Cleaning and Disinfection for DME

Providers know that they must enforce more stringent infection control, but what methods and approaches make sense for DME? The answers aren't always obvious.

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Amid the COVID-19 pandemic, we entered 2021 with a keener awareness of the need for high-level disinfection at all levels of care. Healthcare facilities have worked diligently to develop and implement more stringent infection control policies to ensure patient and staff safety and to mitigate contamination potential.

Organizations such the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and World Health Organization (WHO) have been integral in providing the latest information on decontaminating medical equipment,1 but many of these methods may not be feasible or practical in the durable medical equipment (DME) setting. There is great responsibility to ensure returned equipment is properly disinfected before being dispensed to the next customer. That means the DME provider must have the proper resources to perform disinfection while being mindful of costs and space. Fortunately, numerous disinfection options, including UV light, have been identified.

In an abstract from the periodical Prevention and Control of Infection in Hospitals, disinfection is described in part as “destruction or removal of all organisms capable of causing infection.”2 The abstract further states that “in the healthcare system, instruments and equipment are disinfected with heat, chemical fluids, chemical vapours or gases.”

While DME providers generally refer to manufacturer recommendations for cleaning and disinfection, those recommendations do not always specify the best products to use. Certain methods, such as ozone cleaning, may nullify a product warranty, and the FDA has placed warnings that certain levels are or are not safe for human exposure. If a DME provider assumes that using a product listed as a high-level disinfectant will suffice but fails to understand details such as the way the product is to be utilized or dispensed, the contact or soak time, the dry time, or the method for wiping down, then that failure lends to misuse of the product and, therefore, lack of true decontamination or infection control.3 The concerns are warranted over whether the wiping down of an item is spreading bacteria if not done properly.

In a white paper on using UV-C lighting for disinfection, authors Jeremy Starkweather, John Wynne, and Jason Ylizarde of UV-Concepts, Inc., write, “Continuous quality and process improvement is needed related to the cleaning and disinfection of portable medical equipment (PME) in the healthcare environment. These efforts should minimize the risks of this equipment becoming a vector of transmission and reduce the likelihood of transmission of healthcare-associated infections.”4  

During a recent virtual presentation of their purpose-built UV platform for portable medical equipment, Starkweather pointed out that “you can’t escape the light,” indicating that UV lighting can reach every accessible part of a contaminated surface.5 Intellego Technologies provides further UVC validation with the use of dosimeter indicators to ensure that disinfection and devices are reaching intended targets.6

Lack of quality assurance checks of items on a regular basis will compromise compliance. These new innovations in the infection control arena are showing promise toward true infection control, as well as quality assurance. UV lighting has become one such innovation and is being utilized in healthcare facilities. UV lighting may become a preferred option in the DME business as well.

Citations

  1. Centers for Disease Control and Prevention. Disinfection of Healthcare Equipment: Guideline for Disinfection and Sterilization in Healthcare Facilities (2008). cdc.gov/infectioncontrol/guidelines/disinfection/healthcare-equipment.html
  2. Andersen B.M. (2019) Disinfection of Instruments and Equipment. In: Prevention and Control of Infections in Hospitals. Springer, Cham. https://doi.org/10.1007/978-3-319-99921-0_59
  3. Sopwith W., Hart T., Gardner P. Preventing Infection from reusable medical equipment: a systemic review. BMC Infect Dis 2, 4 (2002). https://doi.org/10.1186/1471-2334-2-4
  4. Starkweather J., Wynne J., Ylizarde J. UV-Concepts Inc., Englewood, CO, USA. Purpose Built UV-C Enclosure for Portable Medical Equipment: Controlling the Environment Is the Key to Consistent Results. https://www.nist.gov/system/files/documents/2020/03/26/7%20Jeremy%20Starkweather%20poster.pdf
  5. UV-Concepts Inc., Englewood, CO, USA. Video: Best UV Disinfection for Portable Medical Equipment. https://www.uvconcepts.com/#uvvideo
  6. Intellego Technologies, Stockholm, Sweden. How UVC Dosimeters Work. https://uvcdosimeters.com/how-it-works/

About the Author

Dottie CoveyElleby, RPSGT, is an Accreditation Corporate Surveyor at Accreditation Commission for Health Care (ACHC).

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