Lindsey Ebbs Podiatry - Insights

How do we sterilise the instruments we use in clinic

Infection control is something Podiatrists alongside all the medical profession take very seriously. Reducing the transmission of microorganisms like bacteria, viruses and fungal infections is paramount for the safe treatment of patients attending our clinic.

Podiatry instruments are what we use on a daily basis for nail cutting, ingrowing toe nails and callus removal alongside other procedures. The recommended guidelines set out for us by our regulatory body regarding infection control procedures involving decontamination and sterilisation of instruments are strictly adhered to by us in clinic in the prevention of infection

The stages of decontamination and sterilisation and what happens to the instruments after they have been used in clinic are as follows;


1

The instruments are thoroughly scrubbed with a brush in water, ensuring the crevasses of the instruments are cleaned of any residual debris.


2

They are then placed into an ultrasonic cleaner for 15 minutes with a detergent specifically for instruments, the debris that may be present on the instruments, drops to the bottom of the ultrasonic machine.


3

Instruments are then rinsed in clean water to remove any detergent residue.


4

They are removed from the water onto dry paper towels and covered until the instruments are dry.


5

A Verify protein test is used to detect any residual protein (blood) that might have been left on the instruments after the previous stages of decontamination, making sure the instruments are clean prior to sterilisation. The crevices of the instruments are swabbed and then the swab is placed in the protein test vial. If there was any protein detected, the liquid in the vial would turn blue confirming the instruments would need to be re- cleaned. No change in the colour of the vial means there is no protein present on the instruments and they are decontaminated and ready for the next stage of sterilisation


6

The instruments are then placed into vacuum pouches ready for the sterilisation stage.


7

The autoclave is tested daily prior to any instrument sterilisation cycles. This is achieved by placing a Bowie- dick test in the centre of the autoclave and the specific cycle is set off. This test confirms that the machine is reaching the correct temperature and steam levels by the bowie- dick test turning a black colour, indicating a successful cycle, the machine is now ready to sterilise the instruments.

8

The instrument pouches are placed into the autoclave and set off on a cycle that will reach a temperature of 134 °C degrees for 4 minutes which is the recommended time and temperature acceptable for the vacuum instrument sterilisation process. Thermal print outs and a internal USB records every cycle the machine completes.


9

Traceability of instruments is very important, for every set of instruments the cycle number is recorded on each set and dated as they have to be used within 21 days after sterilisation. When the instruments are used in clinic the set number is recorded onto the patients’ medical notes. Any instruments can be tracked back to the patient, the date they were used, the cycle number and whether that decontamination process and sterilisation process was completed and successful. All autoclave paper print outs are kept, photocopied and stored for 8 years as well as a digital record from the autoclaves removable USB.


Hopefully this explanation of the process of decontamination and sterilisation of our clinic instruments is simple to understand and also reassuring in that all the instruments we use in clinic have gone through this very strict and rigorous process?

Please do contact us if we can be of any more help on this matter


About the author

Lindsey Ebbs

Bsc, Pod, Med, MChs MCPod

Lindsey qualified in 1988 from Durham School of Podiatry as a State Registered Chiropodist. Lindsey then returned to Durham in 1993 and qualified with a BSc in Podiatric Medicine.

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After working in a private practice in Guisborough and briefly for the NHS, Lindsey set her own practice up in 1989 at Mulgrave place, Whitby. Two years later Lindsey moved to Hunter Street and developed the Hunter Street Podiatry practice for 23 years before moving to the Green Lane Centre in 2013.

When fundholding for GP practices was introduced in 1991 Lindsey was asked to set up a six month pilot Podiatry scheme for Egton Medical Practice to see if it could be rolled out nationally. It was so successful Lindsey stayed for Eight years! These clinics are now present in most GP practices all over the country.

Lindsey specialises in Biomechanics (Musculo- Skeletal Care) with Prescription Orthotics, helping patients with painful joints/muscles and sports people to achieve their full potential of movement.


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