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Page updated 30 April 2007
Whenever equipment requires disinfection, repair or maintenance, the Nurse in Charge or the Head of Department must complete an appropriate permit label and attach it securely to the equipment concerned before despatch. The article or machine must be externally clean and safe to transport.
If the equipment has not been contaminated by either blood or body fluids, a white Permit Label should be attached before it is sent to the appropriate department for work. At UCLH (and in other hospitals by agreement with Estates/Works), this label will function as a "Permit to Work".
If the equipment may have been contaminated by blood or body fluids, a red Permit Label must be used and the apparatus decontaminated appropriately prior to being serviced or worked on internally.
Table 1: Classification of infection risk associated with the decontamination of medical devices and equipment. Adapted from "sterilisation, disinfection and cleaning of medical equipment: Guidance on decontamination from Microbiology Advisory Committee to the Department of Health Medical Devices Agency" (MAC manual) [2].
| Risk | Application of item |
Recommendation |
|---|---|---|
| High |
|
Cleaning followed by sterilisation* |
| Medium |
|
Cleaning followed by sterilisation or disinfection* |
| Low |
|
Cleaning only |
* Other factors to be taken into consideration when choosing a method of decontamination include the nature of the contamination, the time required for processing, the heat, pressure, moisture and chemical tolerance of the object, the availability of the processing equipment and the quality and risks associated with the decontamination method.
Note: Where sterilisation will damage equipment, cleaning followed by high level disinfection may be used as an alternative.
If the outer surface of the equipment is visibly soiled or it has been used for a patient in Source Isolation, it must be cleaned in accordance with the Disinfection Policy and then enclosed in two clear polythene bags. Both bags must be securely tied at the neck before attaching the red Permit Label. Protective clothing must be used when bagging and labelling the equipment.
In the event of contamination by HBV, HCV, HIV or TB, "Danger of infection" labels or "Biohazard" tape must be affixed to the outer covering.
For work requested on large or non-portable equipment, the appropriate Permit Label must be completed in the same manner. If decontamination is not required, complete the white Permit Label and contact the department for the work requested. If decontamination is indicated, complete the red Permit Label and contact the local Infection Control Team for decontamination within the ward or department.
Any member of staff who is in doubt as to which Permit Label to use, should contact a member of the Infection Control Team for advice.
After following the agreed procedures, personnel from appropriate departments (e.g. endoscopy, CSSD, works, etc) will issue a "Clearance Certificate for Inspection, Servicing or Repair of Medical and Laboratory Equipment". This will function as a "Permit to Work" Certificate for outside contractors. (See Permit to Work Form)
Equipment should be accepted for work only if this procedure has been followed.
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