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Infection prevention and control guidelines

10. Reprocessing reusable medical devices

Risk assessment

Infection prevention and control guidelines

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Infection prevention and control guidelines

Risk assessment

The practice’s infection prevention and control coordinator must ensure the level of processing for specific reusable medical devices and equipment is appropriate to the risk of infection posed by their reuse.

Risk assessment is based on the Spaulding classification¹ (Table 10.2. Spaulding classification). The site of use (eg intact or non-intact skin, mucous membranes, sterile sites such as surgical wounds) is a key determinant of the level of risk to the patient.

Table 10.2. Spaulding classification – application to reusable medical devices

Classification	Examples	Process	Storage
Critical Contact with sterile tissue, sterile cavity, or bloodstream	Surgical instruments used for excision Podiatry instruments used to penetrate or abrade skin (nail cutters, scalers, files) Sharps used in neurological testing	Sterilisation by steam under pressure (autoclaving)	Sterility must be maintained Integrity of the package must be maintained Must be protected from environmental contamination
Semi-critical Contact with intact nonsterile mucosa or nonintact skin	Vaginal speculum used for routine cervical sampling Instruments used in wound care (eg forceps, scalpel handles, scissors)	Sterilisation by steam under pressure	Must be protected from environmental contamination
Noncritical Contact with intact skin	Stethoscope Plastic* cuff on sphygmomanometer Pulse oximeter Auroscope	Cleaning with detergent or Cleaning and disinfection with low-level disinfectant	Storage in clean, dry place

*Fabric sphygmomanometer cuffs cannot be cleaned.

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