Part 1 of a part 4 series
Clean. Does it mean not dirty and uncontaminated? Yes. Cleanliness is defined in the Oxford Dictionary, as, “free from dirt or contaminated matter, unsoiled”
But here’s the really big point. With the increase of numerous diseases especially iatrogenic contamination we so desperately want to avoid, perhaps it is time to go back to basics and look at cleanliness as a mean of preventing the spread of these diseases. No-one doubts the benefits of correct sterilisation and it is assumed that all clinical practises sterilise their instruments. However, are those sterilised instruments really clean?
You know, the owner of a successful Instrument Repair business comments that all too often, instruments are sent to him for repair after they had already been “cleaned”. Amazingly when the instruments are dismantled they will often contain old blood and debris! It is likely that sterilized or “cooked” blood and debris on an instrument may be dislodged during a following procedure. Sure, the debris may have been ‘sterilized’, but contaminated instruments or utensils are not sterile, full stop.
So, the cleaning process should not only involve the removal of micro-organisms and body substances from the surface of an instrument; it should also involve the removal of these micro-organisms from all joints of instruments and parts of equipment.
Thorough cleaning is a necessary part of both disinfection and sterilisation. In the past and unfortunately today, in most dental and podiatry clinics outside of a hospital, warm soapy water, to remove visible material, is STILL used.
In today’s climate of resistant bacteria, is “all visible material” good enough? Is warm soapy water used by hand or in the ‘ultrasonic’ good enough? No and you don’t need a degree in physics to understand why. Since 1987 Australian Standard AS2945 stated “hot detergent washing stage 50 o c to 70 o c min 2 minutes, plus AS 4815 and 4187 both state in large print: CAUTION ULTRASONIC CLEANERS CLEAN BUT DO NOT DISINFECT INSTRUMENTS.
The question arises why do the accreditation people still give Podiatrist, Dental and Orthodontists and the like, a tick is beyond comprehension!!!,especially when these Standards are developed to protect the health and safety of the Australian public.
You know, ignorance of the law is no excuse when dealing with devices to be used on live humans.
If you’ve ever had a complaint against you, you’ll know just how distressing it can be. Not to mention the time and effort that goes into addressing it … providing records, correspondence and “please explaining” yourself.
And you’ve got to agree … receiving a complaint is something you don’t wish on your worst enemy and it’s something
you want to avoid at all costs.
So “Why is your clinic”
- Handwashing only and not disinfecting your instruments?
- Using an ultrasonic cleaner when ultrasonic cleaners do not disinfect?
- Drying your instruments by hand?
- Running the risk of your staff receiving a needle stick injury.
- Not complying with all necessary standards set by the Board of Australia in related to infection control including the reprocessing of instruments under AS/NZS 4187
- Inviting the *heavy artillery to pay a visit to your clinic, to close you down.