Background
Methods
Review workgroup composition
Literature review and analysis
Process
Categories for strength of each recommendation | |
Category | Definition |
A. | Good evidence to support a recommendation for use. |
B. | Moderate evidence to support a recommendation for use. |
C. | Insufficient evidence to support a recommendation for or against use |
D. | Moderate evidence to support a recommendation against use. |
E | Good evidence to support a recommendation against use. |
Categories for quality of evidence on which recommendations are made | |
Grade | Definition |
I. | Evidence from at least one properly randomized, controlled trial. |
II. | Evidence from at least one well-designed clinical trial without randomization, from cohort or case-controlled analytic studies, preferably from more than one centre, from multiple time series, or from dramatic results in uncontrolled experiments. |
III. | Evidence from opinions of respected authorities on the basis of clinical experience, descriptive studies, or reports of expert committees. |
Results
Recommendations for general principles [9‐18]
Stakeholders | Responsibility and Accountability |
---|---|
Infection Prevention and Control Department / Unit | • Consultant to CSSD/TSSU on sterilization and disinfection issues • Works closely with CSSD/TSSU on recall events • Conducts regular audits at CSSD/TSSU to ensure compliance with practice standards |
Infection Prevention and Control (IPC) Committee | • Reviews and approves the policies and guidelines on sterilization and disinfection of instruments used in the healthcare facility • Receives report on recall events |
Central supply sterile department: CSSD,TSSU | • Provide disinfection and sterilization for instruments & medical devices hospitalwide • Ensure healthy workforce in compliance to institution recommendations on staff immunization and checks • Ensures appropriate training for staff to do their work safely and well • Reports recall events to IPC and Quality/Risk Management |
Clinical areas e.g. operating room, outpatient clinics, intensive care units, endoscopy centres | • Safe handling of used instruments • Keep used instruments moist with enzymatic cleanser • Safe transportation to CSSD/TSSU for re-processing • Proper storage of sterile items in clinical areas (if any) |
Quality / Risk management | • Assists in investigations of recall events |
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Boiling
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Ultraviolet light
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Glass bead sterilization
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Microwave ovens
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Chemiclave sterilization
Recommendations for facility design: Environmental requirements for reprocessing areas [19‐22]
Recommendations for policies and procedures [23, 24]
Recommendations for occupational health and safety for reprocessing [25‐28]
CSSD zone | Recommended PPE |
---|---|
Decontamination | Hair covering Water resistant gown Heavy duty disposable gloves Water resistant mask Face shield or goggle |
Preparation and packing | Scrubs Hair covering Mask |
Sterilization | Scrubs Hair covering Mask |
Sterile storage | Scrubs Hair covering Mask |
Dispatching | Scrubs Hair covering |