STERILE
PROCESSING UNIVERSITY
"Processing of Patient Care Equipment"
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Background: Patient care equipment is used throughout the healthcare
facility to provide essential services to patients. The general type
of patient care equipment (used on the Nursing units) is usually cleaned,
disinfected, reassembled, and distributed from the CS/SPD Department.
Examples of patient care equipment include; infusion pumps (to regulate
the amount of fluids administered intravenously; also called IV pumps),
feeding pumps (to administer feedings to a patient via a tube inserted
into the stomach), hypo/hyperthermia blankets (machines attached to
a blanket to cool down or warm up a patient's temperature), K-pad modules
(a heating pad using water to provide heat to various areas of the body),
Emerson pumps (used to drain air/fluids from the chest), PCA pumps also
known as patient controlled anesthesia pumps (used to administer pain
medications to patients - the patient controls the administration of
the medication), Oral suction machines (continuous suction); Intermittent
suction (used for gastro-intestinal suction - also known as Wagenstein
suction); CPM machine (continuous passive motion also known as a knee
exerciser); DVT (deep vein thrombosis) or SCS (sequential compression
sleeves) to prevent blood clot formation post surgery; commodes, walkers
and traction devices.
 Feeding Pumps |
 Hypothermia Machine |
 K-pad Modules |
 Emerson Pumps |
 PCA Pumps |
|
 CPM Machine |
 Deep Vein Thrombosis |
 Walker |
Depending on the healthcare facility, the procedures for collecting used patient care equipment and distributing cleaned equipment can vary significantly. In some healthcare facilities, CS/SPD collects the used equipment; in others, the nursing units are responsible to bring the used equipment to CS/SPD. Distribution can vary as well. In some facilities CS/SPD distributes the equipment, nursing may be responsible to pick the equipment up and in others a general dispatch department distributes the equipment along with other supplies. In some facilities, the CS/SPD Department is responsible to clean/disinfect and re-assemble the equipment but another department (e.g. Materiels Management) is responsible for the distribution.
Regardless of the methodology for the collection and distribution of these devices, good procedures need to be developed and followed at all times.
Proper processing - All used equipment is considered contaminated/soiled. Therefore, when used equipment is collected, standard precautions should be used. All used equipment should be returned to the Decontamination area for cleaning / disinfection. It is recommended that all equipment be processed after each patient use. Soiled equipment should be contained during transport, if possible (i.e. on a covered cart, covered with plastic bags). Wear protective attire to protect yourself from blood and body fluids. Gloves should be changed after handling the equipment so that elevators and doorknobs are not contaminated.
Cleaning - Policies and procedures for cleaning, disassembly, disinfection and re-assembly should be developed based upon the equipment manufacturer's written instructions. CS/SPD personnel should be in-serviced in all equipment procedures. Equipment should be cleaned prior to disinfection. Disassemble parts, which can be disassembled. It is important to wear appropriate personal protective attire (PPE) during this process. The equipment manufacturer may recommend special detergents/chemicals to clean the equipment to ensure proper cleaning and compatibility with the materials used in the equipment.
Disinfection - Follow the equipment manufacturer's instructions for disinfection because not all disinfectants can be used on all materials. Don't assume that the disinfectant being used in the department for other purposes can automatically be used to disinfect patient care equipment. Some disinfectants can harm the materials in the equipment. Follow the disinfectant manufacturer's instructions for proper dilution, use, contact time, temperature, etc. Wear appropriate protective attire (PPE) during the disinfection process.
Re-assembly, testing, inspection - Final preparation of the patient care equipment is essential to ensure proper function of the device. Final preparation should include: 1) proper re-assembly of all parts which were disassembled for cleaning / disinfection; 2) addition of necessary accessories (i.e. tubing clamp on Emerson pump); 3) lubrication of moveable parts, if indicated by the equipment manufacturer; 4) minimal function testing (e.g. using a gauge to verify the suction in an intermittent suction machine); 5) timely repair of malfunctioning devices (after cleaning/disinfection devices should be referred to the Biomedical department for repair); 6) last preventative maintenance and inspection date (if the equipment is due or overdue for its annual safety inspection, send the equipment to the Biomedical department) and 7) inspection for a) cleanliness; b) hospital ID (equipment tag);c) signs of abuse/damage and/or missing parts. CS/SPD personnel should also observe for frayed cords, damaged plugs, presence of grounding pin, loose legs, non-working wheels, etc. Any defects should be immediately reported to a Supervisor and the equipment taken out of service until repaired.
Other
considerations - There should be a process in place to monitor the
quality of equipment processing by initial audit and ongoing monitoring.
All patient care equipment owned, leased or rented should be maintained
in a functional manner to ensure safe and effective patient care. A
policy and procedure regarding safety inspection of borrowed/rental
equipment should be developed in conjunction with the facility's safety
and/or risk managers. In addition, all patient care equipment must perform
as expected when used. To ensure this, electrical equipment should be
properly maintained using a preventative maintenance (PM) program. The
PM should be performed by qualified personnel using the manufacturer's
service manual as a reference. Records of the PM should be retained
(either by CS/SPD or the Repair service).
Storage - All patient care equipment should be properly stored,
available and distributed in a timely manner in order to meet patient
care needs. The quality, safety and level of patient care are directly
related to the availability of patient care equipment. Procedures should
be in place to ensure an adequate supply of equipment is available at
all times. During high usage times, frequent rounds on nursing units
to pick up used equipment. Equipment should be organized to enhance
accurate selection, careful handling and timely availability. Recalled
equipment should be removed from service immediately. An adequate supply
of equipment should be on hand to meet patients' needs. Back-up mechanisms
should be in place to meet unanticipated demand (e.g. rental).
Miscellaneous - A catalog of all patient care equipment should
be available to all departments. At least one copy of the User Manual
for each type of patient care equipment should be available in CS/SPD
for reference by the users if needed. Establish equipment control mechanisms
to identify each piece of patient care equipment. This mechanism should
include: a) name of equipment; b) hospital ID number; c) C S/SPD identification
number; d) serial number; e) Manufacturer's name; f) Model number; g)
date purchased; and h) date placed into use. The usage should be documented
by patient and department, date dispensed and date returned. Follow
patient charge procedures to ensure accurate charging for equipment
use. In the event of a safety problem with patient care equipment; refer
to the facility's Safe Medical Device procedure for reporting medical
device problems.
Summary
- Patient care equipment is an essential part of treatment for patient
care. The CS/SPD Department plays an integral part in the processing
and availability of such equipment. Following good policies and procedures
for processing of patient care equipment based upon the equipment manufacturer's
instructions will help achieve this goal.
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