Proper cleaning of electrical equipment

AORN Journal, April, 2008 by Burlingame Byron L.

QUESTION: After taking my patient to the postanesthesia care unit (PACU), I returned to the OR to discover that the person who was cleaning was using a saturated, dripping cloth to dean one of the pieces of electrical equipment. I checked our cleaning procedure, and it did not discuss cleaning electrical equipment. What is the correct procedure for cleaning electrical equipment used for a surgical procedure or stored in the OR?

ANSWER: Equipment manufacturers are required by the US Food and Drug Administration to provide directions for use, which should include the method for cleaning. (1) An individualized cleaning procedure should be established for each piece of electrical equipment based on the manufacturer's directions for use. The written process should include the recommended method and frequency of cleaning, the type of cleaning agent to use, and the method of application. (1)

The suggested method of cleaning should be followed because moisture entering the internal components of the equipment may lead to electrical shortages, and eventually, corrosion. This corrosion may occur slowly over time, resulting in equipment damage. The damage may not be realized until there is an equipment malfunction or failure, which may result in an adverse event. Examples of incorrect cleaning methods are submerging a piece of equipment in cleaning solution when the equipment is not intended to be submerged or using a saturated, dripping cloth for application of the cleaning agent when the manufacturer's instructions state that the equipment should be wiped off with a damp cloth moistened with a hospital-approved disinfecting agent.

All equipment used during a procedure should be cleaned at the end of each use per the manufacturer's written instructions. Electrical equipment should be unplugged from the electrical source when being cleaned. After it is disconnected from the outlet, the exterior surface of the equipment should be cleaned via the recommended cleaning process. If an incorrect cleaning method has been used, the item should be sent to the biomedical department or other repair location for thorough evaluation and testing to ascertain whether the internal components have been damaged. Before the equipment is sent for repair, documentation must be attached to the piece of equipment to inform repair department personnel about potential contamination of the internal parts of the equipment with body fluids. (2)

The cleaning agent manufacturer's directions for use also should be consulted and should be reconciled with the equipment manufacturer's instructions regarding the method of application. The method of application may include requirements such as exposure time (ie, the amount of time the cleaning agent is in contact with the surface to be cleaned). If the cleaning agent is not allowed to remain in contact with the surface for the full exposure time, the item may not be disinfected.

An impermeable barrier may be used during a procedure to help protect equipment from contamination by body fluids. (1, 2) If the equipment is in close proximity to the sterile field, the barrier placed over the equipment should be a sterile impermeable drape. When the equipment is not in contact with or in close proximity to the sterile field, a nonsterile impermeable material may be used.

If equipment is stored in the OR, an impermeable covering may be draped over the equipment to protect it from contamination when not in use. The covering should be disposable or have a washable surface. Equipment stored in the OR may become contaminated by someone touching the equipment with contaminated gloves or contaminated hands, by splatter of body fluids, or by someone placing a contaminated item on the equipment. (1) If contamination occurs, the drape should be disposed of or washed as is appropriate. If the equipment stored in the OR has not been contaminated, cleaning between procedures is not necessary. All horizontal surfaces, including the surfaces of the equipment stored in the OR or the drape placed over the equipment, should be damp-dusted at the beginning of the day and terminally cleaned at the end of the day. (3)

REFERENCES

(1.) Public Health Notification from FDA, CDC, EPA and OSHA: Avoiding hazards with using cleaners and disinfectants on electronic medical equipment. US Food and Drug Administration, Center for Devices and Radiological Health. http://www.fda .gov/cdrh/safety/103107-cleaners.html. Accessed February 7, 2008

(2.) Regulations (Standards-29 CFR) bloodborne pathogens--1910.1030. Occupational Safety and Health Administration. http://www.osha.gov/pls /oshaweb/owadisp.show_document?p_table=STAN DARDS&p_id=10051. Accessed February 7, 2008.

(3.) Recommended practices for environmental cleaning in the perioperative setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2008:375-406.

BYRON L. BURLINGAME

RN, BSN, MS, CNOR

PERIOPERATIVE NURSING SPECIALIST

AORN CENTER FOR NURSING PRACTICE