Don't neglect IV pumps: Tips for getting the job done

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Cleaning IV pumps is not likely to be on anyone’s list of favorite chores, but it’s important to ensure that these devices are properly cleaned and disinfected. A strong policy should not only cover how to clean them, but also who is responsible for doing the job. 

IV pumps are considered noncritical items, according to CDC guidelines based on the Spaulding classification system, says Joan M. Wideman, MS, MT (ASCP), SLS, CIC, owner of JMW Consulting, LLC, in Clawson, MI. Noncritical items are defined as those that will only come into contact with intact skin. 

Even so, if a healthcare worker touches a contaminated surface and then touches a button on the pump or the IV’s connective tubing, he or she may contaminate the item and put the patient at an increased risk for a bloodstream infection, Wideman says.

Learn proper cleaning methods

Each manufacturer outlines a specific protocol for cleaning and disinfecting pumps that must be followed.  Also noted in these instructions are proper precautions to prevent employee exposure to blood, body fluids, and/or disinfecting chemicals. When it comes to devices, always clean first to remove organic debris, then disinfect, says Wideman. 

Some disinfectant solutions have combined cleaning and disinfectant properties, but a two step-process may be necessary with these agents. 

Training should ensure that the cleaning and disinfecting solution that is used on the pumps is compatible with the surface. In addition, for electrical safety, it may be necessary to unplug the device during certain cleaning procedures.  

Of special note are considerations for certain organisms that are difficult to kill, such as Clostridium difficile and Norovirus, she says. 

The cleaning product must be approved by the Environmental Protection Agency and label instructions for contact time (i.e., how long the disinfectant must remain wet to work) must be followed.

Use a checklist

It’s often helpful to make a checklist including the steps outlined by the manufacturer to ensure that the proper protocol is followed each time, says Wideman. Be certain that your policies and procedures also spell out a process for cleaning the IV pump stand and wheels. People often pay a lot of attention to the pump, but very little attention to the stand and wheels, she says.

Selecting the appropriate cleaning products for the stand is important, because using the wrong substances can corrode or pit the surface, making it porous and thus impossible to clean effectively, says Wideman.

Pay special attention to the wheels, because they pick up dust and can give patients the impression that the facility is not clean.

Staff members should track IV pumps to ensure that they are properly cleaned and disinfected before making their way back to patients. 

How this tracking is done will vary widely by facility, depending on what type of electronic or manual systems are in place. 

Some facilities use bar coding and computerized tracking, whereas others may use a paper system, such as a tracking log.

Develop a specific policy

Regardless of how the tracking is done, it’s important that your facility has policies and procedures in place to address these processes. 

Two Joint Commission environment of care (EC) standards—EC.6.10 and EC.6.20—govern medical equipment and overlap with these issues. According to The Joint Commission, a facility needs to have medical equipment management policies and procedures that describe how the organization will establish and maintain a program to promote safe and effec-tive use of medical equipment. 

It covers not only selecting and purchasing the equipment, but also reporting problems with the equipment and monitoring its use. 

Wideman suggests that your IV policies focus on each of the following four points: 

1. Ensure that the pumps assigned to each patient have been cleaned and disinfected, and are operating properly prior to use. 

Outline a process to ensure that all pumps are ready for use and are in good working condition, says Wideman. Some hospitals issue the pump from a central supply area. When it is taken from this area, staff members must ensure that the pump has been properly cleaned and disinfected, is in working order, and has had its preventive maintenance.

2. Keep the pump clean when it’s in use, and specifically designate that responsibility. 

Once the pump is taken to the patient area, it is often not cleaned or disinfected until it is designated for another patient. 

This creates a potential IC problem. Several people will likely push buttons on the device and touch other surfaces, such as the stand, creating a potential reservoir of infectious agents. 

Compounding the problem is the fact that housekeeping staff members are often reluctant to touch medical equipment for fear that they might damage it or change a control setting. Your policy needs to designate who is in charge of cleaning IV pumps and how often they must be cleaned while in use, says Wideman. 

If you decide to put the housekeeping staff in charge of cleaning IV pumps, develop an agreement that outlines the cleaning process and frequency. Ensure that those who are designated to clean the equipment are properly trained to do so.

If nursing personnel will be in charge of in-use cleaning of the high-touch surfaces, they need to have a convenient product readily available for use. 

Check the manufacturer’s instructions to see whether the nurses can use disposable disinfecting wipes, which can be placed nearby for easy access. Or look into purchasing a commercial overlay for the buttons, which makes them easy to wipe clean. Your policy should also outline a process to ensure that no adjustments are made inadvertently when cleaning and disinfecting the equipment.

3. Removing the pump from a patient’s room and bringing it to storage or to be cleaned.

Once the patient no longer needs the IV pump, your policy should designate someone (e.g., a housekeeper or technician) to take the device from the bedside and either bring it to storage (e.g., a utility room) or clean it. If staff members are not going to clean the pump immediately, they should put it in a labeled bag. Doing so prevents clinical staff members from accidentally reusing the IV pump before it is cleaned and disinfected.

Some facilities store used IV pumps in the soiled utility room on the floor until they are ready to be taken to the central cleaning department or cleaned by staff members on the unit or floor. 

If the cleaning is going to be done in that unit, you need to ensure that the person who cleans it follows the proper cleaning procedures. But remember, be certain to spell out who is in charge of this process. 

“If it’s everyone’s responsibility, it’s no one’s responsibility,” says Wideman.

4. Address potential problems with the pump, such as when one is involved in an adverse event with a patient. 

If there is an adverse event that implicates a pump in any way, your facility needs a process in place to “quarantine” the device to ensure that no one will use it, clean it, or change its settings while an investigation is ongoing, says Wideman.