2021-12-27-世界卫生组织-Medical_equipment_related_to_oxygen_therapy_–_Cleaning_–_task_sequence_18页_3mb

Summary of Medical Equipment Related to Oxygen Therapy Cleaning and Disinfection

Core Content

This document outlines the care, cleaning, and disinfection procedures for various medical equipment used in oxygen therapy, including:

• Mechanical ventilators
• CPAP and BiPAP devices
• High flow nasal cannula
• Oxygen concentrators
• Pulse oximeters and patient monitors

The procedures are divided into two main scenarios:

1. Between patients
2. During oxygen therapy (same patient)

The document emphasizes infection prevention and control (IPC), and highlights the importance of manufacturer guidelines, personal protective equipment (PPE), and proper disposal of infectious waste.

Main Steps for Cleaning and Disinfection

General Cleaning and Disinfection Steps

1. Perform hand hygiene
2. Don appropriate PPE (surgical mask, goggles, gown, gloves, and closed work shoes)
3. Prepare disinfectant solutions in well-ventilated areas
4. Disconnect the device from the patient and power
5. Dispose of single-use items (e.g., patient interface, tubing, filters) in designated infectious waste containers
6. Move the device to a non-patient, well-ventilated area for cleaning
7. Change gloves and perform hand hygiene
8. Wipe exterior surfaces with detergent and clean water, then dry
9. Wipe with disinfectant using a compatible agent (e.g., hydrogen peroxide, ethanol, or sodium hypochlorite)
10. Ensure proper drying (either via equipment or air drying)
11. Store the device in a clean, low-contamination area
12. Disinfect before new use
13. Clean twice a month if the device is not in use

Special Notes

• Sodium hypochlorite (0.1% or 1000 ppm) should only be used if the device is known to withstand it and no ammonia or acidic body fluids are present.
• Different disinfectant formulations must not be used during the same step to avoid toxic fumes.
• Avoid using tap water or bottled water for humidifiers, as they may promote bacterial growth.
• Distilled or cold boiled water must be used for filling humidifiers.
• Rinse with sterile or clean water after chemical disinfection, followed by an alcohol rinse and forced-air drying.

Key Information

Equipment Classification

• Respiratory therapy equipment (e.g., ventilators, CPAP, BiPAP, high flow nasal cannula) is classified as semi-critical, requiring cleaning and disinfection before use on another patient.
• High-level disinfection is required for some equipment, using physical methods (e.g., steam, hot water) or chemical germicides.
• Sterilization is only necessary for critical devices that come into contact with sterile body tissues or fluids.

Disinfectants

• Common disinfectants include hydrogen peroxide (>0.5%), ethanol (70-90%), and sodium hypochlorite (0.1%).
• 0.1% sodium hypochlorite is not recommended for all devices due to potential material damage.
• Chemical disinfection should be followed by rinsing with clean/sterile water and air drying.

Waste Management

• Single-use items (e.g., patient interface, tubing, filters) are considered infectious material and must be disposed of in designated biohazardous waste containers.
• Facility standard operating procedures (SOPs) should be followed for infectious waste management.

PPE and Safety

• PPE must be worn during cleaning and disinfection to protect against splashing, spraying, and aerosols.
• Hand hygiene is critical before and after each task.
• Gloves must be changed after each cleaning and disinfection step.

Training and Guidelines

• All personnel involved in cleaning and disinfection should be trained and retrained periodically.
• Manufacturer’s manual must be followed for all steps.
• WHO guidelines and OpenWHO courses on decontamination and sterilization are recommended for reference.

Key Devices and Their Specific Guidelines

Conclusion

Proper cleaning, disinfection, and storage of oxygen therapy equipment is essential to prevent cross-contamination and reduce infection risk. The procedures are standardized across all devices and emphasize PPE use, manufacturer instructions, and safe waste disposal. High-level disinfection is required for semi-critical devices, and sodium hypochlorite should be used cautiously. All tasks must be performed in well-ventilated areas, and training and adherence to guidelines are crucial for effective IPC.