Standard Operating Proceedures

Cleaning

1.1 STANDARD PRECAUTIONS

PURPOSE Standard precautions are applied as a first-line approach to infection control. This forms the basis for your decision-making and practice. Standard precautions are a set of guidelines based on the assumption that all blood and body fluids are potentially infectious. In the context of sterilising practice and the Standard Operating Procedures, standard precautions include: Hand hygiene Examples of when hands should be cleaned Before and after commencing a procedure After handling equipment / instruments soiled with blood or body fluids After direct contact with blood or body secretions After cleaning the environment When you move from a dirty area (such instrument cleaning area) to a clean area (such as the sterilising area) After the removal of Personal Protective Equipment (gloves, gown, face shields etc) When you go to have something to eat or drink After you have gone to the toilet After coughing, sneezing or wiping your nose Personal Protective Equipment (PPE) Worn to protect the healthcare worker from contact with blood and body fluids and must be removed when leaving the cleaning area and replaced with fresh items on returning. Gloves Heavy duty gloves are to be worn when handling items for cleaning Single use gloves are to be changed after use Nitrile gloves are to be worn when handling enzymatic cleaners Face Shields or Safety Glasses and Masks Safety glasses and face shields are multi-use and must be cleaned, after each use, with detergent and water The mask must cover the mouth and nose completely and be tied, so that there is no gaping at the side of the mask Masks are worn once and then discarded Remove the mask by undoing the ties; and avoid touching the mask Fluid Resistant Gowns/Aprons Fluid resistant gowns/aprons and protective sleeves are to be used if there is a possibility of clothes or skin becoming wet or contaminated with blood or body fluids eg when cleaning contaminated instruments If, for some reason, your clothes become soiled with blood or body fluids, you must wash the area on your body soiled and replace your clothes. In some circumstances, you may need to have a shower Occupational Health & Safety requirements Enclosed non-slip shoes Clean attire as per units protocol Hair and beards covered Wearing of jewellery, nail polish or artificial nails is discouraged Cuts and skin abrasions are covered Report incidents/accidents to shift supervisor and complete the relevant documentation

Reference: QH Infection Control Guidelines COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment within 1 requirements. month.  Review annually.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.1 STANDARD PRECAUTIONS

1.2 SOILED PICK-UP SCHEDULE

PURPOSE The negotiated times for pick-ups or delivery of reusable medical devices are to suit each area. Sterilising Services staff must ensure that collection procedures for used items are separate to delivery procedures for clean and sterile items. OPERATING PROCEDURE 5

Apply standard precautions Use the dedicated Trolley/container for this purpose, which should be enclosed, with solid bottom Plastic containers used are to be leak proof and puncture resistant with sealable lids and user area
identification shelving

Avoid placing heavy instruments on light instruments to prevent instruments from being damaged A bin should not exceed 10kgs. If this occurs notify shift supervisor and review bin size and pick up
schedule times

Changes to the schedules will be negotiated through Management and communicated to all staff involved

Do not over load trolley Do not leave unsecured trolleys/containers unattended in corridors or ward/department areas Care must be taken when moving through doorways and via lifts On completion of the soiled round, the trolley and containers must be washed and dried thoroughly If the trolley is not running smoothly report it immediately to shift supervisor

Reference: AS/NZ4187 Section 2 COMPETENT  Meets current best practice requirements.  Review annually.

ADVANCED BEGINNER  Requires re-assessment within 1 month.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.2 SOILED PICK-UP SCHEDULE

1.3 SORTING PRIOR TO CLEANING

PURPOSE On receipt into the department, items should be sorted according to type and corresponding cleaning methods and a check at this stage for completeness or defects allows the staff member to follow through to user area promptly. OPERATING PROCEDURE 5 Apply standard precautions Check if items are to be priority processed and process accordingly Immediately report any sharps such as blades, needles or broken glass left in containers. Document and report to shift supervisor Take care when trying to retrieve instruments from trays or containers, as a sharps injury could occur. Ensure you can see what you are retrieving. Report heavily soiled items from user areas to shift supervisor (items should have gross blood and debris removed immediately following a procedure and prior to returning the item to CSD for processing). NB. This procedure may vary at facilities depending on the proximity of CSD to the point of use and work flow protocols between units If instrument parts are missing follow facility procedure and report immediately to shift supervisor Report any damaged or broken instruments to shift supervisor. Instruments should be cleaned and sterilised prior to being sent for repairs. NB: check with manufacturer of instrument prior to cleaning and sterilising items for repairs as some items may be further damaged by this process Do not throw anything out, if unsure, check with shift supervisor Instruments received from loan set company: check instruments, dismantle multi-part instruments, label and place through the cleaning process prior to packaging and sterilisation At the time of receipt of instruments from loan set company any soil or debris found on a loan instrument is to be reported to the shift supervisor Do not reprocess single use items, report to shift supervisor CLEANING PROCESS: Sort items according to cleaning process required. If unsure of cleaning process (do not guess) Manual cleaning Mechanical cleaning o o Ultrasonic Automated washer disinfector batch washer or index washer Check instrument sets for completion and report any discrepancies to shift supervisor

Reference: AS/NZ4187 Sections 2, 12 & Appendix B COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment within 1 requirements. month.  Review annually.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.3 SORTING PRIOR TO CLEANING

1.4 CHEMICAL & DETERGENT MIXTURES

PURPOSE
Breaking down and removal of blood, proteins and debris during washing stage can be achieved manually or mechanically. NB. Prior to the purchase of chemicals consideration needs to be given to the chemicals compatibility with the medical device, intended cleaning process and the chemicals storage requirements. Manual Wash Properties: Mild alkaline detergent pH range: 8.0 Low foaming properties Non-corrosive Non-toxic Non-abrasive Free rinsing Bio-degradable Use and rate of concentration: as per manufacturers instructions Mechanical Wash Properties: Mild alkaline detergent pH range: 8.0-11.5 Biodegradable Nonabrasive Low foaming Free rinsing Use and rate of concentration: As per manufacturers instructions, automatic dispensing system is preferred Enzymatic Cleaners Breaks down proteinaceous matter Approved by the instrument manufacturer Specific PPE nitrile gloves Used as per manufacturer instructions i.e. Dilution, solution temperature, soaking time and product used within expiry date Used to soak items when blood or debris has dried or hardened Acid Base Agents Use: Only used on stainless steel surfaces for intermittently descaling or destaining Follow chemical manufacturers instructions, including safety precautions, dilution and instrument compatibility Rubber or Nitrile gloves are to be worn when handling acid based agents Dissimilar instruments should not be processed at the same time Mix the agent in metal container with lid Only mix when required and discard at end of the day OPERATING PROCEDURE 5 Know and understand the products you are using, as well as the location of the MSDS Reference: AS/NZ4187 Section 2, 8, 12 & Appendix D COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment within 1 requirements. month.  Review annually. Lubricant Must be water miscible and compatible with instrument and sterilising agent Hand hygiene liquid Approved for use by Infection Control

Steel Coat Stainless steel cleaner: used on the outside of machines as per manufacturers instructions (stainless steel only) Clean cloth used for application and dry clean cloth used for polishing Environment Cleaner Select product as per manual cleaning solution After cleaning ensure cleaner is rinsed off thoroughly and dry area with non-linting cloth Drying Agents Drying agents are surfactants that wet the final rinse water, allowing the water to spread evenly over a surface instead of beading. The even spread of water allows flash drying to take place, reducing the build up of hard water salts on the surface of the instrument, whereas beaded water will dry, leaving concentration of mineral salts. Most drying agents are not as effective on plastics as they are on metal objects HANDLING AND STORAGE OF CHEMICALS As per manufactures instructions and Material Safety Data Sheets and in accordance with facilities Workplace Health and Safety instructions

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.4 CHEMICAL & DETERGENT MIXTURES

Hand Cream Moisturiser and barrier cream should not be applied in the work environment as they can effect the penetration of the sterilant. They must be approved for use by Infection Control

1.5 PRE & POST RINSING

PURPOSE Pre-rinsing allows for the removal of excess blood and debris from items prior to cleaning and assists in the cleaning process by preventing blood and debris drying on items. Rinsing post cleaning facilitates the drying of item prior to placing the item in a drying cabinet OPERATING PROCEDURE 5

Apply standard precautions

Pre-rinsing

Use warm water only for pre-rinsing, as hot water will bake blood and debris onto the surface of the
instrument

Pre-rinse items in warm running water, as soon as possible, after the item has been used Flush any items with lumens with warm running water during pre-rinsing, as this assists with the
removal of gross blood and debris and reduces contamination of the wash water Post-rinsing o Use hot running water for post-rinsing, as this can assist in drying of the item and with removing any excess detergent left on the item after cleaning

Reference: AS/NZ4187 Section 2 COMPETENT  Meets current best practice requirements.  Review annually.

ADVANCED BEGINNER  Requires re-assessment within 1 month.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.5 PRE & POST RINSING

1.6 MANUAL CLEANING

PURPOSE To remove blood and debris from medical devices. Required Equipment for Cleaning  Double sink or equivalent  Water  Instrument brushes of various sizes  Pipe cleaners  Non-linting cloth  Suitable mild alkaline detergent Ph: 8  Pressure equipment o High pressure water o Air pressure o Syringes  Non abrasive pad

Management of Cleaning Materials Use Single or reusable cleaning materials Reusable cleaning materials are to be thermally disinfected between uses and dried thoroughly at the end of each shift or session. Materials are to be kept free of visible debris after use and before reuse Discard cleaning materials in accordance with manufacturers instructions

OPERATING PROCEDURE 5 Apply standard precautions Fill sink to recommended level with correct ratio of warm water and suitable detergent Disassemble and open items and inspect for damage or parts missing, report damage to shift supervisor If the instrument is missing or missing parts notify the shift supervisor and contact user area Clean all surfaces by holding the item low in the sink and applying adequate friction, to limit the generation of aerosols. Take care to protect against sharps injury and prevent damage to the instrument Rinse the item thoroughly under hot running water and check if item is clean

NB. If items are damaged: clean, dry and sterilise prior to sending them for repair unless contradicted by manufacturer instructions Flush, Brush and Flushing lumen items All lumen items are to be flushed, brushed and flushed using the following method: Choose the correct size brush to clean the lumen, the bristles should enter the instrument channel without pressure and just touch the sides of the inner lumen instrument Wet the bristles of the brush Flush lumen with water Pass appropriate size instrument brush through the lumen and rinse debris off brush tip in an appropriate cleaning solution Withdraw brush Repeat until clean Flush thoroughly with running hot water Drying Use a Drying cabinet, Non-linting cloth or Air pressure gun. Problems associated with incorrect drying:  Wet packaging resulting in unsterile item.  Can cause rusting, corrosion or pitting to the item. Reference: AS/NZ4187 Section 2 - Read in conjunction with 5.1 and 5.2 COMPETENT  Meets current best practice requirements.  Review annually. ADVANCED BEGINNER  Requires re-assessment within 1 month.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.6 MANUAL CLEANING

NB. Some equipment may be supplied with appropriate cleaning adaptors (eg Endoscopes and Filsche Clip Adaptors). Substitute cleaning equipment should not be used unless approved by the supplier of the Instrument

1.7 OPERATION OF THE WATER PRESSURE GUN

PURPOSE Used for cleaning internal parts of an instrument OPERATING PROCEDURE 5

Attach Water Pressure Gun to a piece of tubing or hose Depress trigger to obtain required pressure o o o Low pressure is used for micro and delicate instruments Increased pressure is used on more substantial cannulated instruments Different size nozzles are available for a variety of lumen sizes

Carry out this procedure under the water to avoid formation of aerosols. Continue until the water under pressure runs clear

Reference: AS/NZ4187 Section 2 COMPETENT  Meets current best practice requirements.  Review annually.

ADVANCED BEGINNER  Requires re-assessment within 1 month.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.7 OPERATION OF THE WATER PRESSURE GUN

Apply standard precautions

1.8 CLEANING OF OPHTHALMIC & MICRO-INSTRUMENTS

PURPOSE To prevent damage to delicate instruments during cleaning process Cleaning Material Requirements:  Ultrasonic  Non linting cloths  Water (as per manufacturers instruction)  Double sink or equivalent  Suitable detergents  Syringes

 Fine stillettes
OPERATING PROCEDURE 5 NB. Whenever possible, items should be mechanically cleaned and thermally disinfected. Apply standard precautions Follow manufacturers instructions for the instruments if mechanical cleaning process is used. Disassemble, open instruments and place in a lock down container prior to placing the items in the mechanical washer Fill the sink to the recommended level with warm water and a suitable detergent Disassemble and open items Clean all surfaces by holding the item low in the sink and applying adequate friction, to limit the generation of aerosols. Take care to protect against sharps injury and prevent damage to the delicate instruments Lumen items to be flushed with water using water pressure gun, then brushed thoroughly with an appropriately sized instrument brush and flushed again with water using a water pressure gun or syringe o Design of some items with lumens e.g. blind ends prevents the item from being flushed effectively, care needs to be taken to ensure the item is clean

Change wash water regularly Thoroughly rinse items in hot running water Inspect items during cleaning for damage, and ensure that all parts of the item are present and clean Report to shift supervisor any instruments requiring repairs or any missing parts or instruments Drying Use drying cabinet, air pressure gun for internal parts (watching pressure is regulated) or non-linting cloth. Problems associated with incorrect drying:  Wet packaging resulting in un-sterile pack / item  Can cause rusting, corrosion or pitting to the item Reference: AS/NZ4187 Sections 2 & 12 COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment within 1 requirements. month.  Review annually.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.8 CLEANING OF OPHTHALMIC & MICRO-INSTRUMENTS

 Soft instrument brush

1.9 CLEANING OF POWERED TOOLS, AIR HOSES & BATTERIES

PURPOSE To provide guidelines for manual cleaning that prevent damage to powered tools and accessories OPERATING PROCEDURE 5 NB. Never immerse handpiece, air hose, connector ends or batteries in water (hose body may be immersed) Apply standard precautions Check attachments such as blades, drills and burrs are still not attached Manually or mechanically clean attachments according to manufacturer instructions Hose and handpiece are to remain attached during cleaning. Detach battery and clean separately Manually clean the external surfaces of the handpiece Use appropriate cleaning aids to clean attachments Point the attachment end of the handpiece downwards and rinse under hot running water All cannulations of handpieces are to be flushed with water using water pressure gun, then brushed thoroughly with an appropriately sized instrument brush and flushed again with water using a high pressure water gun Manually dry the hose, battery and external parts of handpiece with a dry non-linting cloth Use air pressure gun to dry the attachment end of handpiece Check with equipment manufacturer to determine if drying cabinets may be used at 50 - 60c for 5 10 minutes. Check handpiece and attachments are clean and dry NB : Pneumatic drills should be tested for functioning after cleaning with medical air by the theatre staff

Reference: AS/NZ4187 Sections 2, 12 and Appendix B COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment within 1 requirements. month.  Review annually.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.9 CLEANING OF POWERED TOOLS, AIR HOSES & BATTERIES

1.10 ULTRASONIC CLEANER

PURPOSE
Mechanical aid to cleaning using a process called cavitation, bubbles are generated that implode upon reaching high pressures and dislodge fine particles from the surfaces of instruments.

OPERATING PROCEDURE 5 Apply standard precautions Safety Do not submerge any part of body into the tank whilst in operation it is thought to cause arthritic conditions Do not operate with lid open as aerosols may be created and high frequency sound waves may cause inner ear damage Ensure hands are dry prior to turning power on or off Check material suitability (not all materials can be processed in this machine e.g. plastic and glass also check with instrument manufacturer Overloading of baskets can result in operator injury by causing strain on the body when loading and removing internal basket Overloading can also cause damage to the item and results in the ultra sonic waves not being able to penetrate into areas required Filling the machine Follow the manufacturer instructions Fill the tank with cold water to fill line indicator (25mm from top of tank) Add the cleaning chemical (neutral or slightly alkaline), per the manufacturers specifications, by manual or mechanical dispensing Plug lead from the machine into a power point and turn on the power Degas the machine by closing the lid and turning on for no less than 3 minutes to remove gases from the water and to mix the detergent. Loading the Machine Follow manufacturer instructions All items must be free of visible blood before placing in special designated baskets Place instruments in ultrasonic basket (no more than 1 layer) and not on floor of ultrasonic Disassemble and open items to be processed Place delicate or small pieces of items into lock down baskets Prior to placing lumen instruments in ultrasonic flush with water using high pressure water or syringe, then brush thoroughly with an appropriately sized instrument brush in detergent and water, and flush again with water using a high pressure water or syringe If the machine has an irrigator attachment, connect the lumened items to the fluid ports via the tubing and ensure that the tap on cannulated instruments are open The basket is then lowered into the ultrasonic tank Operate with lid closed for 3 minutes or recommended time Check switches and leads are in good condition, report any damage to shift supervisor

1.10 ULTRASONIC CLEANER

Unloading the Machine If a stand alone model: remove items by using designated lifters at completion of cycle For bench top models: remove items using clean gloved hands Thoroughly rinse instruments with hot running water Place instruments in washer disinfector. Place in drying cabinet or dry with a non-linting cloth, lumened items to be dried with air pressure gun. Emptying the Machine Daily and if solution becomes murky or discoloured

Reference: AS/NZ4187 Sections 2, 7, 8 & 11 (Note: refer to SOP 5.3 Ultrasonic Machine Testing) COMPETENT  Meets current best practice requirements.  Review annually. ADVANCED BEGINNER  Requires re-assessment within 1 month. NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week..

1.10 ULTRASONIC CLEANER

1.11 USE OF BLUE FOOD DYE TECHNIQUE

PURPOSE To detect bone matter on or in orthopaedic instrumentation OPERATING PROCEDURE 5 Apply standard precautions If there is a delay in cleaning orthopaedic instrumentation place instruments in a pre-prepared enzymatic Whilst in enzymatic solution, brush orthopaedic instruments with soft brush Flush brush and flush lumens Rinse and place instruments into ultrasonic machine (SOP1.10) Prepare dye solution ratio- 30mls blue food dye to 300mls water Place instruments into blue food dye solution one by one then rinse with clean water and inspect for bone or debris Repeat cleaning process if bone or debris detected Place instruments into Washer Disinfector Machine (SOP 1.12) When cycle complete use air pressure gun to dry lumen instruments, if any bone or debris detected repeat cleaning process Place clean instruments into drying cabinet (SOP1.15) Inspect instruments for bone or debris, if bone or debris detected repeat cleaning process Clean items are ready for equipment set up (SOP 2.4)

Reference: AS/NZ4187 Section 2 COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment requirements. within 1 month.  Review annually.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.11 USE OF BLUE FOOD DYE TECHNIQUE

solution

1.12 WASHER DISINFECTOR MACHINES

PURPOSE To mechanically remove, either with a batch or continuous type washer disinfector, the bio burden/microorganisms (blood and debris) adhered to items after use and to then thermally disinfect medical devices. The use of washer disinfector machines reduces the manual handling of contaminated items. OPERATING PROCEDURE 5 Apply standard precautions Loading Check Instrument Trays for completeness prior to cleaning process (as per unit protocol) Disassemble, open (e.g. the fine jaws at end of minimally invasive instruments) and place instruments/equipment into specific basket as per process validated at commissioning Load the baskets/racks ensuring they are not overcrowded or over opened so that water and chemical contact will reach all internal and external surfaces Ensure all parts of disassembled instruments are correct and together and anaesthetic circuits are complete Place small/light items in the appropriate baskets with hold down catches to ensure they do not become loose in the machine during operation. NB. Disks or tags may be used to identify instrument trays when they are placed into multiple baskets for cleaning Use a hold down screen as the pressure of water inside the machine can dislodge items Load hollowware so as to prevent retention of water and cleaning solution Minimise lifting of racks Make sure equipment stays in the parameter of the rack. Select the appropriate cycle for the load Lumen Instruments All lumen instruments should be flushed with high pressure water then brushed through with an appropriate size instrument brush with detergent and water and flushed again with high pressure water prior to mechanical cleaning If the machine has the capability of cleaning lumened instruments attach the instrument to the appropriate size port If lumen cleaning attachments are not available the lumen instrument is required to be processed in an irrigating ultrasonic and then placed into the appropriate basket for mechanical cleaning

1.12 WASHER DISINFECTOR MACHINES

Choose the specific rack type that is required e.g. anaesthetic rack for anaesthetic instruments

Washer Disinfector Cycles (inc. Bar-coded systems) Make sure barcode or electronic eye is inserted on the side of the rack and the code corresponds with the material to be loaded, allowing cycle parameters to be met for that material Programmed cycle may include:  Instruments  Utensils plastic (e.g. plastic bowls, metal bowls, tote boxes etc)  Glassware  Anaesthetic Equipment  Accessories (light handles Diathermy quivers etc)  Ultrasonic program Releasing Load: At the completion of washer disinfector cycle and prior to opening the door check the cycle parameters have been met. Take care when unloading items from the mechanical washer as some items may be hot and capable of holding water If racks are manually removed use manual handling principles to minimise injury If the machine does not have the ability to dry the load, unload items and place into drying cabinet. Medical air should be used to remove excess moisture from lumen instruments prior to placing in drying cabinet The drying of anaesthetic equipment will be achieved in a drying cabinet suitable for this type of equipment If the equipment processed is not to be sterilised, e.g. anaesthetic circuits, the cycle parameters should be checked, signed, documented and cycle printouts placed in the control document for record keeping o Cycle parameters may be stored in a micro-processor and a printout of parameters can be attained by programming the control pad  Non-Sonic

Reference: AS/NZ4187 Sections 2, 7, 8 & 11 (Refer to SOP 5.4 and 5.9 for checking and monitoring instructions) COMPETENT  Meets current best practice requirements.  Review annually. ADVANCED BEGINNER  Requires re-assessment within 1 month. NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week..

1.12 WASHER DISINFECTOR MACHINES

1.13 DE-STAINING
PURPOSE To remove corrosion, pitting or other damage on medical devices OPERATING PROCEDURE 5 NB. Ensure the de-staining solution is compatible with the medical device. Apply standard precautions Wear protective clothing including rubber or nitrile gloves Use a stainless steel container with a good fitting lid Strictly follow manufacturers instructions on water / chemical ratio Only expose item to this chemical through recommendation from the manufacturer of that item Do not exceed recommended time of exposure to the chemical After exposure the item is required to be re-washed to remove chemical residue Change chemical daily or more often if solution discoloured. Remove gloves and wash hands. Remove item from chemical mixture using gloved hands

Reference: AS/NZ4187 Section 2 & Appendix D COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment within 1 requirements. month.  Review annually.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.13 DE-STAINING

1.14 OPERATION OF THE AIR PRESSURE GUN

PURPOSE Drying internal parts of instruments following cleaning process OPERATING PROCEDURE 5 Apply standard precautions Attach the tubing to air outlet and secure air pressure gun to other end of tubing or hose Attach gun nozzle to the lumen opening on the instrument Depress trigger to obtain required pressure o o Slight pressure to be used for micro and delicate instruments as per manufactures instruction Increased pressure used for more substantial cannulated instruments

Make sure the instruments are directed onto a disposable non linting cloth or a deep receptacle to avoid spread of aerosols Check instruments/items, if debris or blood is present, re-wash instruments

Reference: AS/NZ4187 Section 2 COMPETENT  Meets current best practice requirements.  Review annually.

ADVANCED BEGINNER  Requires re-assessment within 1 month.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.14 OPERATION OF THE AIR PRESSURE GUN

1.15 DRYING CABINET

PURPOSE To dry the cleaned item prior to wrapping and packaging and prevent damage that occurs to the item if it is left wet. OPERATING PROCEDURE 5 Loading Apply standard precautions Assess the material that can go into the dryer as per manufacturer instructions e.g. flexible scopes should not be placed into a mechanical dryer o Lumen instruments should be blown with medical air prior to placing in dryer Do not overloading drying baskets Anaesthetic and respiratory circuits are dried using the tubing manifolds Nothing should exceed 1 hour in the drying cabinet including anaesthetic equipment Cabinet temperature operates between 65C to 75C Unloading Heat resistant gloves may be worn to unload items Remove items on a regular basis Avoid leaving items in the dryer too long Assess items are dry before removing Dont leave items to dry in ambient or open air dry outside of the machine as this may cause damage to the item If the dryer temperature is seen to be a problem report immediately to the shift supervisor Care must be taken when trying to retrieve an instrument from a tray of instruments as a sharps injury could occur (ensure you can see what you are retrieving)

Reference: AS/NZ4187 Sections 2, 7, 8 & 11 COMPETENT ADVANCED BEGINNER  Meets current best practice  Requires re-assessment within 1 requirements. month.  Review annually.

NOVICE  Requires immediate action by manager to manage risk.  Requires re-assessment in 1 week.

1.15 DRYING CABINET