Re-use Policy:

 No other single-use instrument apart from those listed below shall be re-used.

 Each single-use instrument which is authorized for re-use shall have a sticker mentioning the
date of re-use, as well as the number of its re-use. The sticker shall be smudge-proof.

NAME OF THE NO. OF TIMES IT

S. NO METHOD OF DISINFECTION
INSTRUMENT CAN BE REUSED
Wash under running water and dry. Pack with 1gm
of formalin tablets in a specified rack for 24 hrs or
1. Harmonic Scalpel till further re-use. Before re-using wash with 4 Times
normal saline.
Wash under running water, soak in Peracetic
Endopath Scissors
acid (Rely+onParasafe) for 10 minutes, and then
2. (ETHICON) Thrice
wash with distilled water before re-using.

Wash under running water; soak in Peracetic

acid (Rely+onParasafe) solution for 10 minutes.
3. GA Mask 5 times
Wash with distilled water before re-using.

Disinfection of instruments
Laparoscopic instruments:
 Rinse under running water, soak in Peracetic acid (Rely+onParasafe) for 10 min, wash under
running water, detach all parts, soak in 3M rapid for 10 min, wash under running water, dry and
fix. Before using put it in Peracetic acid (Rely+onParasafe) solution for 10 min, wash in distilled
water.

Suction Equipment:
When emptying non-disposable suction jar the following precautions should be taken:
 A plastic apron and household gloves should be worn. A mask should be worn to prevent against
any splash/in case of patients with pulmonary tuberculosis.

 The jar must be disconnected from the vacuum system, carried carefully to the dirty utility room
and poured gently into sink. The contents should be flushed with copious amounts of running
water.

 The jar should be rinsed and washed with neutral pH detergent and hot water solution. It should be
rinsed again in fresh water and dried.

 The bottle should be emptied when full and cleaned daily irrespective of the amount of fluid
aspirate. Fresh tubing should be attached just prior to use.

 The routine use of disinfectant is not necessary for cleaning suction jars as organic matter in the
contents readily inactivates disinfectants. The only exception to this is when patient has pulmonary
 tuberculosis. in such cases, send the jar to CSSD for decontamination.

Humidifier:
 Clean and disinfect the device between patients with soap and water and fill with sterile water
which must be changed every 24 hrs, or sooner if necessary.

NAME OF THE
S.NO METHOD OF DISINFECTION
INST RUMENT

Clean with water and immerse in Multi-enzyme solution,

Rinse with water and dry. Bulb of the laryngoscope should
be removed and cleaned with alcohol swab.
1. Laryngoscope with blades In case of suspected infection/blood, the blade
should be sent for sterilization to CSSD.

Wash under running water; Should be cleaned with

2. Ambu bag with mask Enzymatic detergent and water, dried.
Wash under running water; soak in Peracetic acid
(Rely+onPerasafe).
3. Ventouse cup Solutions for 10 minutes, Wash under running
water, wash with DISTILLED WATER.
Wash under running water, Soak in 3M rapid enzyme for
10 mins, immerse in clean water and rinse all channels
with tap water, Purge all endoscope channels with air to
ensure removal of water and immerse endoscope in
Laparoscopic instruments and
PERACETIC
4. accessory parts
ACID (RELY+ON PERASAFE) for 10 mins and wash in
distilled water thoroughly and dry.
Wash under running water, Soak in in 3M rapid enzyme
for 10 mins, immerse in clean water and rinse all
channels with tap water, and immerse inPERACETIC
ACID (RELY+ON PERASAFE) for 10
5. Telescope
mins and wash in distilled water thoroughly and
dry.
Wash under running water, Soak in in 3M rapid enzyme
for 10 mins, immerse in clean water and rinse all
channels with tap water, Purge all endoscope channels
with air to ensure removal of water and immerse
resectoscope inPERACETIC ACID (RELY+ON
6. Resectoscope
PERASAFE) for 10 mins and wash
in distilled water thoroughly and dry.
7. LMA Fastrach Single use.

8. Doppler machine Wipe with Bacillol Spray

9. Syringe pumps Wipe with Bacillol Spray

10. Infusion pumps Wipe with Bacillol Spray

11. Monitor Probes Wipe with Bacillol Spray

12. IV pole Wipe with Bacillol Spray

Cleaned with 1% sodium hypochlorite and dried. Must

be changed daily and in between each
13. Suction Bottles
patient. Store dry.

14. Oxygen Flow Meter Wash with soap and water

15. Suction and Oxygen Tubings single use

16. Oxygen Hood Wash with soap and water

Disinfect with alcohol swab/ hand rub between patients.
Use dedicated stethoscopes in high-risk area
eg.ICU/NICU or patients with infection or
17. Stethoscope
colonization with MDROs.

Wash sleeve with soap and water once a week.

18. BP apparatus In between patients disinfect with 70% alcohol wipe or
hand rub, tubing & inflation bulb.

19. Breast Pump with tubings For single patient use. Wash with soap and water.
Steel and plastic procedure
20. Wash with soap and water
trays
21. Crash Trolley Wipe with Bacillol Spray

22. Cardiac Tables Wipe with Bacillol Spray

23. NST machine Wipe with Bacillol Spray

24. Ventilator panel Wipe with Bacillol Spray

First soaked in sodium hypochlorite for 20 min, then
rinsed under running water, soak in 3M
Surgical Instruments, dressing
25. rapid for 15 min in the ultrasonic machine, wash under
sets, speculums
running water and sterilize by autoclave.
Cleaning and disinfection of Ambu bag:
Disassembly for cleaning as shown below:

Ambu bag parts that can be cleaned and sterilized:

Part Disinfection & Sterilization

Autoclave 1340c for 10 mins, dry
30 mins
Patient valve 
Bag 
Inlet valve 
Extension tube 
Silicon Facemask 
Oxygen reservoir bag X
Oxygen reservoir tube X

Inspection of parts:
 After cleaning, disinfection or sterilization inspect all parts for damage and replace if
necessary.

 When inserting the valve housing of the inlet valve: Make sure that the bag opening seats
smoothly against the flange.
 When inserting the patient valve disc: Make sure that the butt of the stem is pushed through
the hole in the middle of the patient valve housing
  When mounting the outlet cap: note that the slot of the outlet cap should face the patient
connector
Decontamination and Disinfection of general items:

Equipment/Site Methods of Disinfection

Non-infected patients: Wipe with detergent solution and rinse.
Chemical cleaning may be used for stain and scum removal.
Baths Infected patients and patients with open wounds: Chlorine
compound with detergent.
Non-infected patients: Wash with detergent and dry.
Bed frames Infected patient: Chlorine compound/ Phenol.
Washing and chemical disinfection.
Bed pans Patients with enteric infections: Heat disinfection after emptying
and washing or chemical disinfection with Chlorine compounds.
Bowls (surgical) Autoclave
Wash and dry, Store inverted.
For infected patients use Individual bowls and disinfect on
Bowls (washing) discharge.
Heat disinfection / Chlorine/ Phenol
Floors (Dry cleaning) Sweeping
Wash with detergent solution; routine disinfection not required.
Floors (wet cleaning) Known contaminated area: Chlorine / Phenol
Damp dust with detergent
Furniture and Fittings and Locker Known contaminated and special areas (ICU): Damp dust
tops with Bacillocid
Instruments Heat (autoclave)

Wash with detergent solution and dry

Mattresses and Pillows Contaminated: Disinfect with Bacillocid

Mops (dry, dust Do not use for more than 2 days without washing and drying
attracting)

Mops (wet) House keeping
Rooms(terminal cleaning/
disinfection)
Trolley tops (Dressing)
Tubing (Anaesthetic or ventilation) Single use.
Manual: Rinse after each use, wring and store dry. Chemical
disinfect periodically
If chemical disinfection required after usage on infected areas:
rinse in water, soak in Chlorine (1000 ppm av Cl for 30 min) rinse and
store dry.
Non infected patients: Wash surfaces in detergent solution
Infected patients: Wash surfaces with 1% sodium hypochlorite
disinfection) Fogging/ Fumigation not recommended
Clean with detergent.
If contaminated: Clean first, then use Chlorine.
Urinals Use Chlorine/ Phenol

Preparation of Sodium Hypochlorite Solution (1%):

10% Sodium hypochlorite is procured in cans from the manufacturer, and diluted to 1% (which is the
most common dilution level for disinfection), by adding 1 part sodium hypochlorite to 9 parts water.
The Minor Spill Kits contain 10 ml of 10% sodium hypochlorite and 90 ml of water separately, which
are added together for use in case of a minor spill.

OT Cleaning:
 At the beginning of the day, all the theatres including OT tables, trolleys, Mayo’s stands,
OT lights etc. are cleaned with Bacillocid.

 Floor sweeping is done by Daya and OT equipments and surfaces are disinfected by OT
Technicians and Nurses.

 After each case, the theatre is cleaned with Bacillocid solution.

 At the end of the day, OTs floor is swept and OT tables, equipmentsetc are cleaned with
Bacillocid.

 Each day after surgery, all equipments are cleaned with 3M rapid Enzyme.

 Used instruments are washed with water, soaked in 3M rapid Enzyme, and sent to CSSD
department.

Chemicals Used:

Name Pur ose Dilution/Mode of Use

Spiral Floor cleaner, disinfectant 30 ml in 1 l water (low strength)
50 ml in 1 l water (high strength)
Lizol Washroom cleaner 2 capful in 1 liter water
Vim Powder Stainless Steel Sink Cleaner Ready-to-use
Wheel Powder Doormat Cleaner Ready-to-use
Bacillocid extra Surface cleaning, mopping, 10ml in 1 liter of water.
fogging of high risk areas
Colin Glass surface cleaner Ready to use
Harpic Toilet bowl cleaner Ready to use
Washing of Infected Linen:
 The infected linen is washed at the end, after the soiled linen.

 All the infected linen received in the Laundry( from unit 1 and unit 2 ) is first soaked in 1%
Sodium Hypochlorite solution for 15-20 mins in the “Spotting Station” and then removed and
allowed to semi-dry.

 Linen used for patients with MRSA, HIV, Hepatitis B, cholera and other infectious diseases is
decontaminated by soaking it for 30 min to one hour in 1% Sodium Hypochlorite solution.

Schedule for Collection of Surveillance Areas:

 OT, CSSD – Monthly
 ICU, NICU, Labour Room, Disinfectants – Quarterly
 Water - Monthly

NICU OT LR
Incubator/Warmer Wall Delivery Table
O2 Flowmeter Floor LR Warmer
Infusion Site Table PT Table
Steth Light Top Light
Ventilator Ventilator NST Machine
Humidifier AC Medicine Trolley
Breast Pump Monitor Sterile Pack
Tap Handle Suction Bottle AC
Cardiac Table Instrument Trolley Infusion Pump
Phototherapy Boyle’s O2 Flowmeter
AC Scissors
Medicine Trolley Mayo
Baby Warmer
Medicine Trolley
Anesthesia Work
station
Disinfectants and Dilutions:
S. Name of the
Composition Quantity Purpose Dilution Shelf life
No disinfectant
900 ML OF
CLEANING OF WATER+100ML
BLOOD AND OF SODIUM 10% STAYS FOR
SODIUM AVIALABLE BODY FLUIDS HYPOCHLORITE 1 YEAR, 1%
1 LIQUID
HYPOCHLO IN 5 LITERS SPILLS, WASHING SOLUTION MAKE STAYS FOR 24
CHLORINE
RITE SOLUTION OF INFECTED 1% SODIUM HOURS
LINEN HYPOCHLORITE
SOLUTION

ETHYLENE GLYCOL, FOR CLEANING

SURFACTANTS, 2- MEDICAL ,
METHOXYMETH SURGICAL 10 ML PER 1
AFTER
3M RAPID MULTI YLETHOXY INSTRUMENTS LITER LUKE
AVIALABLE MAKING FOR
2 ENZYME PROPANOL, SODIUM (E.G. DELIVERY WARM WATER
1% STABLE
CLEANER TETRA BORATE IN 1LITER SETS AND OT SOAK IT FOR 10-
FOR 24 HOURS
DECAHYDRATE, C10- SURGICAL 15 MIN
C16 ALKYL INSTRUMENTS,
DERIVATIVES DRESSING SETS)

TRIPLE SALT: FOR 10GMS OF

POTASSIUM DISINFECTION OF BACILLOCID IN 1 STABLE FOR 7
MONOPAERSUL SURFACES LIKE LITER OF WATER DAYS IF
3 BACILLOCID PHATE, SODIUM C10- BED AND FLOOR MAKES 1%, FOR COLOUR
13 ALKYLBENZENE OTHER FOGGING 5GMS CHANGESFROM
SULFONATE, 500GMS ENVIRONMENTA OF BACILLOCID WHITE
SODIUM CHLORIDE L SURFACES AND IN 1 LITER OF DISCARD
FOGGING WATER IMMEDIATELY

AFTER
OPENING USE
FOR
AVAILABLE PRE AND POST READILY INDIVIDUAL
4 BETADINE 10% POVIDONE IN 100ML SURGICAL SKIN AVAILABLE IN PATIENTS,
IODINE AND 500ML ANTISEPSIS 10% ACCORDING TO
THE
MANUFACTURE
GUIDELINES