Please can you tell me what you would recommend for cleaning procedure trays/trolleys prior to preparing IV drugs or any other aseptic procedure in hospitals. I work for a large NHS Trust and have recently had some debate on cleaning trays. I currently advocate cleaning a plastic tray with soap & water and then decontaminating with 70% alcohol wipe but the evidence for this is limited. Does anyone have any evidence supporting the correct procedure?
Cheryl
This would fall under the guidelines for disinfection. There are 3 categories of items that require disinfection - noncritical, semi-critical, and critical. This would be a noncritical situation since the tray or trolley will not come into contact with broken skin or mucous membranes. There are numerous acceptable disinfecting agents. You can find lots more information from the CDC at
http://www.cdc.gov/hicpac/Disinfection_Sterilization/2_approach.html
You can also go to www.apic.org and do a search using "disinfection" and pull up lots of resources. Dr. William Rutala is the leading expert on this subject and has lots of publications.
Hope this helps, Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I think we tend to be more technological in the US. After removing any visible contaminates with soap and water, we usually clean hard surfaces with a Clorox type wipe or a wipe with one of the numerous n-Alkyl d-e a-m-chloride products that are pretty ubiquitous in US hospitals. An example is the Super Sani-Cloth from PDI. In two minutes exposure time it will kill pretty much anything that lives including spores and visuses. It is carcenogenic, so it should not contact skin, but it decontamination time is quicker than most similar products. I think the concept of trays and trollys is not common in many hospitals, except for surgical trays and carts which are gas sterilized and dedicated central lne carts full of pre-packaged sterile supplies.. IV medications come pre-mixed from pharmacy or in unit dose vials which are drawn up just prior to use. We are big on packaging, so except in some long-term care settings, each pill is in an individual sterile package which is opened at the bedside into a disposable cup and handed to the patient. I think we could learn much from our NHS colleagues about specific aseptic procedures and techniques, but when it comes to surface decontamination and multi-layer sterile packaging, we went with engineering controls from early on. While not as practical as ANTT, it is less variable from person to person.
Daniel Juckette RN, CCRN, VA-BC