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

John,
Like most of the replies you have had, we have a decontamination/ permit to work form which must be completed before we will collect the equipment. The equipment is checked when it is collected and if it looks contaminated, we ask the staff to clean the outside. But this system is not perfect, often the form is filled in by the ward clerk (sorry, administrator) who doesn't know what they are signing.

I agree that it is right and proper that any equipment is cleaned and/or decontaminated beforehand. However, the reality is that this can never fully deal with all scenarios - as indicated by others.

My view is that we should all be aware of the potential risks and be given suitable training and the facilities to deal with this. There are plenty of guidelines around, and whether they are 'official' policy or not, they should be used, if only for your own safety.

What about scenarios where equipment may be cleaned externally, for example after a spillage, but the fluid works its way inside the equipment without the operator being aware. Of course, only when the technician asked to look at the equipment opens it up does the problem then become apparent - at which point there's exposure. This can only be dealt with at service or repair - precautions probably always need to be taken if there's a risk of this scenario but I doubt they are in the majority of departments.

Some MHRA guidance has actually suggested that internal filters, fans, etc, on ventilators/respiratory therapy equipment be cleaned on a regular basis, by those technically qualified to access them, to minimise the potential for patients and staff being exposed to MRSA-like infection or other airborne contaminants in dust. This is a service issue and one that, unless there's facilities to handle potentially comntaminated dust and particles, can affect everyone in a workshop.

I'm inclined to agree with techman but the facilities need to be provided to enable tecchnicians that are trained and knowledgeable to do this safely without putting anybody else at risk of exposure to potentially harmful substances.

I can only comment on this subject from the outside as I don't work for the NHS. When I get to a unit (usually an NICU, PICU or theatre) to service something, if the item looks like it could do with a clean, then that is what I will give it before I start work. If it is on a patient, I will clean it as soon as it comes off the patient (whilst still on the unit and using what the staff use to clean it and only if the relevant person is unavailable), then do the service, then return the item to the sluice for cleaning again. I have only ever once had to return an item to the user for cleaning as it was contaminated with blood. The relevant person was extremely embarassed. (And rightly so)

My feeling on this is it is better to be cautious and safe then just risk it, as engineers could quite easily spread bugs from one unit to another before they are discovered.

Mark

We have been through all this before. Initially when the decontam certificate was not completed we would remove the unit but inform staff that they should complete the appropriate form otherwise the next time equipment would be left with a reminder that unless a certificate was completed the unit would be not be uplifted. Again the ward would be informed that a valid certificate would be required. Should this happen again the technician arriving to collect the equipment would inpect and if a certificate was not present there would be no verbal warning but the technician would leave the equipment where he found it. Should there be any follow up ie complaint the details would have been logged on our system and a copy would be provided to the area manager. Copy would also be sent to infection control. Slowly the message is getting through.

If the equipment is cleaned by the ward staff you are not transporting dirty/infected equipment through the hospital exposing staff and visitors to the risk of infection. If it does happen report them to risk and infection control (or the local newspaper ). Given the current feeling on infection this should stimulate action.

"Should technicians clean equipment before repair" - There should be no need.
Should technicians take precautions to protect themselves against potential infection from internal contamination or badly cleaned equipment - Of course.
Robert

A written procedure to tell nurses how to clean equipment? Whatever next! Should have been something they learned at their mothers’ knee.

The Decontamination Declaration is universal throughout the NHS, surely? Of course the policy must be followed, and insisted upon. It doesn’t hurt to send a few back occasionally, just to remind 'em, as it were.

But meanwhile, doesn’t every technician take necessary precautions, especially when opening up equipment? By this I mean putting on the gloves when necessary, donning a mask occasionally, and washing hands regularly?

Should technicians clean equipment? Yes, when necessary. But I would add cleaning after repair too. I like to have equipment sent back as clean as possible (and I’m talking about Mr. Sheen here). It helps to reassure the user that something was actually done with the equipment! All part of the service, Ma’am.

Hi John et al.

Persistence, no I gave up!

Risk Management accused me of creating a risk to patients and ward staff, (ignore my staff - we are single use and disposable).

Risk Management, Infection Control and the Auditors clearly stated that EBME were in fact removing medical devices from wards and departments without a Certificate of Contamination Status. That this is a risk to all concerned and following any service or repair of a medical device, EBME were transferring the risk back into the patient environment.

This was also reported to the external Patients Forum who insisted on seeing me about it, a cortege of some six lovely persons.

Risk Management and Infection Control said that I and not EBME were a 'chink in the armour' and that I create and support infection risks associated with medical devices.

Support, yes! I focused and implemented a scorched earth policy. No certificate number when reported, no technician.

Works well now, but is a pain to my staff and no doubt nursing too.

Progress, be proactive, not reactive.

Jimbo