Ensure that workers wear appropriate PPE to preclude exposure to infectious agents or chemicals through the respiratory system, skin, or mucous membranes of the eyes, nose, or mouth. Prepare and package items to be sterilized so that sterility can be achieved and maintained to the point of use. Prioritize disinfecting frequently touched surfaces. No recommendation is made about routinely performing microbiologic testing of either endoscopes or rinse water for quality assurance purposes. Sodium hypochlorite is the active ingredient in two variations of professional-grade disinfectant wipes from Clorox Professional Products Company; hydrogen peroxide is the active ingredient in Midlab’s approved HP2O2 product; and glycolic acid is the active ingredient in Pine-Sol (listed as Tuck 3 on the EPA’s website). Institute the following control measures to reduce the occurrence of contaminated disinfectants: Do not flash sterilize implanted surgical devices unless doing so is unavoidable. Clean and disinfect the immediate workspace used. Use standard sterilization and disinfection procedures for patient-care equipment (as recommended in this guideline), because these procedures are adequate to sterilize or disinfect instruments or devices contaminated with blood or other body fluids from persons infected with bloodborne pathogens or emerging pathogens, with the exception of prions. The 2003 and 2008 recommendations still apply; however, CDC does not yet make a recommendation regarding these newer technologies. Surfaces and objects in public places, such as shopping carts, point of sale keypads, pens, counters, vending machines, and ATMs should be cleaned and disinfected before each use or as much as possible. CDC twenty four seven. Because narrow-lumen devices provide a challenge to all low-temperature sterilization technologies and direct contact is necessary for the sterilant to be effective, ensure that the sterilant has direct contact with contaminated surfaces (e.g., scopes processed in peracetic acid must be connected to channel irrigators). Use an Environmental Protection Agency (EPA)-approved disinfectant against COVID-19 and read the label to make sure it meets your needs. Dental instruments that penetrate soft tissue or bone (e.g., extraction forceps, scalpel blades, bone chisels, periodontal scalers, and surgical burs) are classified as critical and should be sterilized after each use or discarded. Decontaminate mop heads and cleaning cloths regularly to prevent contamination (e.g., launder and dry at least daily). They are components of commercial bleaches, cleaning solutions, and disinfectants for drinking water and waste water purification systems and swimming pools. However, sodium hypochlorite is NOT effective in the disinfection of bacterial spores and prions. DETERMINE HOW AREAS WILL BE DISINFECTED. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Keeping surface wet with disinfectant for a period of time (see product label). Sodium Hypochlorite Bleach Disinfectant Solutions ... (5.25% sodium hypochlorite) diluted to the appropriate strength for the clean up job at hand is also an effective disinfectant, although bleach may cause damage ... Pathogens Branch of the CDC recommends the daily preparation of bleach disinfectant solutions. When necessary, use flash sterilization for patient-care items that will be used immediately (e.g., to reprocess an inadvertently dropped instrument). Wipe clean tonometer tips and then disinfect them by immersing for 5-10 minutes in either 5000 ppm chlorine or 70% ethyl alcohol. This issue will be revisited as additional evidence becomes available. Summary of advantages and disadvantages of commonly used sterilization technologies, Table 7. Disinfection and Sterilization Guideline – Print Version pdf icon[PDF – 163 pages]. Establish a program for monitoring occupational exposure to regulated chemicals (e.g., formaldehyde, EtO) that adheres to state and federal regulations. Flush and brush all accessible channels to remove all organic (e.g., blood, tissue) and other residue. Remove from clinical use any instrument that fails the leak test, and repair this instrument. Always read and follow the directions on the label of cleaning and disinfection products to ensure safe and effective use. Use low-temperature sterilization technologies (e.g., EtO, hydrogen peroxide gas plasma) for reprocessing critical patient-care equipment that is heat or moisture sensitive. Centers for Disease Control and Prevention . (No recommendation/unresolved issue)”. When using FDA-cleared high-level disinfectants, use manufacturers’ recommended exposure conditions. Most EPA-registered hospital disinfectants have a label contact time of 10 minutes. Do not use a bleach product if the percentage is not in this range or is not specified. Hang endoscopes in a vertical position to facilitate drying. Retain sterilization records (mechanical, chemical, and biological) for a time period that complies with standards (e.g., 3 years), statutes of limitations, and state and federal regulations. Special considerations should be made for people with asthma. Clean housekeeping surfaces (e.g., floors, tabletops) on a regular basis, when spills occur, and when these surfaces are visibly soiled. 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