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I have been approached by an opthalmologist for advice on how to clean a tonometer (an instrument used to measure intraocular pressure) following use on a patient who is positive for Hepatitis B. I am unsure on how they clean it at the moment. Any information would be greatly appreciated.
Thanks
HeidiHeidi Gettons
Infection Control Coordinator
The Bays Hospital
Mornington VIC
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Hi Heidi,
The issue of how to appropriately clean Tonometer prisms has been a long running one at the Eye & Ear, which I have recently inherited.
The current procedure here is to clean the Tonometer prism with a 70% Isopropyl Alcohol wipe/swab between patients. If a patient has a suspected infectious eye then the Tonometer is rinsed under running water for 30-60 seconds, then soaked in a disinfectant solution, we currently use 3% Hydrogen Peroxide solution, for 10mins (alternatively a 500 ppm Sodium Hypochlorite solution could be used). Finally, the tonometer is rinsed under running water again for 60 seconds & dried with a one-way clean & soft tissue. This complies with the tonometer manufactures guidelines. I am guessing there is a very small risk of transmitting Hep B from the eye but you may want to apply this higher level of disinfection for this patient.
Having said all this I believe our current process needs reviewed with the use of disposable Tonometer prisms given full consideration. However, there has been a long running cost versus benefit debate here in the light of little or no evidence of infections being transmitted by tonometers. Please feel free to contact me directly if you need any further information.
Regards,
Paul Simpson, RN, MSc
Infection Control Consultant[Description: Description: Description: cid:image001.png@01CC5B6A.3AEF15F0]
32 Gisborne Street, East Melbourne, 3002, VIC
Tel: +613 9929 8523 | Pager: 366 | Fax: +613 9663 7203[Description: cid:image003.png@01CD2EAB.01304B80]
—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of SUBSCRIBE AICALIST Heidi Gettons
Sent: Tuesday, 24 July 2012 2:28 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Cleaning of TonometersI have been approached by an opthalmologist for advice on how to clean a tonometer (an instrument used to measure intraocular pressure) following use on a patient who is positive for Hepatitis B. I am unsure on how they clean it at the moment. Any information would be greatly appreciated.
Thanks
Heidi
Heidi Gettons
Infection Control Coordinator
The Bays Hospital
Mornington VIC
Ph: 59765249
Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
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______________________________________________________________________
Attention:
The information in this e-mail message may be confidential, and may also be subject to legal privilege, public interest or legal professional privilege.If you are not the intended recipient, any use, disclosure or copying of this e-mail is unauthorised.
If you have received this message in error, please contact the sender.
This footnote also confirms that this email message has been checked for the presence of computer viruses.
The Royal Victorian Eye and Ear Hospital however does not warrant the message is free of viruses.
It is recommended as a prudent business practice the recipient perform a virus scan of any message received.
______________________________________________________________________Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
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Hi Heidi
We do the following, based on the manufacturers instructions:
1. Single use for any suspected or known eye infection
2. Tonometers is rinsed and cleaned with 70% Isopropyl Alcohol wipe/swab between patients (for the am or pm clinic session)
3. At the end of each session, the Tonometers are cleaned (neutral detergent), rinsed and soaked for 10mins in Milton solution
4. The tonometers are rinsed under running water and dried with a lint free cloth
5. Each month, 8-10 tenometers are chosen at random for fluroceine leak testing and a visual inspection with a slit lamp this is part of the quality program
Thanks
Joe
Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000Phone: 93827199
Mobile: 0418984255
Fax: 93827510
Page: 21552joeanne.bendall@sesiahs.health.nsw.gov.au
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Paul Simpson
Sent: Tuesday, 24 July 2012 3:42 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Cleaning of TonometersHi Heidi,
The issue of how to appropriately clean Tonometer prisms has been a long running one at the Eye & Ear, which I have recently inherited.
The current procedure here is to clean the Tonometer prism with a 70% Isopropyl Alcohol wipe/swab between patients. If a patient has a suspected infectious eye then the Tonometer is rinsed under running water for 30-60 seconds, then soaked in a disinfectant solution, we currently use 3% Hydrogen Peroxide solution, for 10mins (alternatively a 500 ppm Sodium Hypochlorite solution could be used). Finally, the tonometer is rinsed under running water again for 60 seconds & dried with a one-way clean & soft tissue. This complies with the tonometer manufactures guidelines. I am guessing there is a very small risk of transmitting Hep B from the eye but you may want to apply this higher level of disinfection for this patient.
Having said all this I believe our current process needs reviewed with the use of disposable Tonometer prisms given full consideration. However, there has been a long running cost versus benefit debate here in the light of little or no evidence of infections being transmitted by tonometers. Please feel free to contact me directly if you need any further information.
Regards,
Paul Simpson, RN, MSc
Infection Control Consultant[cid:image001.png@01CD69AD.642EF4B0]
32 Gisborne Street, East Melbourne, 3002, VIC
Tel: +613 9929 8523 | Pager: 366 | Fax: +613 9663 7203
[cid:image002.png@01CD69AD.642EF4B0]—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of SUBSCRIBE AICALIST Heidi Gettons
Sent: Tuesday, 24 July 2012 2:28 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Cleaning of TonometersI have been approached by an opthalmologist for advice on how to clean a tonometer (an instrument used to measure intraocular pressure) following use on a patient who is positive for Hepatitis B. I am unsure on how they clean it at the moment. Any information would be greatly appreciated.
Thanks
Heidi
Heidi Gettons
Infection Control Coordinator
The Bays Hospital
Mornington VIC
Ph: 59765249
Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.
You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au
______________________________________________________________________
Attention:
The information in this e-mail message may be confidential, and may also be subject to legal privilege, public interest or legal professional privilege.If you are not the intended recipient, any use, disclosure or copying of this e-mail is unauthorised.
If you have received this message in error, please contact the sender.
This footnote also confirms that this email message has been checked for the presence of computer viruses.
The Royal Victorian Eye and Ear Hospital however does not warrant the message is free of viruses.
It is recommended as a prudent business practice the recipient perform a virus scan of any message received.
______________________________________________________________________
Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.
You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au
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Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
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