Detail description of Spoulding classification, cleaning and disinfection of Hospital

1. Fundamentals of Infections
Control
Aman Ullah
B.Sc. MLT
M. Phil Microbiology
Master in Health Research
Certificate in Health and Physical Education

2. Objectives

3. Cleaning, Disinfection and
Sterilization
Cleaning
 General removal of debris (dirt, food, feces, blood,
saliva and other body secretions)
 Reduces amount of organic matter that contributes
to proliferation of bacteria and viruses
Disinfection
 Reducing the number of microbes on a surface to
very low levels
Sterilization
 killing or removal of all microorganisms

4. Cleaning, Disinfection and
Sterilization in Healthcare Settings
Practice standards are based on Spaulding's
Classification system
Spaulding’s levels are based on the potential for
infectious disease spread via equipment,
instruments, furniture and others
 Spaulding’s levels:
•Critical
•Semi-critical
•Non-critical

5. Critical Items
Require sterilization
Includes items that enter sterile tissue or the
vascular system
Examples include surgical instruments and
accessories, biopsy forceps, cardiac and
urinary catheters, implants, needles

6. Semi-Critical Items
Require minimum high level disinfection (or
sterilization)
Includes items in contact with non-intact skin or
mucous membranes
Examples include respiratory therapy equipment,
anesthesia equipment, flexible and laryngoscopes,
bronchoscopes, GI endoscopes, cystoscopes,
vaginal ultrasonic probes
Cleaning process must precede high-level
disinfection

7. Non-Critical Items
Require intermediate-level or low-level
disinfection
Includes items in contact only with intact skin
Examples include BP cuffs, stethoscopes,
durable mobile patient equipment
However, these items could potentially
contribute to secondary transmission, by
contaminating the hands of health care
workers or by contact with medical equipment
that will subsequently come in contact with
patients

9. Cleaning
The principal aim of cleaning is to remove visible dirt
Mechanical process: the dirt is dissolved by water,
diluted until it is no longer visible, and rinsed off
Soaps and detergents act a solubility promoting
agents
Two main functions: nonmicrobiological (improve or
restore appearance, maintain function and prevent
deterioration), microbiological (reduce the numbers
of microbes present, together with any substances
that support their growth or interfere with
disinfection/sterilization

10. Disinfection
Activity of a disinfectant process can vary widely
According to CDC following can be made:
• High-level disinfection: can be expected to destroy
all microorganisms, with the exception of large
numbers of bacterial spores.
• Intermediate disinfection: inactivates Mycobacterium
tuberculosis, vegetative bacteria, most viruses, and
most fungi; does not necessarily kill bacterial spores.
• Low-level disinfection: can kill most bacteria, some
viruses, and some fungi; cannot be relied on to kill
resistant microorganisms such as tubercle bacilli or
bacterial spores

11. Standard procedure for cleaning and disinfection

12. Standard procedure for cleaning and disinfection

13. Standard procedure for cleaning and disinfection

14. Standard procedure for cleaning and disinfection

15. Standard procedure for cleaning and disinfection

19. Thanks