EBME Forums Forums Management Medical Equipment Management Should technicians clean equipment before repair?

DB 2003 (05) management of medical devices prior to repair, service or investigation

I have been asked a number of times in the last month about medical equipment cleaning and decontamination. I have seen numerous pieces of equipment coming to the workshop with decontamination declarations signed by the user. Even when they have been signed, some of these devices are still dirty. My concern is that some staff are willing to sign the declaration, but the equipment is still contaminated/dirty. This then puts the onus on the technician to either clean the equipment themselves, or return it to further cleaning. I tend to leave it to the discretion of the technician as it can sometimes be more hassle taking the equipment back, finding the nurse...etc. This is an area that comes up again and again. It seems to me that the MHRA basically says it is the responsibility of the manufacturer to tell us how a piece of equipment should be cleaned/decontaminated. Has anyone actually documented a generic cleaning process that covers most equipment coming into an ebme dept and is it working well? Is it time that every EBME technician was trained in cleaning and decontamination? or should we trust the users?
See: MHRA DB2003(05)

I feel like this issue is going around in circles and technicians are put at risk.

Should technicians clean equipment before repair? single choice
	YES
	NO
Votes accepted starting: 01/01/70 1:00 AM You must vote before you can view the results of this poll.

John
This problem has gone on for more years than I can remember. Our Control of Infection Manual clearly states that all equipment should be accompanied by a Contamination Status Certificate.
However in practice this is rarely the case, although we insist on one being completed for certain types of equipment such as suction etc.
A certificate may well be expected for equipment sent in, but what happens when the techinican
visits a ward and collects an infusion pump due for service. If he waits for a certificate, sure as eggs, somebody will come along and need to use the pump. All our nursing staff are supposed to clean such items between patients and unless the device is obviously dirty we accept it and clean it ourselves. Physically dirty equipment is reurned to the clinical area and appropriate words of admonishment are given.
Graham

Graham,
Most EBME depts would like to have a decontam status form signed by the user that can be trusted. In truth, it is a pipedream. Even if equipment looks clean - it may be hiding all sorts of horrible bugs. I think that techs should be given gloves, cleaning materials, and training in cleaning equipment. (What can/can't be used... how effective different methods are etc) We should (as a minimum) clean equipment before it goes out.
Some depts (with equipment libraries) have a 'dirty room' where equipment arrives, is cleaned and only then goes onto the 'goods in' shelf. I think this is the way to go.

Hi John

As usual, I got battered by the Trust's Audit when our department received yet again its yearly audit.

Certificates of Contamination Status for Medical Devices are insisted upon when requests are reported to EBME. My staff are under no illusions on this one, no certificate, then don't leave the department to attend to the request.

And they don't. No ticket, no shirt!

I am happy to contribute to any scenarios that others may suggest in this topic.

Regards.

Jim

Jim - You are one of the few who seems to have got a handle on this. Was it just sheer persistance? Did you get support from the users?

John.

What about when the workshop is located on the unit ie: Critical Care Techs and i come in on a Monday morning to find a bloody syringe pump on my nice clean workbench sporting a paper towel with the words "fix me" scribbled on it?
This continues despite my best efforts at trying to enforce the requirements with regard to cleaning and labelling U/S equipment.

In Lincoln we have gloves, aprons, sanicloths, anti-bacterial foam sprays provided. However we do expect the users to DECONTAMINATE the equipment ie remove any traces of bodily fluids etc before sending to us. We have a card system whereas the user attach a white ( never contaminated ), yellow ( was contaminated but cleaned ) or red card ( contaminated but still so after cleaning ) to the equipment before sending to us and it works pretty well. Very rarely we have to send equipment back to the user for decontamination before we look at it.

It is useful for the EBME tech to clean the gear before returning it as it will reveal any physical damage to it.

Its very interesting that a third of those that voted have said yes.

We use a tag system that tells us the decontamination status and the fault / repair required as well as the person / dept reporting it. I can email a copy to anyone who would lkie it.
I have to say that since installing the system we have had a great success with minimal "faulty" & "fix me" type reports and we have been able to trace those that are problems via either the tag or the medical equipment management system data.
We also report any problems on the risk management register as training isues for users etc.
The only other comment is that dont we (med eng) all need to know how to clean equipment properly anyway as there will always be instances such as blood splashes getting past a ventilator cover inside the main case, which the user doesnt remove. Or the possibility of secretion build up bloking airways and so forth which we would have to deal with.

Here at this trust we also have a decontaminated section on our reported fault form. Not that it is always filled in correctly, signed, blah blah.

I like to give the equipment i'm about to work on a quick once over, just for my own peace of mind.
I also give it a clean once i have finished a repair.

If i consider the equipment too dirty or what i think is a contaminant then i return it to the user and tell them its needs a clean.

I have on a couple of occasions informed infection control because i felt it neccessary.

Some equipment is such a pain in the hello to clean with all the grooves/nooks n cranies. I understand that ward based staff dont have access to some parts of the equipment to clean.

The bottom line is: will this ever change with staff shortages, inproper training and general poor standards of house keeping???

I dont think so... its life!