Page 67 - policy and procedure infection control

Policies and Procedures on Infection Control

4.7.2 Definitions
Cleaning

Removal of blood, secretions and debris from endoscopes and accessories
Disinfection

Reduction of number of viable micro-organisms on a device to a level that is appropriate to
be used safely on a patient where sterilisation of the device is not necessary. Disinfection
may also be undertaken as a preliminary step to sterilisation, if necessary. Disinfection
should be carried out immediately after cleaning and immediately prior to use.

Sterilization
Validated process used to render a device free from all forms of viable micro-organisms.
Endoscopic accessories

All devices used in conjunction with an endoscope to perform diagnosis and therapy,
excluding peripheral equipment.

Single-use accessories
Also called “disposable”, these are provided in a sterile state ready for use. The opening of
a sterile package implies immediate use, as is routine in surgery. After a single-use device
has been used, all materials should be properly disposed of. Under no circumstances
should a single-use device be reused.
Reusable accessories

All reusable accessories should be sterilised. The sterilisation should be carried out after
proper cleaning, as detailed below. Manufacturers provide validated standard reprocessing
parameters (dilution, temperature and time) for cleaning, disinfection and sterilisation.

4.7.3 Cleaning – Rising – Disinfection – Sterilisation Sequence
Non-compliance with guideline is the chief factor compromising the safety of endoscope
reprocessing. The consequence of failure to follow recommendation may not be only
transmission of pathogens (due to pathological material from one patient being produced
into the next patient), but also misdiagnosis instrument malfunction, and a shortened
instrument lifespan.
Preliminary-cleaning

Preliminary-cleaning starts before the endoscope is detached from the light source/video-
processor and the reprocessing begins as soon as the endoscope is removed from the
patient.
1. Wipe down insertion tube with a detergent-soaked gauze
2. Place the distal end of the endoscope into the enzymatic detergent solution which is
diluted according to the manufacturer’s instruction.

56 Ministry of Health Malaysia