I agree with you Louis but we have a problem on our hands; it's not ours in the making and it can't be solved because other groups are responsible for it. We should do our bit and be able to trust others to do theirs, perhaps but this will not happen, until somebody picks up some really nasty infection in EBME and it's traced back to a piece of contaminated equipment that should have been cleaned.

Ok Louis, you wear gloves but what do you then do with the equipment after you've done your bit - shove it back on a shelf without anyone knowing its decontamination-status? I wouldn't blame you, since the response from some clinical-staff would be less than enthusiastic if you raised the issue but if you didn't raise the issue, wouldn't this be perpetuating the merry-go-round? The "Magic Roundabout", so to speak, where Florence is never seen wielding an azowipe.

That also brings me on to another issue - what is the status of the equipment after the "grubby little maintenance man" has finished with the kit? How do EBMEs fayre in this respect? Do you clean or decontaminate the internal (and user-inaccessible) circuit of anaesthetics systems during routine maintenance, as the MDA seems to suggest in its recent guidance, published on the internet? What handover arrangements do you have?

In my opinion, patients (you and me on occasion) should be examined and treated using clean equipment, they should expect no less. For example; I wouldn't want to be the next patient to have my bladder or heart imaged after somebody with raging skin-complaint or infection has been scanned unless the doppler-probe has had a bit more than a wipe with blue-roll - irrespective of whether my concerns are "evidence based" or unfounded in scientific terms - would you? Just in the same way you would not be particularly happy with wearing a BP-cuff that stinks of urine, faeces and vomit, or an oral or tympanic thermometer that is being used without probe covers stuffed in your orifices, Eh? We have all come across this and it is shameful.

Unfortunately, because of the culture we're in, if clinical staff - usually infection control, can justify to moaning EBME staff that equipment that's not regularly cleaned presents minimal risk to others it becomes acceptable to clinical staff that equipment cleanliness is low-priority, so they don't spend time an effort doing the housekeeping.

There is a wide range of general equipment out there which, may or may not, have had direct patient-contact but the common factor is that it's all used by clinical staff and it should be cleaned. These clinical staff take precautions by wearing the relevent PPE, etc, etc which protects them and they should ensure the equipment is cleaned every time it is used, to protect others. When they're finished with the kit it seems that there's no time to clean it (or it's not their job) before it's rushed off to another ward, used to treat another patient or just returned to a storage area. Not always the case but a fairly common occurrance, I think. The kit sits there, festers and just gets stickier each time it's used.

What I would like to know (perhaps John Sandham has already condsidered this) is how do we deal with this sort of problem when we're out there actually doing the job, rather than processing nice little "certificates of conformity", in the comfort of the EBME department? It's great making references to standards, etc, etc and ticking off "to do" lists and how well CA is being implemented and having meetings but sometimes I think we forget the reasons why all this is important. I doubt that new-starters fully appreciate it when they first walk through the door into a Hospital.

Anyhow, it's annoying that the people appointed to do their bit on the management-side (in clinical and non-clinical areas) can't seem to get anywhere close to solving this problem once and for all. In all my dealings with infection control and H&S, in the past, I have never come away from a problem satisfied that steps have been taken to avoid a reocurrance of the same problem. It is always a "I'll take it away and clean it" response - "problem solved" (for today). It's as if the H&S issues affecting other NHS staff don't matter in the scheme of things, when there's a "poorly-patient" or "overbearing consultant" to consider.

Time for lunch; I hope it's served-up on a clean plate........