Reprocessing of specific categories of medical devices
Devices for which sterilisation is not required
Frequently used devices that only contact intact skin, such as glucometers, pulse oximeters, stethoscopes, blood pressure cuffs and non-invasive ultrasound probes, must be cleaned after each use at the point of use.
Each practice should undertake a risk assessment to determine the probability of contamination with pathogens, the vulnerability of the patient population to infection, and potential for exposure. Cleaning method, process, frequency and cleaning agents used should be based on this assessment as well as on the manufacturer’s instructions for use.
For example, they may be cleaned with an instrument-grade detergent and, if required, disinfected with a low- or intermediate-level TGA-registered/listed disinfectant (see Table 9.4. Classification of disinfectant activity), or cleaned and disinfected with a combined ‘two in one’ detergent/disinfect product (solution or wipe).
During an epidemic or pandemic, special protocols may be advised by health authorities.
Most indwelling invasive medical devices, such as hormonal implants, intrauterine devices and suprapubic urinary catheters, are introduced using disposable single-use devices.
For any commercially prepared implantable materials, the manufacturer’s batch lot/number must be recorded.
Practices must develop, implement and review processes to address infection prevention and control issues relating to the insertion, use and maintenance, and removal of invasive medical devices. Devices should be removed when no longer needed.
See also: Aerosol-generating procedures
Spacers for administering inhaled medicines
Spacers used with pressurised metered-dose inhalers (eg for patients with asthma or chronic obstructive pulmonary disease) are not required to be sterile. They can be stored in a clean, dry environment.
Spacers must not be shared or used by multiple patients unless sterilised.
Metal spacers (rarely used in Australia) and some plastic spacers can be sterilised.
Most spacers (standard plastic, antistatic polymer or polycarbonate polyurethane) are intended for use by a single patient and cannot be sterilised. They must be discarded after use or given to the patient to re-use.
Spacers can be washed for reuse by one patient (not shared), following the manufacturer’s instructions. Practices should advise patients on spacer hygiene.2
Practices can keep cardboard disposable spacers for use in emergencies or when a patient does not have their own spacer.
Masks for administering inhaled medicines
Masks used with spacers and inhalers (eg for administering bronchodilators to infants) or masks used with nebulisers are intended for use by a single patient and cannot be sterilised. They must be discarded after use or given to the patient to re-use, following the manufacturer’s instructions.
Before use, they are not required to be sterile and can be stored in a clean, dry environment.
Nebulisers are no longer recommended for administering inhaled medicines, unless unavoidable (eg a patient with severe acute asthma unable to inhale salbutamol through a pressurised metered-dose inhaler plus spacer).3 The use of nebulisers carries a high risk of transmitting viral infections because they generate droplets and aerosols that can spread infectious particles for several metres and can remain airborne after the patient leaves.3
Nebulisers are not required to be sterile at the time of use. They can be stored in a clean and dry environment.
Tubing is for single patient use only, and cannot be reprocessed. (For nebulisers used at home by a single patient, tubing must be replaced every few months according to the manufacturer’s instructions.)
Peak expiratory flow meters
Mouthpieces cannot be shared or reused by another patient. Instruct patients to bring their own peak flow meter, if required during a consultation.