z neta decontamination, Artykuły z zakresu dezynfekcji

//-->.pos {position:absolute; z-index: 0; left: 0px; top: 0px;}National Endoscopy ProgrammeDecontamination Standards forFlexible EndoscopyMarch 2007IntroductionEndoscopy Services strongly recommended that a document be developed toencompass all decontamination standards. The NHS national EndoscopyTeam established a working group to design a quality assurance tool that canbe used by endoscopy users to self assess their decontaminationenvironment and processes against national standards.This framework has been developed to support the safety item of the GlobalRating Scale (GRS). It will be used as the assessment tool fordecontamination in JAG Quality Assurance visits and is likely to adopted byother quality assurance agencies.The document should be used as the basis for departmental policy andprocedure documentation which will need to be produced as evidence duringexternal assessments together with other forms of evidence outlined in thedocument.Members of the GRS Endoscope Decontamination Working Party:Libby Thomson- Lead Nurse, St George’s Endoscopy Training Centre,Nurse Lead BSG Working Party on Endoscope DecontaminationMiles Allison- Chair of BSG Working Party on EndoscopeDecontamination / Clinical Lead National Endoscopy Programme for Wales /UK CJD incidents PanelTina Bradley- Laboratory Manager, Hospital infection research laboratory,BirminghamGeoff Sjogren- Decontamination Lead - Surrey/SussexDavid Green-Lead Nurse Infection Control, Bradford Teaching HospitalsPam Hardman- Senior Nurse Matron Endoscopy, East & North HertfordshireNHS TrustRoger Leicester- Director of Endoscopy Services, St George’s EndoscopyTraining CentreThis document has been developed in consultation with the BSG, NHS andIndustry.Decontamination standards for flexible endoscopesEvidenceOperational ManagementWritten procedures for decontamination of endoscopy equipment areavailable and reviewed every 2 years.Nominated decontamination lead at Trust board level.OrganisationalstructureInterview withTrust LeadTrustdecontaminationpolicyYesNoAction PlanOperational decontamination manager who has(i)clear line management;(ii)representation on Trust committee whose remit includesdecontamination; and(iii)ability to act on any concerns regarding decontaminationpractice from endoscopy personnelOverall decontamination training lead attached to the endoscopy unit.Interview withUnit LeadInterview withInfection ControlEndoscopy UserGroup agenda /minutesAdverse incidentbook and actionplansAudits and actionplansAudit and actionplansRecords of stafftrainingInvolvement from the infection control department and a namedmicrobiologist in managing and maintaining the service.Decontamination matters regularly discussed in Endoscopy User Groupmeetings.A record of adverse incidents and evidence of appropriate action taken.Evidence of bi-annual audits of decontamination processes and actiontaken.Evidence of annual Trust audit on decontamination processes andaction taken presented to Trust Board.There is evidence that detergents, disinfectants, endoscopes,Automated Endoscope Reprocessing machines (AER) and disinfectantgenerators are be used in accordance with the manufacturers’guidelines.There is evidence of document control for standard operatingprocedures.There are written procedures for out of hours emergency endoscopy toensure that it only occurs if there is someone available who is trained inendoscope decontamination.Out of hoursprotocolTraining &AssessmentrecordEnvironment, design and layoutThere is a:(i)designated and dedicated decontamination area(ii)separate dirty, clean and storage areas(iii)one-way flow for equipment.There is adequate ventilation and extraction in place to protect staff,patients and the public from exposure to hazardous substances.Estates recordsThere is a double sink for the washing and rinsing of endoscopicequipment within the decontamination area which is sufficient to meetrequired capacity and throughput.Sinks should be:(i)of adequate size to ensure manual cleaning is carried outeffectively and(ii)positioned to minimise the risk of occupational injuryThere is a dedicated hand washing basin that is used in thedecontamination area.SafetyEndoscopy decontamination areas should be designed to ensure aneffective and efficient service that does not harm staff, patients or thepublic.There is evidence of COSHH risk assessments.Units should have evidence of their risk assessment for the use ofPersonal Protective EquipmentAll staff involved in decontamination have access to and wearappropriate personal protective equipment including full face visors,single-use gloves and aprons.During manual cleaning, forearms should be protected.Staff must wear protective equipment as instructed bymanufacturers’ when mixing and loading chemicals into the AER.theRiskassessmentsStaff interviewsRespiratory protection is employed against chemical and microbialhazards in line with COSHH assessments.Health surveillance for staff should be considered, in consultation withoccupational health departments for exposures to disinfectants that arenot aldehydes or chlorine-releasing agents or other strong irritants. Ifagents similar to glutaraldehyde are used, then health surveillanceshould be carried out.There is a policy and equipment available for spillages; chemicals,detergents, body fluids.In the event of the inability to provide an automated decontaminationsystem, the endoscopy activity must cease until the automated processis regained. Manual disinfection and rinsing are not acceptable.A procedure must be in place for the safe and proper disposal of anyresidual chemicals, either residual container quantities or quantitiesbeyond their expiration date, used in the endoscopy reprocessing area.The procedure should include disposal guidelines according to thenature of the detergent or disinfectant, and should specify who isresponsible for such disposal.Staff TrainingThere is evidence of a structured induction, training and re-validationprogramme for staff involved in decontamination using a competencyassessment tool.CompetencyTraining packageOH policyStaff interviewsSpillage policySite visitEvidence ofaction takenStaff interviewsThere is evidence of mandatory training records eg. manual handlingThe Decontamination E-learning training package is used as part of adecontamination training package.www.decontamination.nhs.ukTraining programmes are based on:Competence 21 of the national endoscopy competence framework and;Competencies 1 to 6 of the Decontamination Competence Framework.Competence is measured and documented using an assessmentframework.www.skillsforhealth.org.ukTraining programmes should include:- identification of individual endoscopes and all associatedchannels- design and function of endoscopes- theoryon decontamination, microbiology,detergents,disinfectants and AERs- health & safety and infection control- knowledge and skills assessment on assembly and dismantlingof scopes, pre-cleaning, manual cleaning, reprocessingaccessories and ancillary equipment, disinfection and use of theAER, drying, transportation, storage, tracking/traceability andmaintenance, testing and validation.Training recordsTrainingprogrammes/assessmentrecordsTraining recordsThere is evidence of COSHH training.Training recordsThere is evidence of staff training from the manufacturers of AERs andgenerators.Instructions for decontamination processes including Top Ten Tips fromMHRA are visually displayed.Up-to-date manufacturers’ (endoscope, AER and chemical) instructionsand departmental policies are easily accessible.Training recordsThere is evidence that staff who undertake testing and validation ofAERs are trained.Stages of endoscope decontaminationDecontamination of endoscopes is undertaken at the beginning and endof each list, and between patients, by trained staff in a dedicated room.There is evidence that Trusts have undertaken a risk assessment as tothe need for manual cleaning and automatic disinfection beforeendoscopes are used at the start of each day.All endoscopes have a record of their decontamination status such thatthey are fit for use on patients.Preliminary cleaningEndoscope channels are flushed immediately following the procedureand the external surfaces socially cleaned, ideally by the endoscopist.An air/water flushing valve is used in endoscopes with combinedair/water channels.Channels are checked for patency during this process.Endoscopes are transported to the decontamination area in a coveredreceptacle that is of an appropriate size so as to avoid contaminatingRisk assessmentTracking system

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