The ultimate goal of the 2008 Health Care Facility Disinfection and Sterilization Recommendations is to reduce the rate of health care-associated infections through the appropriate use of disinfection and sterilization. Each recommendation is categorized based on scientific evidence, rationale, applicability, and federal regulations.
Some recommendations include examples to assist the reader; however, these examples are not intended to define the only way to implement the recommendations. The CDC system used to categorize the recommendations is defined in the (ranking) section below.
IA Category. Strongly recommended for implementation and strongly supported by well-designed experimental, clinical, or epidemiologic studies.
Category IB. Strongly recommended for implementation and supported by some experimental, clinical, or epidemiological studies and a strong theoretical rationale.
Sponge Brush
Category IC. Required by state or federal regulations. Because of state differences, the reader should not assume that the absence of an IC recommendation means that there are no state regulations.
Category II. Recommended for implementation and supported by clinical or epidemiologic studies or theoretical rationale.
No recommendation. Unresolved issues. This includes practices for which there is insufficient evidence or no consensus on efficacy.
Inform each worker of the potential health effects of his or her exposure to infectious agents (e.g., hepatitis B virus [HBV], hepatitis C virus, human immunodeficiency virus [HIV]) and/or chemicals (e.g., EtO, formaldehyde). This information should meet the requirements of the Occupational Safety and Health Administration (OSHA) and identify areas and tasks where exposures may exist.
Educate health care workers on the selection and proper use of personal protective equipment (PPE).
Protective Medical Disposable Clear Plastic Face Shield
Ensure that workers wear appropriate PPE to prevent exposure to infectious agents or chemicals through the respiratory system, skin, or mucous membranes of the eyes, nose, or mouth.PPE may include gloves, gowns, masks, and goggles.The exact type of PPE depends on the infectious or chemical substance and the expected duration of exposure. It is the employer's responsibility to provide such equipment and training.
Establish a program to monitor occupational exposure to regulated chemicals (e.g., formaldehyde, EtO) and comply with state and federal regulations.
Avoid direct contact with patient care equipment by health care workers with tear dermatitis on their hands.
In hospitals, most cleaning, disinfection, and sterilization of patient care equipment is performed in a central processing department to allow for easier quality control.
Careful cleaning of patient care supplies with water and detergents or with water and enzyme cleaners prior to advanced disinfection or sterilization procedures.
Removal of visible organic residues (e.g., blood and tissue residues) and inorganic salts by cleaning. Use cleaners that remove visible organic and inorganic residues.
Endoscopic Sponge
Clean medical instruments as soon as possible after use (e.g., while in use), as soiled material on the instruments will dry out. Dried or baked-on materials on instruments make the removal process more difficult and the disinfection or sterilization process less effective or ineffective.
Perform manual cleaning (i.e., using friction) or mechanical cleaning (e.g., using an ultrasonic cleaner, washer-disinfector, or washer-disinfector).
If using an automatic cleaner/disinfector, ensure that the equipment is used according to the manufacturer's recommendations.
Ensure that the cleaner or enzyme cleaner selected is compatible with the metals and other materials used in the medical device. Ensure that the rinsing step is sufficient to remove cleaning residues to a level that will not interfere with the subsequent disinfection/sterilization process.
Inspect device surfaces for integrity breaks that would interfere with cleaning or disinfection/sterilization. Discard or repair equipment that no longer works as intended or cannot be properly cleaned, disinfected, or sterilized.
