Disinfection of Neonatal Resuscitation Equipment in Low-Resource Settings: The Importance, the Reality, and Considerations for the Future
Abstract
:1. Introduction
2. A Brief History of Disinfection
3. The Importance of Equipment Reprocessing: From Spaulding to PATH
3.1. Disinfection of Equipment in High-Resource Settings
3.2. Disinfection of Equipment in Low-Resource Settings
4. Reprocessing Realities in Kenya and Malawi
5. Considerations for the Future of Reprocessing in Resource-Constrained Settings
5.1. Engagement of Front-Line Providers for Front-Line Solutions
5.2. Simplification of the PATH Guidelines for Feasibility
5.3. Quality Assurance of Reprocessing in Resource-Constrained Settings
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Classification | Definition | Level of Reprocessing | Examples |
---|---|---|---|
Critical | Enters sterile tissue | Sterilization | Surgical instruments |
Semi-critical | In contact with nonintact skin or mucous membranes but does not penetrate them | Minimum high-level disinfection Sterilization preferred | Respiratory equipment Anesthesia equipment |
Noncritical | Touches only intact skin, or does not directly touch patient | Low-level disinfection | Electrocardiogram machine Oximeter Bedpan |
Stage | Steps |
---|---|
Precleaning | 1. Rinse with water 2. Clean with enzymatic solution 3. Rinse with distilled water |
Cleaning | 1. Ultrasonic cleaner 2. Automatic washer |
Inspection and Test of Function | 1. Assemble equipment 2. Package 3. Test function 4. Place indicator for sterilization |
Sterilization | Steam preferred |
Storage | Store in clean, dry place |
Stage | Steps |
---|---|
Preparation | 1. Wear complete personal protective equipment 2. Clean reprocessing area 3. Prepare reprocessing materials 4. Label containers |
Predisinfection | 1. Preclean 2. Disassemble 3. Clean 4. Rinse (Remove limescale if needed) 5. Dry before sterilization or chemical disinfection |
Disinfection | 1. Disinfect by: a. Chemical HLD b. Heat HLD c. Sterilization 2. Dry |
Postdisinfection | 1. Inspect 2. Reassemble 3. Test function 4. Store |
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White, A.M.; Mutai, D.; Cheruiyot, D.; Rule, A.R.L.; Mortensen, J.E.; Schaffzin, J.K.; Kamath-Rayne, B.D. Disinfection of Neonatal Resuscitation Equipment in Low-Resource Settings: The Importance, the Reality, and Considerations for the Future. Int. J. Environ. Res. Public Health 2021, 18, 7065. https://doi.org/10.3390/ijerph18137065
White AM, Mutai D, Cheruiyot D, Rule ARL, Mortensen JE, Schaffzin JK, Kamath-Rayne BD. Disinfection of Neonatal Resuscitation Equipment in Low-Resource Settings: The Importance, the Reality, and Considerations for the Future. International Journal of Environmental Research and Public Health. 2021; 18(13):7065. https://doi.org/10.3390/ijerph18137065
Chicago/Turabian StyleWhite, Anne M., Dominic Mutai, David Cheruiyot, Amy R. L. Rule, Joel E. Mortensen, Joshua K. Schaffzin, and Beena D. Kamath-Rayne. 2021. "Disinfection of Neonatal Resuscitation Equipment in Low-Resource Settings: The Importance, the Reality, and Considerations for the Future" International Journal of Environmental Research and Public Health 18, no. 13: 7065. https://doi.org/10.3390/ijerph18137065