toilets (Patients)/Raised Clean with detergent and water or toilet After each
Seats sanitiser solution. patient use
Toilet Brushes Rinse in flushing water and store dry. Daily

Sanitise in washer/sanitiser. Weekly

Tourniquets Wash with detergent and water and soaked for Weekly or when
one hour in diluted Presept (140ppm) and store visibly soiled
dry.
Use disposable tourniquets for patients in Single patient
isolation. use
Toys All shared toys must be able to be washed with Weekly or when
detergent and water. Toys must then be contaminated /
disinfected by immersing in diluted Presept placed in mouth
(140ppm) for one hour or toys that cannot be
immersed, thoroughly wipe with an alcohol-
based surface wipe. Soft toys must not be
provided unless exclusively for one child’s use
or is disposed of after use.
(The Activity Room in Christchurch Hospital
has its own departmental procedures)
Urinals Rinse and sanitise in washer/sanitiser. After each

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Decontamination of Equipment

Equipment / Item Method Frequency

Urine Bag Holders/Stands
patient use
Single patient assigned only.
Metal urine bag holders/stands: Sanitise in
washer/sanitiser or disinfect with an approved
disinfectant between patients e.g. Sodium After each
Hypochlorite 1000ppm (bleach). patient use

Plastic urine bag holders: Clean with detergent

Vacutainer® / Luer adapters
/ Blood transfer device
and water and soaked for one hour in diluted
Presept (140ppm) and store dry.
Vacutainer® / Luer adapters. Disposable/single Single use
use (clear): Dispose of in sharps container with
needle attached.

Vacutainer® / Luer adapters. Reusable After each

(yellow/blue pronto device): Wash in detergent patient
and water and soaked for one hour in diluted
Presept (140ppm) and store dry (Selected
clinical areas only).

Vacutainer® Blood transfer device- (e.g. Blood Single use

culture) – single use disposable.
Wheelchairs Wash with detergent and water. After each
Disinfect with appropriate disinfectant when patient use
required e.g. alcohol-based surface wipe,
sodium hypochlorite 1,000 ppm (bleach).

Associated documents

CDHB Policies, Volume 11, Clinical: Reprocessing of Single Use devices (available
on CDHB intranet)

Reference

CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008,

available from
http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

Policy Owner CDHB Infection Prevention & Control Service

Date of Authorisation 11 June 2012

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Decontamination of Equipment

Appendix A: Cleaning of Patient Handling Equipment

Item Action Frequency Example Comment
• Hoist slings Send to laundry in At end of patient stay or Individually assigned.
• Sliding sheets black laundry Bag* when soiled.
• Handling belts

• Hoist Wipe with detergent At least weekly. Wipe with disinfectant

• Standing lifter and water after use. (eg. Alcohol-based
• Turntables surface wipe /chlorine
based solution) when
used on patient in
isolation.

• Transfer boards Wipe with detergent
and water after use.
Between patient use. Wipe with disinfectant
(eg. Alcohol-based
surface wipe / chlorine
based solution) when
used on patient in
isolation.

Ref. 1599 Authorised by: Infection Control Service August 2008

Note: The items shown may differ slightly from those in your clinical area.
*When sending items to the Laundry, ensure they are clearly labelled with return location, including hospital site. Laundry can arrange labelling.
Colour of laundry bag may vary depending on the hospital – check local guidelines.

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Decontamination of Equipment

Appendix B: Dilution Instructions for chlorine based disinfectants

Dilution Instructions for Presept* Disinfection Tablets

Required Dilution Rates
Disinfection Concentration Additional
0.5g 2.5g 5.0g
of: of available Instructions
Tablets Tablets Tablets
Chlorine
18 tab in 7 tab in 1L 9 tab in Refer to policy –
Blood spillage 10,000ppm
0.5L water water 2.5L water page
Wipe down surfaces
General
4 tab in 1L 4 tab in 5L 3.5 tab in with disinfectant-
environmental 1,000ppm
water water 10L water saturated disposable
use
cloth.
Breast pumps,
1 tab in 2L 1 tab in 1 tab 20L Immerse for one
rubber and 140ppm
water 10L water water hour.
plastic tubing.
Diluted Presept solutions are unstable and should be freshly prepared daily

Sodium Hypochlorite 5% (Chlorwhite) Dilution Instructions

Required
Disinfection Concentration Dilution Application and
of: of available Rate Exposure Time
Chlorine
Toilets, Direct stream of product onto area being cleaned.
Showers, Agitate with brush or cloth.
Undiluted
Baths, Sumps, Leave at least 10 minutes.
Sluices Rinse with water.
Surfaces 1,000 ppm 20mL/L 2 capfuls per litre of water.
Blood and 10,000 ppm 200mL/L 20 capfuls per litre of water.
Body Spills Use an equal volume of diluted chlorwhite
solution to spill volume.
Allow two minutes contact time to achieve
decontamination.

Instructions for Use of Presept and Sodium Hypochlorite (eg. Chlorwhite)

Steps Action
1 Handle with care.
2 Wear gloves, plastic apron and eye protection.
3 Ensure adequate ventilation while diluting and avoid directly inhaling fumes.
4 Follow the manufacturer’s dilution instructions.
5 Recap liquid sodium hypochlorite bottle. Wipe around lid to remove undiluted
solution. Bottles of undiluted sodium hypochlorite should not be left in
patient/public areas.
Note: Sodium Hypochlorite (eg. Chlorwhite) may remove colour from some carpet and
fabrics.

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