The proper maintenance of respiratory equipment

Clean medical inhaler
Photo by Mockup Graphics on Unsplash

When we talk about disinfection, we talk about the prevention and control of infection in the environment. Therefore, equipment used for respiratory therapy is considered semi-critical. The equipment must then be cleaned and disinfected properly between patients. The WHO gives us the proper maintenance of respiratory equipment in procedures to follow. The procedures are checklists in steps of a cycle. Let’s explore all the summarized steps up to the cycle finish. And yes, the cleaning step is before the disinfection step!

Checklists for care, cleaning, disinfection and sterilization of respiratory devices

1. Perform hand hygiene

The title and image say it all

2. Don appropriate personal protective equipment

The personal protective equipment to be worn during the disinfectant preparation includes surgical mask/respirator, googles/face shield, long-sleeved fluid resistant gown/gown plus apron, rubber gloves and boots or closed work shoes.

3. Wash with detergent and rinse with clean water

The external device surfaces must be wiped with a damp cloth or disposable wipe that is soaked in detergent and clean water. Then, remaining detergent residue must be wiped off with a dry lint-free cloth. A mechanical action (scrubbing/brushing) should be used to remove visible dirt deposits and calcifications.

4. Disinfect

4a. Physical disinfection – Heat for heat resistant equipement (steam/hot-water)

A high-level of physical disinfection can be achieved with steam (e.g. autoclaving at lower temperature) or hot-water at least 121°C. This is an inexpensive and effective method for sterilization or high-level disinfection.

4b. Chemical disinfection for plastic plus other parts that can be damaged by heat

b) If the disinfection needs to be with chemicals solutions, it should be performed in a well-ventilated area and away from patients. Use a disposable wipe or a fresh cloth that is soaked in a compatible disinfectant. Hydrogen peroxide 0.5% or ethanol 70-90%. Wipe from top to bottom and avoid contact with electrical connectors.

5. Dry equipment / Rinse equipment

a) Physical equipment often has a drying feature within the machine (e.g. washer, pasteurizer or autoclave). Following pasteurization, the wet equipment is typically dried in a hot-air drying cabinet or air-dried. Make sure to carefully inspect and ensure that no water is left in the equipment.

b) If a chemical solution was used for disinfection, rinse the equipment with sterile or clean water (i.e. water boiled for 5 mins and cooled down). It is preferred to use sterile water for rinsing off residual liquid chemical disinfectant from the respiratory device.

6. Store equipment in closed packages

Last step. Title says it all.

This was a summary of the Care, cleaning and disinfection of respiratory equipment in sterile services department’s article by World Health Organization.

This article is a free translation of WHO’s article.

Source:
World Health Organization
– https://www.who.int/publications/m/item/care-cleaning-and-disinfection-of-respiratory-equipment-in-sterile-services-department
– https://www.who.int/images/default-source/health-topics/coronavirus/care-cleaning-disinfection-of-respiratory-equipment.tmb-479v.png?sfvrsn=14530f0b_1

Surface Cleaning Methods & Products with RCP

Hygen microfiber from Rubbermaid Commercial Products
Hygen microfiber from Rubbermaid Commercial Products

The COVID-19 has led us to adopt new protocols to ensure patient and staff safety in healthcare facilities. Having said that, it is crucial to equip yourself with the right surface cleaning and disinfection products in healthcare facilities! What are the right products? How should you clean? Let’s explore them with the help from Rubbermaid Commercial Products, a world leader in the commercial cleaning industry! Of course, in these strange days, depending on the availability of some products, Lalema has suggestions as well ;)!

SURFACE CLEANING PRODUCTS

First of all, here are some products suggested by RCP for surface cleaning. Overall, most of them are available. Otherwise, we have replacements.

Recommended surface cleaning products
Recommended surface cleaning products

Hygen microfiber cloths – Rubbermaid Commercial Products’ all-purpose 16″ x 16″ HYGEN microfiber cloths remove 99.9% of the viruses and bacteria tested on surfaces.

Bowl Brush – This bowl brush has a plastic handle. The brush is made of polypropylene bristles. It is odor and stain resistant.

Toilet brush holder – This toilet brush holder is made of polypropylene. It is stain and odor resistant.

Bottle and Sprayer: Graduated bottle for inserting and spraying cleaning solutions.

As a replacement for Hygen disposable microfiber cloths and its charging tub system, we suggest this:

Dry Wipes and MYOSAN TB Kit – Kit of dry wipes and MYOSAN TB designed to disinfect and eliminate microorganisms on hard surfaces. It should inactivate the new coronavirus SARS-CoV-2, the virus that causes COVID-19.

Dry Wipes and MYOSAN TB Kit
Dry Wipes and MYOSAN TB Kit

BEST PRACTICES

Second, as expectations for cleanliness and hygiene rise, facilities must ensure that they have an established surface cleaning and disinfection process. This includes regular cleaning of high-traffic areas. Below are the best surface cleaning practices used in hospitals around the world today.

CLEANING TIPS

  1. Clean systematically, clockwise or counterclockwise – No surface is forgotten, this process saves time and is more ergonomic
  2. Go from clean to dirty – This reduces the likelihood of the spread of infections and contaminants
  3. Clean from the top to the bottom – Any dust or debris dislodged from the upper surface will naturally fall to the lower surfaces
  4. Wipe in one direction (unidirectional wiping) – Unidirectional wiping ensures that the solution is applied over the entire surface, while circular wiping re-contaminates areas
  5. Color Coding – Use single color wiping cloth for each zone. For example:
  • Red for high risk areas
  • Blue for mirrors
  • Yellow for baths and showers

8-SURFACE FOLDING METHODOLOGY

Finally, the 8-surface folding methodology! This is the 8-sided folding for microfiber cloths. It optimizes the use of the cloth while reducing the risk of cross-contamination during the cleaning process. Here are the steps:

8-SURFACE FOLDING METHODOLOGY
8-SURFACE FOLDING METHODOLOGY

8-surface folding methodology by Rubbermaid Commercial Products

  1. Start by opening a clean microfiber cloth
  2. Fold the microfiber cloth in half
  3. Fold the microfiber cloth into four pieces
  4. Clean surfaces with both sides of the cloth exposed
  5. Open the microfiber cloth once to change the sides
  6. Fold over to expose both clean cleaning surfaces
  7. Fully open the microfiber cloth when all four sides have been used
  8. Repeat steps 2 to 7 to use all eight sides

In short, these tips are only general since we could have gone deeper into the details or in further checklists. However, the importance is to set up a methodology for surface cleaning and disinfection and to be equipped with the right products. Don’t forget to wear personal safety equipment! Let’s save the subject of floor cleaning for another day!

Lalema would like to thank and salute all the staff in the healthcare facilities for their services!