SKILL  KNOWLEDGE  SAFETY

HLTSTE301C - Clean re-usable medical devices

Description

This unit of competency describes the skills and knowledge required to follow the correct procedures for handling reusable medical equipment including, collection of soiled items, identification, inspection, cleaning operation, and the monitoring and maintenance of associated cleaning equipment

The range of functions is prescribed around known standards, guidelines, policies and procedures, under the supervision of a qualified person

Pre Requisites

 HLTIN301C Comply with infection control policies and procedures

Application

The application of knowledge and skills described in this competency unit could take place in a range of health settings, including hospitals and specialist sterilisation facilities. The application of knowledge and skills takes place around standards, guidelines, policies and procedures and under the supervision of a qualified person

Functions at this level require a broad overview of microbiology and disinfection in relation to AS/NSZ 4187-2003

Performance Criteria

 1. Follow procedures for safe practice    
1.1 Use cleaning procedures that comply with AS/NZS 4187 and AS/NZS 4815 guidelines, manufacturers recommendations and organisation policies and procedures
1.2 Identify the need for and use standard precautions
1.3 Identify and use appropriate personal protection
1.4 Identify and comply with relevant organisation OHS policies and procedures
1.5 Identify infection risks and implement an appropriate response (or report to designated personnel) in accordance with the policies and procedures of the organisation
1.6 Identify different methods for safe handling of sharp instruments and improperly disposed sharps such as needles, scalpel blades etc.
1.7 Identify the protocol for care following exposure to blood or other body fluids of the organisation
1.8 Manage spills of blood and body fluids in line with organisation policies and procedures
    
2. Collect contaminated items and equipment    
2.1 Prepare and stock designated collection equipment eg trolleys, containers, case carts
2.2 Follow the designated route and timetable for collecting contaminated items and equipment
2.3 Confine and contain contaminated items prior to transport
2.4 Comply with transport protocols, ie contaminated goods are not left unattended en route
2.5 Transport used items and equipment to the cleaning area according to cleaning are according to organisation policies and procedures
2.6 Appropriately clean, dry and store collection equipment after each use
    
3. Sort and process contaminated items and equipment    
3.1 Identify and sort items in accordance with AS/NZS 4187 and AS/NZS 4815 and organisation policies and procedures
3.2 Prepare and clean items, eg initial and manual mechanical procedures, in accordance with AS/NZS 4187 and AS/NZS 4815 and organisation policies and procedures
3.3 Report disposable sharps and ensure their removal and disposal according to organisation policies and procedures
3.4 Remove and dispose of waste at point of use, and report any variance in accordance with regulatory and policy requirements
3.5 Prepare specialised items for specific cleaning procedures
3.6 Identify and give priority to specific items requiring priority processing
3.7 Segregate and process delicate items in accordance with organisation policies and procedures
3.8 Identify faulty and damaged items and report to designated person
3.9 Lubricate instruments in accordance with AS/NZS 4187 and AS/NZS 4815 and organisation policies and procedures
3.10 Dry items in accordance with AS/NZS 4187and  AS/NZS 4815 and organisation policies and procedures
    
4. Follow required work flow processes    
4.1 Work flows in one direction only, from dirty to clean
4.2 Designated work areas are segregated and clearly identified
4.3 Perform all tasks in the designated area
4.4 Identify and report interruptions to work flow according to organisation requirements
    
5. Load and operate cleaning appliances safely and efficiently    
5.1 Clean and stock cleaning equipment and environment in accordance with manufacturer's recommendations and organisation policies and procedures
5.2 Test, check and prepare all equipment for use in accordance with relevant standards, manufacturers' recommendations and organisation policies and procedures
5.3 Identify, select, store and use chemical products according to manufacturer's instructions and OHS guidelines, with reference to material safety data sheets visible for all chemicals in use
5.4 Use appropriate manual handling techniques when operating cleaning appliances
5.5 Identify faulty/damaged cleaning equipment, including detergent dispensing systems and report to the designated authority for repair
5.6 Check processed items for cleanliness, dryness and need for reprocessing if necessary
    
6. Follow procedures for monitoring the efficiency of cleaning     
6.1 Complete monitoring and/or test procedures, eg water quality, detergent residue, chemical, soil removal efficacy, in accordance with standards and organisation policies and procedures
6.2 Ensure processes take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues
6.3 Monitor and document physical parameter, eg time, temperature, concentration in accordance with standards and organisation policies and procedures
6.4 Interpret and report any variance of procedures and physical parameter to the designated person
6.5 Complete and archive quality management documentation in accordance with standards and organisation policies and procedures

Required Skills & Knowledge

 Essential knowledge:
  •     Basic principles and practices of cleaning and disinfection, including thermal and chemical disinfection
  •     Enterprise code of practice
  •     Fundamental knowledge of infection control principles as it affects the sterilisation work environment
  •     Fundamental knowledge of microorganisms as it affects the sterilisation work environment, including protists, viruses and prions and their relationship to disease
  •     General categories of instruments and associated cleaning requirements
  •     Hazard identification and risk control
  •     Manual handling requirements for cleaning reusable medical devices
  •     Monitoring and maintenance requirements of cleaning and drying equipment
  •     OHS policies, guidelines and symbols and there relevance to working in the sterilisation area
  •     Relevant state/territory guidelines for sterilising services
  •     Standards, including AS/NZS 4187, AS/NZS 4815 and all relevant infection prevention guidelines and ISO 155883 Parts 1 and 2
  •     The importance of sterilisation technology as a contribution to client safety
  •     The legal responsibilities of health care providers in relation to confidentiality, client rights, duty of care and implications of negligence
  •     The work flow process and the reasons for design of work area
  •     Use of chemicals in the cleaning process, including knowledge of detergency action

Essential skills:
  •     Address relevant OHS, infection control and manual handling requirements
  •     Apply fundamental knowledge of microbiology as it affects the sterilisation work environment, and as detailed in Required Skills and Knowledge
  •     Apply knowledge of the importance of cleaning as a contribution to client safety
  •     Comply with AS/NZS 4187 and AS/NZS 4815 for sterilisation purposes
  •     Demonstrate consistency of performance over a number of trials
  •     Ensure documentation is complete and accurate

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role. This includes the ability to:
  •     Apply cleaning processes
  •     Apply problem solving skills - to use available resources and prioritise workload
  •     Collect, sort and process contaminated items and equipment
  •     Follow organisation policies and procedures
  •     Operate machines and equipment
  •     Select and use personal protection equipment
  •     Use literacy, numeracy and oral communication skills required to fulfil the position in a safe manner as specified by the health care facility

Range Statement

 Cleaning equipment may include:    
  •     Collection equipment
  •     Batch-type washer/disinfectors
  •     Rack conveyor washers/tunnel washer
  •     Load retaining devices
  •     Ultrasonic cleaners
  •     Manual cleaning sinks, hand washing sink, hot and cold running water supply
  •     Cleaning accessories, including brushes, non-linting cloths, syringes
  •     High pressure water equipment
  •     Drying cabinets
  •     Compressed air gun

Personal protective equipment may include:    
  •     Gloves
  •     Aprons
  •     Goggles
  •     Face shields
  •     Masks
  •     Gowns
  •     Ear muffs
  •     Shoe covers
  •     Hair cover

Reusable medical equipment may include:    
  •     Surgical and medical instrumentation and equipment
  •     Anaesthetic/respiratory equipment
  •     Hollow ware
  •     Specialist surgical instruments, such as:
  •     flexible and rigid endoscopic equipment
  •     insulated instruments
  •     laparoscopic instruments
  •     microscopic instruments
  •     handpieces
  •     power tools
  •     fibre optic equipment

Cleaning procedures may involve the use of specific chemicals such as:    
  •     Detergents
  •     Enzymatic cleaners
  •     Rinse aid
  •     Stain remover

Separate processing requirements apply to:    
  •     Initial cleaning
  •     Definitive cleaning, including:,
  •     mechanical
  •     ultrasonic and manual cleaning
  •     anaesthetic/respiratory

Cleaning may involve:    
  •     Disassembly
  •     Solutions including:
  •     soaking
  •     enzymatic
  •     lubrication
  •     stainless steel stain remover
  •     Brushing of lumen/cannulated items
  •     Non-immersible items
  •     Complex specialised instrumentation
  •     Leak testing of flexible endoscope
  •     Mechanical lubrication

Evidence Guide

 Critical aspects for assessment and evidence required to demonstrate this competency unit:
  •     The individual being assessed must provide evidence of specified essential knowledge as well as skills
  •     Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
  •     Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Context of and specific resources for assessment:
  •     Assessment should replicate workplace conditions as far as possible.
  •     Simulations may be used to represent workplace conditions as closely as possible. Acceptable simulation requires cleaning of a full range of reusable devices:
  •     surgical and medical instrumentation and equipment
  •     anaesthetic/respiratory equipment
  •     hollow ware
  •     specialist surgical instruments
  •     Use of operational cleaning and drying equipment
  •     Resources essential for assessment include:
  •     access to relevant workplace or appropriately simulated environment where assessment can take place
  •     access to Australian standards, government and organisation policies and procedures
  •     cleaning equipment operation manuals

Method of assessment     
  •     Observation in the work place (if possible)
  •     Written assignments/projects, eg for fundamentals of microbiology and principles of cleaning and disinfection
  •     Interviewing and questioning
  •     Formal appraisal systems
  •     Supporting statement of supervisor(s)
  •     Authenticated evidence of relevant work experience and formal learning

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