Care equipment and the environment can easily be contaminated with fluids such as:
- other body fluids
- infectious agents
The equipment is classified as either:
- single use
- single patient use
- reusable invasive equipment
- reusable non-invasive equipment
This is equipment which is used once on a single patient and then thrown away. Single use equipment mustn't be reused, even on the same patient.
Single patient use
Single patient use equipment can be reused on the same patient.
Reusable invasive equipment
This can be used once then decontaminated, for example, surgical instruments.
Reusable non-invasive equipment
This is often referred to as communal equipment and can be reused on more than one patient following decontamination between each use, for example, a commode or a patient transfer trolley.
Correct decontamination is cleaning, disinfecting and sterilising healthcare equipment and the environment. Decontamination is essential to lower the number of cross-infections between people and also to prevent Healthcare Associated Infections (HAI). Processes need to be in place within healthcare settings to ensure the environment and equipment, for example patient rooms and commodes, are decontaminated properly.
The level of decontamination used will depend on the risk involved with the medical instruments or equipment. The risk levels are:
High risk items
These come into close contact with broken skin or are introduced into a normally sterile body area, for example:
- surgical instruments
- urinary catheters
- other catheters
These items would either be single use or must be sterilised.
Medium risk items
Medium risk items come into close contact with mucous membranes or are items contaminated with particularly virulent or readily transmissible organisms for example, endoscopes or semi-invasive ultrasound probes. These items should be single-use, disinfected or sterilised.
Low risk items
Low risk items only come into contact with normal intact skin for example, a bed or a commode. Cleaning and drying is usually enough for these items.
There are new and innovative ways to clean the healthcare environment and now there's also reusable patient care equipment. We've investigated these and have produced literature reviews.
The National Infection Prevention and Control Manual (NIPCM) provides mandatory guidance on decontamination of care equipment and the care area along with literature reviews.
Further guidance can be found in the Decontamination section of the Compendium of Healthcare Associated Infection Guidance.
Read our publications related to decontamination below:
- A-Z Template for Decontamination of Re-usable Communal Patient Equipment
- Best methods for removal and destruction of pathogens
- Guidance for decontamination of semi-critical ultrasound probes
- NHSScotland Guidance for the interpretation and clinical management of endoscopy final rinse water
- NHSScotland Risk Based Recommendations for the Decontamination of Semi-invasive Ultrasound Probes: Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016
- NSS Time to clean report
- Patient equipment and environment cleaning compliance monitoring tool
- Process Document: Existing and emerging technologies used for decontamination of the healthcare environment
- Report on National Time to clean a Bedspace Study
- Roles and responsibilities for reusable patient care equipment and environmental decontamination
- Routine and terminal cleaning of isolation rooms and cohort areas in healthcare settings, and terminal cleaning of wards following outbreaks or increased incidence of infection
- Summary report from pilot of patient equipment and environment compliance monitoring tool
- Time to Clean: Estimated time spent by healthcare workers on decontamination of communal reusable patient care equipment
- UK and International Review of Alternative Approaches to Environmental and Equipment decontamination
Read our literature reviews and practice recommendations:
- Decontamination Literature Review - Time to clean
- Existing and emerging technologies used for decontamination of the healthcare environment
- Antimicrobial Copper surfaces
- Antimicrobial Copper and Silver solution
- ATP Bioluminescence and Fluorescent Markers
- Chlorine dioxide
- Electrolysed water
- HINS light
- Hydrogen Peroxide
- UV light
Cleaning is defined as a process which physically removes infectious agents and the organic matter on which they thrive but doesn't necessarily destroy infectious agents. Cleaning must be performed before disinfecting or sterilising an item as any residue left on the instrument can affect the disinfection or sterilisation.
Disinfection is a process used to reduce the number of viable microorganisms but might not inactivate some infectious agents. It can be performed using heat or chemicals.
Sterilisation is a process that makes an object free from viable micro-organisms. It can be performed using heat or chemicals.