| In all health care settings |
This document is intended for health care providers to ensure that the critical elements and methods of decontamination, disinfection and sterilization are incorporated into health care facility procedures. The document describes essential elements and methods in the safe handling, transportation and biological decontamination of contaminated medical equipment/devices.
"Best Practices for cleaning, disinfection and sterilization in all health care settings," originally published in April 2006, has been updated to:
- Incorporate revisions from the following updated Canadian standards:
- CSA Z314.3-09 Effective Sterilization in Health Care Facilities by the Steam Process
- CSA Z314.2-09 Effective Sterilization in Health Care Facilities by the Ethylene Oxide Process
- CSA Z314.8-08 Decontamination of Reusable Medical Devices
Include new information from the Centers for Disease Control and Prevention's 'Guideline for Disinfection and Sterilization in Healthcare Facilities', published in 2008.
New material from these documents is highlighted in grey in the text.
| How and when to use this document |
The best practices for reprocessing medical equipment set out in this document should be practiced in all settings where care is provided, across the continuum of health care. This includes settings where emergency care is provided, hospitals, long-term care homes, outpatient clinics, community health centres and clinics, physician offices, dental offices, offices of allied health professionals, public health and home health care.
All reprocessing of equipment/devices, regardless of source, must meet these best practices whether the equipment/device is purchased, loaned, physician/practitioner-owned, research equipment/device or obtained by any other method.
| Assumptions and general principles for infection prevention and control |
The best practices set out in this document are based on the assumption that health care settings in Ontario have basic infection prevention and control systems or programs in place. If this is not the case, these settings must work with organizations that have infection prevention and control expertise, such as regional academic health science centers, regional networks, public health units that have certified infection prevention and control staff and local infection prevention and control associations (e.g. Community and Hospital Infection Control Association – Canada chapters), to develop evidence-based programs.
In addition to the general assumption (above) about basic infection prevention and control, these best practices are based on the following assumptions and principles:
- Health care settings routinely implement best practices to prevent and control the spread of infectious diseases.
- Health care settings devote adequate resources to infection prevention and control.
- All staff are, or will be, certified in the Ontario Ministry of Health and Long-Term Care (MOHLTC)’s infection prevention and control core competencies.
- Health care settings provide regular education and support to help staff consistently implement appropriate infection prevention and control practices. Effective education programs emphasize:
- The risks associated with infectious diseases and their transmission via medical equipment/devices and objects
- The importance of immunization against vaccine-preventable diseases
- Hand hygiene (including the use of alcohol based hand rubs or hand washing)
- Principles and components of Routine Practices (Health Canada. Infection Control Guidelines: Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Health Care. (Can Commun Dis Rep. 1999; 25 Suppl 4: 1-149.)
- Assessment of the risk of infection transmission and the appropriate use of personal protective equipment, including safe application, removal and disposal
- Appropriate cleaning and/or disinfection of care equipment, supplies and surfaces or equipment/devices that have been in the health care environment
- Procedures that are considered high risk and rationale
- Individual staff responsibility to keep clients/patients/residents, themselves and fellow staff members safe
- Collaboration between occupational health and safety and infection prevention and control departments/individuals.
NOTE: Education programs should be flexible enough to meet the diverse needs of the range of health care providers and other staff who work in the health care setting. The local public health unit and regional Infection Prevention and Control networks may be a resource and can provide assistance in developing and providing education programs for community settings.
- All health care settings promote collaboration between occupational health and safety and infection prevention and control in implementing and maintaining appropriate infection prevention and control standards that protect workers.
- The facility is to be in compliance with the Occupational Health and Safety Act, R.S.O. 1990, c.O.1 and associated Regulations including the Health Care and Residential Facilities - O. Reg. 67/93 Amended to O. Reg. 631/05.
- All health care settings have established communication with their local public health unit.
- All health care settings have access to ongoing infection prevention and control advice and guidance to support staff and resolve any uncertainty about the level of reprocessing required for a particular piece of equipment/device or a given situation.
- Health care settings have established procedures for receiving and responding appropriately to all international, regional and local health alerts regarding medical equipment/devices. They also communicate health alerts promptly to all staff responsible for reprocessing medical equipment/devices and provide regular updates.
Current alerts are available from local public health units, the MOHLTC, Health Canada’s medical devices alerts website, local regional infection prevention and control networks, etc.
- All health care settings regularly assess the effectiveness of their infection prevention and control education programs and their impact on practices, and use that information to refine their programs.
- All health care settings have a process for evaluating personal protective equipment (PPE) to ensure it meets quality standards where applicable.
Click below to download Practices for cleaning, disinfection and sterilization (69 pages, PDF, 444 Kb).
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