Volume 7 • 2020 • Issue 1

36 | 2020 | Issue 1 sources including International Standards Organization (ISO), Public Health Agency of Canada, Health Canada documents, and other CSA documents. There are also two infrastructure needs that are integral parts of reprocessing—the design of the space where reprocessing occurs, and instructions from the manufacturer on how to reprocess its product or device. Planning for Adequate Space and Design of the Reprocessing Area The reprocessing area requires thoughtful consideration during design of clinical spaces. Inadequate consideration can result in problems with insufficient space or inappropriate areas for performing the necessary tasks. Determine the size and flow within the space required by estimating average patient numbers and thereby determining instrument inventory. The inventory as well as future projected staffing will determine anticipated space requirements. Counter space is needed for instruments that await cleaning and disassembly. Plumbing requirements as well as floor space needs to be adequate for automated and manual cleaning of instruments and devices and for dedicated hand hygiene sinks in the cleaning (decontamination) area. Other considerations are counter and storage space for packaging; size and number of sterilizers; and holding area for instruments awaiting placement into storage. Construction of this area should involve using seamless non-porous materials to facilitate the need for continual cleaning in a high traffic area. The design must accommodate a one-way workflow because this design will act to mitigate against risk of errors by busy staff as well as protecting against recontamination. Physical separation of the cleaning area from the packaging area prevents spatter created during cleaning from being deposited on instruments that have already been cleaned. Mindful and expert consideration is required for plumbing, an HVAC system that allows correct air exchanges per hour, and lighting and magnification in an ergonomic setting. Finally, storage of sterile instruments is preferred in its own separate area and at the very least, separated from the decontamination area due to the moisture and bioburden from spatter where instruments are cleaned. Hiring a contractor who is familiar with CSA Z8000-18 Canadian healthcare facilities 5 is highly recommended. Follow MIFUs for cleaning with ultrasonic cleaning units. Attention is required to the use of recommended ultrasonic cleaning solution, correct water temperature, degassing the fresh solution, and placement allowing all instrument surfaces to be exposed to the cavitation process. ➜ S upporting Y our P ractice Infection Prevention and Control at the Dental Office Photos: Graduate Orthodontic Clinic, Schulich School of Medicine and Dentistry.