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Principles of cleaning, sterilisation and disinfection

You should appropriately decontaminate equipment that comes into contact with patients, including:
  1. trial frames
  2. chin and forehead rests
  3. refractor heads
  4. handheld occluders
  5. rulers
  6. tonometer heads
  7. medical devices such as contact lenses and sample frames
  8. gonioscopes and other diagnostic lenses.
You should decontaminate equipment in all situations where you or your patients are at risk of any known transmissible infection, including nursing homes, schools and workplaces.
There are three levels of decontamination. You should use the one that is most appropriate for the item being decontaminated. The three levels are:
  1. cleaning to remove organic or inorganic debris. This may be done with detergents or ultrasonic cleaning
  2. disinfecting to reduce viable microorganisms with heat or chemicals
  3. sterilising to kill or remove all microorganisms, including spores. This is not normally required in optometric practice.
You must clean the items first.
Not all equipment needs to be sterile before being used and you should:
  1. clean equipment which does not come into close contact with mucous membranes or sterile body areas, e.g. trial frames and refractor heads
  2. clean surfaces in the consulting room, unless contaminated with body fluids, see d below
  3. disinfect equipment which comes into contact with intact mucous membranes, or becomes contaminated with blood and other bodily fluids, using a chlorine-releasing disinfectant such as sodium hypochlorite 1% (10,000 ppm of available chlorine) 
  4. disinfect surfaces in the consulting room if contaminated with body fluids, using a chlorine-releasing disinfectant such as sodium hypochlorite 1% (10,000 ppm of available chlorine)
  5. sterilise equipment introduced into a sterile body area or in contact with a break in the skin or mucous membrane
  6. follow the manufacturer’s instructions for a suitable alternative agent if the item or surface cannot withstand chlorine-releasing agents for disinfection.
You should have access to a hand basin in the consulting room.