What Is It?

Generally, residential aged care facilities would not use items that require sterilisation for reuse. Disposable single-use equipment and dressing items would generally be used. However, if items need to be sterilised, then a suitable service provider must be sourced by the facility which is able to/must comply with all relevant standards.

The decision to clean, disinfect or sterilise an item depends on the potential for infection associated with its use. Items are categorised as critical, semi-critical, or non-critical, depending on their intended use. 

Procedure For Reprocessing

Instruments must not be stored by soaking in disinfectants as they may become contaminated or may degrade over time. The manufacturer’s instructions must be checked for compatibility of the instrument or equipment with the method of disinfection to be used.

Any reusable instrument or equipment that comes into contact with intact skin must be cleaned before it is used using a cleaning agent such as pH-neutral detergent or a proteolytic enzyme that has been selected as suitable for the task.

Ensure all chemicals are removed from instruments and equipment by thorough rinsing before re-use or further reprocessing. A dedicated cleaning area must be available for the cleaning of instruments and equipment.

Reusable equipment or instruments must be visually inspected to establish that they are clean, intact, and in working order before storage or further processing.

Required PPE is to be worn as necessary.  All clinical equipment is to be identified and listed accordingly on a cleaning schedule.

Oxygen and Respiratory Equipment

Oxygen and respiratory equipment, including oxygen masks, nebulisers, and tubing, must not be shared between residents. All oxygen and respiratory equipment should be designated for individual resident use and should be cleaned on a regular basis using detergent and water, then dried thoroughly.

All oxygen equipment should be changed and or/replaced according to manufacturer’s instructions.  All used oxygen equipment is to be discarded in accordance with waste guidelines when changed or no longer used.

It is preferred that nebuliser machines are allocated to single resident use when undergoing therapy. Filters are to be changed in accordance with manufacturer’s instructions.

Suction Apparatus

Suction catheters are for single use only and should be disposed of after each use. Disposable suction liners are recommended.

Reprocessing and decontamination of reusable suction equipment should be carried out using a utensil washer/disinfector by the local central sterile supply department (CSSD), or disposable suction containers should be used.

Enteral Feeding Equipment

Enteral feeding equipment should be changed every 24 hours and clearly labelled with the resident’s identification. It must be thoroughly cleaned after each administration.

Manufacturer’s instructions for cleaning must be followed. If these are not available, use the following procedure

Clean by rinsing the bag and tubing thoroughly with cold water

Wash with warm water and detergent

Hang to dry 

Prepare enteral feeds in a clean working area and wash hands thoroughly before commencing. Label products with the date and time of opening. Opened formula products must be kept refrigerated and discarded after 24 hours.

Glucometers

Blood glucose monitoring devices have been implicated in the transmission of bloodborne viruses, so particular care must be taken when using this equipment. Residents are to be allocated their own glucometer, which has been identified accordingly.

To prevent the transmission of bloodborne viruses between residents, healthcare workers must

Not re-use a platform or barrel supporting a disposable lancet on more than one resident

Dispose of blood glucose lancets immediately after each use in a yellow sharps container

Not store used lancets with unused lancets

Wear gloves when performing lancet finger pricks

Perform hand hygiene between each resident contact in accordance with the '5 Moments for Hand Hygiene' principles

Clean the glucometer after each use

Injector Pens

Needlestick injuries have been related to injector pens. Administration of insulin (or other drugs) via an injector pen should be for resident self-administration only, for instance, if a resident, who usually self-administers medication using an injector pen, is compromised due to illness or injury, the healthcare worker is to use a single-use retractable syringe/needle (e.g., insulin syringe) to administer the medication.

Never re-cap a used injector pen needle.

Injector pens must only be used by clinical employees who have been fully trained on the safe use of injector pens and appropriate sharps management. Safety needles should also be made available.