1.40 Cleaning & Changing Of Patient Care Equipment
Category: UWHC Patient Care Policy
Effective Date: December 21, 2016
Manual: Respiratory Care Services
Section: Aerosol Therapy
Respiratory Therapy (RT) equipment needs to be changed and cleaned at regular, specified,
predetermined intervals to minimize nosocomial infection and equipment malfunction.
A. All patients receiving therapy or a diagnostic procedure shall use only "CLEAN" equipment.
"CLEAN" is defined as previously cleaned, sterilized, or disinfected with a bactericidal agent or
B. Intervals for equipment change shall be based on published Centers for Disease Control and
Prevention (CDC) guidelines; institutional standard established by monitoring and surveillance
and/or published research.
C. A PSN and an Equipment Malfunction Form will be filed for all equipment that fails to function
correctly while on a patient.
D. Clean equipment spiked with sterile water must be used within 24 hours.
E. Patients no longer requiring the use of equipment should have an order to discontinue therapy.
The equipment should be removed from the patient’s room within 4 hours.
F. All disposable RT supplies shall be disposed of in the patient’s room.
G. All high touch surfaces on durable equipment (e.g. ventilators, non-invasive machines) will be
cleaned daily between the hours of 000 pm and 0400 pm, and as needed, by RT staff using
Saniwipe Towelets. The cleaning will be documented in Health Link in the equipment change
All durable Respiratory Care equipment
A. All equipment requiring decontamination will be exchanged according to the following schedule
or when obviously soiled or broken. (See related link.)
B. Properly remove liquid from the soiled equipment prior to discarding.
C. Equipment will be taken to designated soiled utility rooms and placed in labeled bins for RT
equipment. Dirty RT bins will be checked by Respiratory Therapy Assistants (RTA) and taken
to Materials Management Reprocessing (MMR). (See related link for bin locations).
D. Durable medical equipment (electrically or battery powered) may be wiped down with hospital
grade antimicrobial disinfectant between patients. This equipment must be returned to the
Respiratory Equipment Center for preventative maintenance at the frequency noted on the
maintenance tag containing manufacturer recommendations.
A. RC Department P&P #1.59 “Equipment Quality Assurance.”
B. UWHC P&P # 12.24 “Electrical Safety.”
C. UWHC P&P # 12.06 “Medical Equipment Management Plan
D. UWHC P&P # 13.20 “Cleaning, Disinfection & Sterilization of Patient Care Instruments and
E. CDC Guidelines
Approved by Director and Medical Director of Respiratory Care: