Cleaning and disinfecting medical devices is essential for preventing health care-associated infections (HAIs) and protecting patient safety. With over 2 million patients developing HAIs annually in the U.S., resulting in around 100,000 deaths, proper medical device cleaning protocols are critical. This article outlines best practices for medical device cleaning across various areas of a healthcare facility.

Endoscopes
Endoscopes, which are used for a variety of minimally invasive medical procedures, require meticulous cleaning and disinfection due to the complex design challenges they present. Traces of bodily fluids or tissues left after a procedure can lead to pathogen transmission. Facilities must follow strict guidelines for cleaning:

- Immediately flush and drain endoscopes after use to remove any debris.

- Use enzymatic or detergent solutions specifically for endoscope cleaning. Scrub all accessible channels, crevices, and accessories with brushes.

- Ensure cleaning agents fully contact all internal surfaces for the recommended contact time.

- Rinse thoroughly to remove residual debris and cleaning agents that could damage equipment.

- Perform a final disinfection cycle using an EPA-registered liquid chemical sterilant designed for endoscopes or an automated endoscope reprocessor.

- Inspect endoscopes under good lighting after Medical Device Cleaning to check for any remaining debris or damage before storing.

Surgical Instruments
The array of metal and composite surgical instruments used in procedures presents unique cleaning challenges due to fragile components, intricate designs, and small crevices where contaminants can hide. Proper protocols include:

- Rinse instruments under running water to remove any large debris immediately after use.

- Disassemble if necessary and scrub inner channels of reusable parts with brushes using enzymatic cleaners.

- Use ultrasonic cleaners for hard-to-reach areas or porous materials that trap debris.

- Inspect under good light for any remaining debris or damage before sterilization.

- Rinse thoroughly and follow with high-level disinfection or sterilization appropriate for each instrument's intended reuse case.

General Surface Cleaning
While medical devices require specialized care, routine surface cleaning throughout healthcare facilities is also important to prevent transmission. Effective protocols include:

- Use of EPA-registered disinfectants appropriate for different surface types like hard non-porous, soft porous, and electronic equipment.

- Following manufacturers' instructions on contact time, concentration, and safety precautions for each cleaning product.

- Regular cleaning of high-touch surfaces like bed rails, call buttons, infusion pumps, and door handles.

- Proper cleaning technique including wiping/scrubbing motion, use of disposable wipes for one-time use surfaces, and changing cleaning cloths frequently.

- Color-coded cloths or separate carts for different surface types to prevent cross-contamination during cleaning.


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