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Infection Prevention and Control Strategies for Reusable Medical/Dental Instruments

Infection Prevention and Control Strategies for Reusable Medical/Dental Instruments

Ambulatory healthcare facilities — such as clinics, surgery centers, medical offices, and dental offices — must make concerted efforts to prevent and control the risk of infectious diseases and outbreaks. The importance of infection prevention and control in ambulatory care has become more defined in recent years as a result of the increasing shift from inpatient to outpatient care.

A number of methods can help practitioners and staff in ambulatory healthcare facilities work to prevent and control outbreaks of infections and other infection-related adverse events. One area to target as part of infection control initiatives is the appropriate and thorough decontamination of reusable medical/dental instruments and devices. Examples of these items include thermometers, otoscopes, stethoscopes, forceps, ultrasound equipment, blood glucose meters, blood pressure cuffs, dental handpieces, periodontal scalers, etc.

Below are a number of risk management strategies for healthcare providers and staff to consider as part of their infection control efforts related to medical/dental instruments and devices.1

Strategies for Reprocessing Reusable Medical/Dental Instruments and Devices

  • Provide clear differentiation between reusable and single-use disposable devices.
  • Reinforce that single-use disposable devices should not be reused under any circumstances or in any situation.
  • For each reusable instrument or device, determine the level of disinfection or sterilization needed. The level will depend on how the item is used.2
    • Critical instruments/devices: Those that penetrate sterile tissue, bone, or the vascular system; require thorough cleaning and sterilization.
    • Semi-critical instruments/devices: Those that contact mucous membranes or nonintact skin; require thorough cleaning and high-level disinfection.
    • Noncritical instruments/devices: Those that contact only intact skin; require low-level disinfection.
  • Develop written policies and procedures for reprocessing reusable devices.
  • Keep policies, procedures, and manufacturer's reprocessing instructions for reusable devices in reprocessing areas.
  • Provide training and validate competency for employees processing reusable devices. Training should occur at least annually and when new equipment is introduced.
  • Provide thorough guidance for the appropriate use of personal protective equipment.

Strategies for Sterilizing Reusable Medical/Dental Instruments and Devices

  • Ensure that the facility's infection control policies require appropriate cleaning, decontamination, and sterilization of critical reusable instruments and devices.
  • Establish standards for routine maintenance of sterilization equipment according to manufacturer instructions.
  • Implement biological monitoring of the sterilization process.
  • Develop written policies and procedures for managing reprocessing errors or failures.

Strategies for High-Level Disinfection of Reusable Medical/Dental Instruments and Devices

  • Ensure that the facility's infection control policies require at least thorough cleaning and high-level disinfection for reusable semi-critical instruments and devices.
  • Develop a system for identifying which instrument was used on which patient.
  • Perform routine maintenance on high-level disinfection equipment according to manufacturer guidelines.

Strategies for Low-Level Disinfection of Reusable Medical/Dental Instruments and Devices

  • Implement a policy for low-level disinfection of noncritical medical instruments and devices. Disinfection should occur periodically or when the items are visibly soiled.
  • Ensure that adequate supplies of disinfectants or germicides approved for use in healthcare facilities are available and accessible to staff.

For more detailed information about reprocessing reusable medical/dental instruments and devices, as well as other infection prevention and control topics, visit the Centers for Disease Control and Prevention's Infection Control website.

1 Note: The types of instruments and devices used in ambulatory healthcare facilities vary. Not all guidance in this document applies to all facilities. Healthcare leaders, providers, and staff should determine appropriate infection prevention and control efforts based on their facilities and patient populations.

2 Centers for Disease Control and Prevention. (2016, September). Guide to infection prevention for outpatient settings: Minimum expectations for safe care (Version 2.3). Retrieved from www.cdc.gov/HAI/settings/outpatient/outpatient-care-guidelines.html; Centers for Disease Control and Prevention. (2016, October). Summary of infection prevention practices in dental settings: Basic expectations for safe care. Retrieved from www.cdc.gov/oralhealth/infectioncontrol/guidelines/index.htm

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