Decontamination: the process of cleaning, disinfecting and sterilising our instruments.

For many chiropodists and podiatrists the main type of the work they do involves the use of instruments to treat hard skin or nails.

These instruments can be broadly placed into three different categories: single use (i.e. used once and disposed of), single patient use/patient held (i.e. instruments used on a single patient multiple times and looked after by the patient) or reusable (decontaminated between patients).

Each system has its pros and cons and the one the podiatrist chooses will be based on many considerations including financial, storage and moral/ethical viewpoints.

At Walk we have chosen to use reusable instruments because we feel that these offer the best solution for our patients and also for us as practitioners, being of superb quality and longevity, reducing the chance of repetitive strain injuries and having a smaller impact on the environment by reducing waste.

All of our instruments undergo a full process of decontamination which is defined as “the combination of processes which includes cleaning, disinfection and sterilization to render a reusable item safe for further use.” (Society of Chiropodists and Podiatrists, 2009).

We want to ensure that the instruments we use are safe and fit for the intended purpose without putting our patients at risk.  To that end, we use the following process to decontaminate our instruments:

1. Dirty instruments are manually cleaned using a brush and cleaning solution in warm water.
2. Instruments are transferred for an ultrasonic cleaner to remove small and difficult to remove pieces of debris.
3. Instruments are then rinsed in a dedicated sink to remove debris and the cleaning solution.
4. Once rinsed, instruments are then placed in an autoclave and sterilised for a total of three minutes at a temperature between 134 and 137 degrees centigrade.

While this process can be completed in the clinical room, it is recommended that a separate room is used to safeguard patients and clinicians.  At Walk we use room adjacent to the clinical room for decontamination.

Our autoclave meets the Pressure Systems Safety Regulations (2000) and is examined annually by a competent person to ensure that the machine continues to meet these requirements and the results of these tests are available to any patient upon request.

The autoclave we use has a printer attached that provides a breakdown of the sterilising cycle showing the temperature during the three-minute programme.  This is checked by the podiatrist upon completion of the cycle and the printout stored in a separate folder and countersigned for our records.  This ensures that the process we use is transparent and can be traced.  Again, patients can freely examine these records upon request.

Each pack is then marked with the date of sterilisation and initialled by the clinician who has sterilised the instruments.  If the instruments are not used within a set period of time then they undergo the decontamination process again.

So there’s a lot that goes into making sure that the instruments we use are sterile and free from infection, but we’re happy that this is the best process for us and represents the greatest safety for our patients.

If you have any questions about our decontamination process or would like to book an appointment then please get in touch on 01562 515661 or 077 666 888 29.

References:

Society of Chiropodists and Podiatrists (2009) Standards for the decontamination of reusable podiatry instruments in primary care.  [Online: http://www.pebblepad.co.uk/scpod/download.aspx?oid=14032&useroid=0&action=view] [Accessed: 19/05/2013]