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Sterilization and infection control in the era of COVID-19

by Lauren Dubinsky, Senior Reporter | February 10, 2021
From the January/February issue of HealthCare Business News magazine

When determining how to properly clean a piece of equipment, the first place to look is the manufacturer’s recommendations, which should provide at least one effective method of disinfection and may offer guidance for use in a hospital. However, Jones cautioned that these recommendations do have some drawbacks, such as inclusion of cleaning products not available at the hospital or vague instructions.

She also emphasized that specific hospital policies and procedures must be followed. These include delegation of roles and responsibilities, specifying who cleans the equipment, how is it cleaned and when it is cleaned as well as how to train the staff to do this properly.

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When this is not done right, the consequences can be dire. There are reports of multi-facility outbreaks linked to improper cleaning and disinfection of semi-critical and critical medical equipment.

In 2015, outbreaks related to duodenoscope reprocessing made national news. The FDA ordered all duodenoscope manufacturers to conduct postmarket surveillance studies in October of that year.

A systematic review found that seven distinct carbapenem-resistant Enterobacteriaceae (CRE) outbreaks were related to endoscopes — five of which were specifically related to duodenoscopes. In response, the FDA released a safety communication in April 2019 highlighting the importance of monitoring reprocessing procedures in accordance with the manufacturer’s instructions.

What’s more, 32 patient infections associated with heater-cooler devices were reported to the FDA in 2010 and 2015 as a part of their adverse event reporting system. The most recent safety communication released by the FDA in February 2020 provided updated instructions for disinfection practices to reduce microbial growth.

But as we saw with COVID-19, “not all outbreaks are related to failures in very complicated high-level disinfection or sterilization processes,” said Jones.

“As an infection preventionist, you’re usually really worried about transmission of germs or pathogens on items like portable vitals machines or telemetry monitors that require low-level disinfection,” she added.

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