Long Term Inadequate Cleaning/Disinfection of POCT Devices
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One of my biggest struggles is keeping POCT equipment clean. The more attention I pay to my equipment, the more I find.
I posit that: end users wiping devices down with disinfecting wipes between patients does not adequately clean/disinfect any device over the long term without additional cleaning measures (unless it is a VERY well designed device).
Every POCT device in my program has crevices, gaps, connections, etc that are impossible to clean/disinfect with a disinfection wipe by hand.
I perform weekly audits of all POCT locations and as devices age, they build up contamination in all kinds of awful places that will not be observable by the average user (or even a TJC/CAP inspector).
I have started to perform deep-cleaning of my devices during these weekly audits. Our glucometers have a gap in their connection housing that goes all around the device. During inspections, no one notices what hides inside that gap. Grab a flashlight or hold it at the right angle under the light and suddenly all sorts of contamination is revealed. Open the battery compartment and even more is revealed.
I'm experimenting with various tools to clean all of my devices' crevices (and contacting manufacturers about design and infection control concerns).
Battery compartments, printer lids, doors and hinges... the more I look at my POCT devices, the more build-up I find. The more I find, the less likely it seems that end users would be able to detect and invest the proper time into cleaning most of these hard-to-detect and/or hard-to-access contaminated areas. They do okay at cleaning the "outside," but some of the "outside" is not easy to visualize.
What are you doing to maintain the cleanliness of your instruments long term?
Do you have any regular "deep cleaning" or additional measures beyond the manufacturer reccommendations or end user cleaning?
I posit that: end users wiping devices down with disinfecting wipes between patients does not adequately clean/disinfect any device over the long term without additional cleaning measures (unless it is a VERY well designed device).
Every POCT device in my program has crevices, gaps, connections, etc that are impossible to clean/disinfect with a disinfection wipe by hand.
I perform weekly audits of all POCT locations and as devices age, they build up contamination in all kinds of awful places that will not be observable by the average user (or even a TJC/CAP inspector).
I have started to perform deep-cleaning of my devices during these weekly audits. Our glucometers have a gap in their connection housing that goes all around the device. During inspections, no one notices what hides inside that gap. Grab a flashlight or hold it at the right angle under the light and suddenly all sorts of contamination is revealed. Open the battery compartment and even more is revealed.
I'm experimenting with various tools to clean all of my devices' crevices (and contacting manufacturers about design and infection control concerns).
Battery compartments, printer lids, doors and hinges... the more I look at my POCT devices, the more build-up I find. The more I find, the less likely it seems that end users would be able to detect and invest the proper time into cleaning most of these hard-to-detect and/or hard-to-access contaminated areas. They do okay at cleaning the "outside," but some of the "outside" is not easy to visualize.
What are you doing to maintain the cleanliness of your instruments long term?
Do you have any regular "deep cleaning" or additional measures beyond the manufacturer reccommendations or end user cleaning?
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disinfecting their equipment with teeth- and hair- brushes at the nursing station is an AWESOME conversation starter :) LOL
As you describe, some of the difficulty lies in the design of the device.
On the seam around the glucose meter where the top and bottom meet,
I bought thin enough (rounded) blades, not sharp, handled “spreaders” like one would use for jam or butter, and fit the blade into a piece of cleaning wipe then run it around the meter with the rounded blade fitting in the seam.
I get the manufacturer thought perhaps it was such a tiny gap width that wiping top and bottom would do the trick. Nope.
I remove the battery door and run a nonsterile cotton swab wet from the wipe around the fitting where the lid sits into the well because that discoloration we think is from liquid pooling under the battery door from so much wiping down of meter.
We avoid deep cleaning the interior of the POC Molecular instruments we have since the procedure involves bleach but do lean in to do that when a negative QC fails.
I appreciated your comments.
Mere dust is also a problem for us (eg the top part of our meter docks, the top part of all bench top analyzers). Glucose meter operators wipe out where the meter sits and leave the dust layer on the top.
To try to move the mark in POC stations with bench top POC A1c instruments, which have required air filter changes, I emphasize the dust sitting on anything ends up in the A1c instrument (as evidenced by the increasing number of filter changes they have to do in some locations).
Note to those of us working ambulatory - I try to use as ammunition in POCT what staff 'must do' in cleaning/disinfection of other items used in a patient care environment. One TJC inspection we were cited for DUST on top of xray equipment and also floor lamps in exam rooms (high intensity, have hoods to help targeting light for procedures, examination). All staff performing POCT are involved doing many duties/tasks and it's not only devices which touch patients with requirements to clean/disinfect.
One more thing some staff/POC Operators fail to hard wire as they accumulate experience.