Decontamination

Background

Care equipment

Care equipment and the environment can easily be contaminated with fluids such as:

  • blood
  • other body fluids
  • secretions
  • excretions
  • infectious agents

The equipment is classified as either:

  • single use
  • single patient use
  • reusable invasive equipment
  • reusable non-invasive equipment

Single use

This is equipment which is used once on a single patient and then thrown away. Single use equipment mustn't be reused, even on the same patient.

Single patient use

Single patient use equipment can be reused on the same patient.

Reusable invasive equipment

This can be used once then decontaminated, for example, surgical instruments.

Reusable non-invasive equipment

This is often referred to as communal equipment and can be reused on more than one patient following decontamination between each use, for example, a commode or a patient transfer trolley.

Decontamination

Correct decontamination is cleaning, disinfecting and sterilising healthcare equipment and the environment. Decontamination is essential to lower the number of cross-infections between people and also to prevent Healthcare Associated Infections (HAI). Processes need to be in place within healthcare settings to ensure the environment and equipment, for example patient rooms and commodes, are decontaminated properly.

The level of decontamination used will depend on the risk involved with the medical instruments or equipment. The risk levels are:

  • high
  • medium
  • low

High risk items

These come into close contact with broken skin or are introduced into a normally sterile body area, for example:

  • surgical instruments
  • needles
  • urinary catheters
  • other catheters

These items would either be single use or must be sterilised.

Medium risk items

Medium risk items come into close contact with mucous membranes or are items contaminated with particularly virulent or readily transmissible organisms for example, endoscopes or semi-invasive ultrasound probes. These items should be single-use, disinfected or sterilised.

Low risk items

Low risk items only come into contact with normal intact skin for example, a bed or a commode. Cleaning and drying is usually enough for these items.

There are new and innovative ways to clean the healthcare environment and now there's also reusable patient care equipment. We've investigated these and have produced literature reviews.

Guidance

The National Infection Prevention and Control Manual (NIPCM) provides mandatory guidance on decontamination of care equipment and the care area along with literature reviews.

Further guidance can be found in the Decontamination section of the Compendium of Healthcare Associated Infection Guidance.

 

Publications

Read our publications related to decontamination below:

Literature reviews

Read our literature reviews and practice recommendations:

Read our literature reviews and practice recommendations on existing and emerging technologies used for decontamination of the healthcare environment:

Definitions

Cleaning

Cleaning is defined as a process which physically removes infectious agents and the organic matter on which they thrive but doesn't necessarily destroy infectious agents. Cleaning must be performed before disinfecting or sterilising an item as any residue left on the instrument can affect the disinfection or sterilisation.


Disinfection

Disinfection is a process used to reduce the number of viable microorganisms but might not inactivate some infectious agents. It can be performed using heat or chemicals.


Sterilisation

Sterilisation is a process that makes an object free from viable micro-organisms. It can be performed using heat or chemicals.