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clients/patients/residents at high risk for CJD must be subjected to rigorous
decontamination processes as detailed in the Health Canada/Public Health Agency of
Canada infection control guideline, Classic Creutzfeldt-Jakob Disease in Canada .
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Best Practices for Cleaning, Disinfection and Sterilization in All Health Care Settings February, 2010
2. Environmental Requirements for Reprocessing Areas
A. Physical Space
There must be a centralized area for reprocessing medical
Reprocessing performed outside
equipment/devices. Reprocessing performed outside the
the centralized area must be kept to
centralized area must be kept to a minimum and must be
a minimum and must be approved
approved by the reprocessing committee or those
by the reprocessing committee or
accountable for safe reprocessing practices and must
those accountable for safe
conform to the requirements for reprocessing space. In
reprocessing practices and must
smaller settings, such as clinics or offices in the community,
conform to the requirements for
this refers to any segregated area where reprocessing of
reprocessing space.
equipment/devices takes place, away from
clients/patients/residents and clean areas.
The environment where cleaning/decontamination is performed must1, 16:
a) have adequate space for the cleaning process and storage of necessary equipment and supplies;
b) be distinctly separate from areas where clean/disinfected/sterile equipment/devices are handled
or stored;
c) have easy access to hand hygiene facilities;
d) have surfaces that can be easily cleaned and disinfected;
e) have slip-proof flooring that can withstand wet mopping and hospital-grade cleaning and
disinfecting products; and
f) have restricted access from other areas in the setting and ensure one-way movement by staff.
Decontamination work areas shall be physically separated from clean and other work areas by walls or
partitions to control traffic flow and to contain contaminants generated during the stages of cleaning.
Walls or partitions should be cleaned regularly and be constructed of materials that can withstand
cleaning and disinfection.16
Decontamination sinks16:
a) shall be designed and arranged to facilitate soaking, washing and rinsing of equipment/devices
with minimal movement or delay between steps;
b) should be adjacent to waterproof counter tops and a backsplash;
c) shall not have an overflow;
d) should be at a height that allows workers to use them without bending or straining;
e) should be large enough to accommodate trays or baskets of instruments;
f) should be deep enough to allow complete immersion of larger devices and instruments so that
aerosols are not generated during cleaning; and
g) should be equipped with water ports for the flushing of instruments with lumens, if appropriate.
Hand hygiene facilities should be located in all personnel support areas and at all entrances to, and exits
from, the decontamination area. Hand hygiene facilities should include:
a) accessible hand washing sinks with hands-free controls, soap dispensers and paper towels;
and/or
b) alcohol-based hand rub (ABHR).
Refer to Appendix B, Recommendations for Physical Space for Reprocessing , for details
regarding reprocessing area space requirements.
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Best Practices for Cleaning, Disinfection and Sterilization in All Health Care Settings February, 2010
B. Air Quality
The Regulation respecting Control of Exposure to Biological and Chemical Agents (O. Reg. 833/90) made
under the Occupational Health and Safety Act provides occupational exposure limits such as ceiling
exposure value (CEV) for chemical agents (e.g., glutaraldehyde). A CEV is the maximum airborne
concentration of a chemical agent to which a worker is exposed at any time. If control measures are not
available during reprocessing involving a chemical agent, air sampling may be required to ensure that the
regulated limit has not been exceeded for the chemical being used.
The health care setting must have air changes, temperature and humidity appropriate to the
process/product being used (refer to manufacturer s recommendations for products and CSA Standards).
In health care settings where there are dedicated central reprocessing areas, negative pressure airflow
must be maintained in soiled areas and positive pressure airflow must be maintained in clean areas and
be monitored.16
Refer to Appendix B, Recommendations for Physical Space for Reprocessing , for specific
information regarding reprocessing area ventilation, temperature and humidity requirements
C. Water Quality
The health care setting should be aware of the quality of its water supply and develop policies to address
known problems. There should be written reprocessing contingency plans in place that address loss of
potable water, boil water advisories and other situations where the water supply becomes compromised.
Refer to Appendix B, Recommendations for Physical Space for Reprocessing , for information
regarding reprocessing area water quality requirements
D. Environmental Cleaning in Sterile Processing Departments
The housekeeping department should consult with the management of the sterile processing department
and infection prevention and control to establish policies and procedures for cleaning practices and
cleaning frequency. As a minimum16:
a) the facility shall have written cleaning procedures with clearly defined responsibilities for all areas
in the facility where decontamination is performed;
b) all work areas, stands, tables, countertops, sinks and equipment surfaces shall be cleaned and
disinfected at least daily;
c) floors shall be cleaned at least daily;
d) if a spill occurs, the affected area shall be cleaned immediately;
e) sinks shall be cleaned each shift at a minimum and more frequently as necessary;
f) sinks used for cleaning endoscopes and respiratory equipment shall be cleaned between each
use;
g) the sequence of cleaning shall be from clean areas to soiled areas, from high areas to low areas
(i.e., top of walls to floor) and from least contaminated to most contaminated;
h) cleaning staff shall not move back and forth between clean and soiled areas; and
i) cleaning equipment used in the decontamination area shall not be used in any other area.
Refer to the MOHLTC s Best Practices for Environmental Cleaning for Prevention and Control of
Infections in All Health Care Settings for guidance regarding cleaning in reprocessing areas,
available at:
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Best Practices for Cleaning, Disinfection and Sterilization in All Health Care Settings February, 2010
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