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Re: Alcohol hand rub in CSSD

#75540 Quote
Morris, Sylvia (Health)
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Morris, Sylvia (Health)

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I have been waiting for Terry’s comments as it is probably a surprise to some that our CSSD world is always changing.

In the past I would have had a blanket ban on ABHR in CSSD, often being horrified seeing several bottle of ABHR sitting on the sink in the “dirty” decontamination area. I still believe that ABHR should not be available in the decontamination area as there is a likelihood of dirty hands after removal of gloves, however I now agree that they can have a role in the clean areas such as the packaging area and sterile store.

I would have the following provisos:

That staff applying ABHR allow the solution to dry completely before handling instruments or packaging.

That staff receive sufficient education to understand that ABHRs work on clean hands and if their hands are dirty from a particular task they have performed before handling instruments or packs that they find a nearby sink and wash their hands before applying an ABHR.

In my role I am involved in the review of the structure of CSSD’s and in the past would have always recommended a hand washing sink in the packaging area or sterile store but in recent times this is no longer considered essential and sometimes it is considered a risk if close to the packaging area due to splashing and increased plumbing risk. Often there is a hand hygiene sink outside the clean area that staff should use before they enter a clean area and the ABHR is a supplement.

The challenge is the Infection Control Team selecting an ABHR which has the right concentration of alcohol and also provides staff with some protection from regular use.

The main risk to sterile packaging is a dirty and poorly ventilated environment, rough handling, dirty or wet hands.

Best wishes

Sylvia

Sylvia Morris
Sterilising and Reusable Medical Device Reprocessing State Coordinator
Infection Control Service
Health Regulation and Protection
Department for Health and Wellbeing/Government of South Australia
Level 3 Citi Centre 11 Hindmarsh Square Adelaide SA 5000

HCW infection prevention: http://www.sahealth.sa.gov.au/infectionprevention
General public: http://www.sahealth.sa.gov.au/hospitalinfections

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Hi Everyone,

My response to being told that you can’t use ABHR in CSSD is ‘where’s the evidence?’

If you read the ingredients of liquid soap you will also find it contains emollients.

I remember vividly watching a demonstration at a polypropylene sterilisation wrap factory of the impact of liquid soap in the permeability of the product when applied directly to the surface. However – who would ever think to apply liquid soap to a sterilisation wrap?

Long story short, they wouldn’t and the hand hygiene process would ensure that clean, dry hands are no risk to the sterile barrier.

Therefore I am of the opinion that YES, CSSD staff can use an ABHR when appropriate in the CSSD workspaces, as long as they use the product correctly and ensure their hands are dry before touching sterile barrier systems and RMDs.

If CSSD staff can’t use an ABHR because there’s an emollient in it, then it follows that anybody touching a CSSD produced sterile package should not be allowed to use ABHR.

IF someone has evidence to the contrary – please share.
Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination

PO BOX 2249, Greenvale VIC Australia 3059

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This correct most ABHR have an emollient of some description which may compromise sterile wrap. CSSD staff should have available a handwashing sink.

Liz Vanderlinde
Infection Prevention Control Co-ordinator
North West Private Hospital
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Brickport Road, Burnie TAS 7320, Australia
T +61 3 6432 6005 F +61 3 6431 5766
E liz.vanderlinde@healthecare.com.au W
Healthe Care Hospitals are accredited by ACHS NSQHS Standards or ACHS EQuIP National
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QIC Standards
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Hello – just after some advice on using the 70% alcohol hand rub in CSSD. I was under the impression it would be acceptable to use but my CSSD staff have said they were told as it has a moisturiser component it can’t be used. I am aware that straight moisturiser can’t be used during the shift – any thoughts?
Thanks
Jenny

Kind regards,
Jenny McCarthy
Operating Room Manager/Infection Prevention and Control Coordinator
Maryvale Private Hospital
PO Box 348, Morwell, 3840
286 Maryvale Rd. Morwell, 3840
T +61 3 5132 1283 | F +61 3 5132 1281
E jenny@maryvaleph.com.au

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