Semi-critical medical devices are items that come in contact with intact mucous membranes or non-intact skin such as vaginal specula, nasal specula, vaginal/anal ultrasound probes, gastrointestinal/nasopharyngeal endoscopes, and laryngoscopes.
Two methods of reprocessing of semi-critical medical devices are sterilization and high-level disinfection. Depending on the item, the manufacturer may have strict instructions to only sterilize or only high-level disinfect (HLD). If the manufacturer states both options, choose sterilization.
The following points describe the requirements and limitations of HLD:
- Manufacturer’s instructions for the medical device must be followed to identify acceptable method of reprocessing.
- Manufacturer’s instructions for each medical device must be followed to identify compatible and validated disinfectant agents that can be used on the item.
- Adequate cleaning is imperative prior to HLD.
- Medical devices must be thoroughly dried, as any trace of moisture promotes microbial overgrowth and materials deterioration.
- Chemicals used for HLD must be labelled, stored and handled. Personnel must be properly trained to handle these toxic chemicals. Education must include the correct selection and use of personal protective equipment such as gloves, gowns, and eye protection.
- MSDS sheets must be accessible to staff at all times on all chemicals used in the facility.
- Most HLD products require a spill kit that must be stored near where the product is used and stored.
Physicians should remember that HLD only kills some organisms and not spores. Best practice states that sterilization is the gold standard and should be selected if possible. As both sterilization and HLD require additional processes and different reprocessing equipment, using disposable devices represents the safest and most convenient option for physician offices.