A Practical Guide to Decontamination in Healthcare

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  • Format: Hardcover
  • Copyright: 2012-07-23
  • Publisher: Wiley-Blackwell
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Reusable devices play an essential role in the variety of surgical and investigational procedures. Practices vary widely, but with new international norms these practices are becoming increasingly standardized. These practices vary from simple cleaning and disinfection, all the way to sterilization of devices and can range from small clinics to large "super-centres" that manage instruments for a variety of hospitals within a general area. The area is rather topical considering the various types of infectious agents these processes can be associated with when things go wrong, including agents such as those responsible for AIDS, tuberculosis, hepatitis B and variant CJD. Although there are various country-specific guidelines on decontamination practices and text books that describe some of these aspects (in particular various disinfection and sterilization techniques), there are no general textbooks for healthcare professionals in this area on decontamination practices.

Author Biography

Gerald McDonnell, STERIS Limited, Basingstoke, UK

Denise Sheard, Sterile Services Training Consultant, Cape Town, South Africa

Table of Contents

Introduction to Decontamination Sciences and Service
Brief history
Role of department
Design, function and workflows
Skills and knowledge requirements
Departmental organisation
Ethics and legal responsibilities
Resource management
Communication skills and abilities
Staff safety and dress codes
Standard departmental procedures
Career growth and personal development
Anatomy and Physiology
Cells, tissues and organs
Body systems
Circulatory system
Digestive system
Endocrine system
Muscular system
Nervous system including sensory organs
Reproductive system
Respiratory system
Skeletal system
Urinary tract system
Microbiology and Infection Control
General introduction
Types and behaviour of micro-organisms
Methods of transmission
Control and destruction of micro-organisms
Control of infection team
Responsibilities for control of infection
Reporting mechanisms
Control of infection methods in healthcare establishments
General arrangements
Universal precautions
Blood-borne pathogen policy
Hand hygiene protocols
Use of personal protective equipment
Principles of asepsis
Routine maintenance of work environment
Housekeeping requirements
Maintenance of heating, lighting, water and air handling systems
Waste disposal
Pest control
Regulations, Standards and Guidelines
Safety and Guidance Notices
Policy on single use only medical devices
Containment, Transportation and Handling of Used Medical Devices
Point of use preparation
Safe containment of devices for return to decontamination facility
Transportation systems
Receipt of sued medical devices into decontamination facility
Requirements for Cleaning and Disinfection of Used Medical Devices
Water supply
Quality assessment
Influences on water quality
Test methods
Water purification systems
Distillation, deionisation and reverse osmosis systems
Cleaning chemicals
Rinse aids and other additives
Safety precautions
Waste disposal systems for effluent
Automated washer disinfectors
Automated cart/container washers
Ultrasonic cleaners
Manual cleaning appliances
Medical gas air hoses
Loading carts and configurations
Cart accessories
Instrument baskets and containers
Accessories for baskets & containers
Standard work room facilities
Protocols for Wash Area Activities
Receipt of used medical devices & initial sorting
Dis-assembly of complex devices
Loading baskets and carts to automated washer disinfector
Routine testing and use of automated washer disinfectors
Routine testing and use of ultrasonic cleaning equipment
Manual cleaning practices
Use of accessories for pre-cleaning and manual cleaning practices
Cleaning of power tools and devices with electrical contacts
Periodic testing and annual certification of key processing equipmentfor cleaning and disinfection of medical devices
Surgical Instrumentation
Materials used in manufacture of medical devices
Manufacturing procedures
Classification of surgical instruments
Artery forceps (haemostats)
Dressing forceps
Rongeurs and cutting forceps
Suction devices
Tissue forceps
Tossie forceps
Minimal invasive surgical equipment
Instrument identification procedures
Function testing practices
Endoscopes and Endoscopic Accessories
Inspection and Packing Area (IPA)
Validation of cleaning and product release systems
Inspection and test procedures
Prioritisation and allocation of work
Pack specifications
Use of process indicators
Objectives of packaging process
Selection of packaging materials
Methods of packing
Secure sealing of packs
Labelling systems
Terminal Processing of Packs
Methods of sterilization
Moist heat (steam)
Porous load sterilizers
Bench top sterilizers
Low temperature steam and formaldehyde
Ethylene oxide
Dry heat
Gas plasma
Chemical sterilization (high level disinfection)
Other methods being considered
Loading sterilizer carts
Product release systems
Materials Management
Raw material acquisition, storage and transfer arrangements
Chemical storage
Storage requirements for processed packs
Issue and distribution systems
Pack and product traceability systems
Inventory control
Quality Management System
Standards to be observed
Design of QMS
Audit trail
Quality assurance and customer satisfaction
Supervision Principles
Framework for the supervision process
Communication principles
Leadership and motivation
Human relations
Role in recruitment and selection of staff
Role in orientation
Role in training
Role in performance evaluation
Critical responsibilities
Role in Total Quality Management System
Work analysis/job design
Assertiveness, employee discipline, staff interaction
Team building
Time management
Conflict management
Management of change
Financial management
Budget planning
Budget management and cost containment
Career management
Responsibilities and accountabilities
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