Since it is not practical to test the decontamination status of instruments at the end of the decontamination process, testing is required to ensure that decontamination equipment is working consistently and effectively to the parameters that were set when it was installed and during validation.

If instruments are stored wet prior to sterilization, residual water is a potential breeding medium for residual microbes. Water droplets on instrument surfaces might also impede the sterilization process by not allowing effective steam penetration.

Moving to an automated process is the recommended method for cleaning re-usable medical devices. The reasons for this are: to increase safety for staff who process the instruments; automated systems can be validated and tested to ensure that are consistently effective. Washer disinfectors will be the preferred automated system.

This depends on the type of equipment (ultrasonic cleaner, washer disinfector or sterilizer) but there are tests carried out each day, some additional tests carried out weekly and further test (most of which a qualified Test Person must carry out) performed according to manufacturer's instructions

The size of a LDU depends on how many surgeries will use the facility, how many instruments will be processed and how many pieces of decontamination equipment will be required. This needs to be worked out for each individual setting. We can always help and advise you with this.

Even when using an automated system, there are likely to be some instruments that cannot be cleaned in this manner. Therefore, manual cleaning is required for these instruments and for occasions when the automated system is unavailable. The preferred method for manual cleaning involves the use of two sinks, one for cleaning and one for rinsing, or a sink and a basin as a short term temporary measure.

Yes. Having a hand hygiene sink in the LDU enables it to be readily available and used exclusively for the routine hand washing required when processing instruments through decontamination (before instrument cleaning and between the dirty and clean processes).

To reduce the possible recontamination of instruments the preferred direction of air flow is from the "clean" area to the "dirty" area. When installing ventilation equipment consideration should be given to the heat and steam generated by the decontamination equipment used. An extraction fan sited above the "dirty" area will help provide the correct direction of air movement and assist in providing a comfortable working environment for staff. The use of freestanding or ceiling-mounted fan units is not recommended.

Yes. The way the instruments are transported must comply with Carriage of Dangerous Goods Regulations.

The purpose of cleaning is to remove debris and reduce microbial load as far as possible before sterilization. Prions, unlike other potentially infective agents, are not destroyed by sterilization. It is therefore essential that instruments are cleaned effectively to ensure that there is no residual debris or contamination prior to sterilization.

An Automatic Control Test (ACT) is used to determine whether the machine is continuing to reproduce the cycle parameters (e.g time and temperature,) specified at validation. It is recommended that an ACT is performed daily. This can be done by checking that the parameters recorded on the printout or data logger are compatible with the values obtained when the equipment was last tested by a test person. The ACT can be performed by either using a TST strip for N class or a Helix device for S and B class.