I was almost done with my mock OSHA inspection in an OB/GYN office, and the last section of my survey covered decontaminating and disinfection.
One of the physicians was leaving an exam room holding a metal vaginal speculum in a paper towel. I could not believe what I was seeing! Luckily I didn’t collide with him, but I saw him soon enough to follow up on my concern.
But before that, I immediately conferred with the office manager to see exactly how the practice handled this issue. I found out that the physicians always wrapped the vaginal specula in paper towels and dumped them in/on the sink. Whoever had free time washed them with soap and water, using a brush to remove the debris. The specula were then placed on the autoclave tray to be processed.
On other mock inspections, I have seen staff members carry the vaginal specula out of the exam room in a dishpan, no lid, no soaking solution.
Believe it or not, I have heard that some practices have actually placed the washed specula in the break room dishwasher !
OSHA regulations clearly define vaginal secretions as OPIM (other potentially infectious material) therefore specific decontamination policies must be followed.
These are the guidelines I have implemented for my clients using metal vaginal specula:
- These devices are classified as “semi-critical” and should be autoclaved if possible.
- If the practice does not have an autoclave, use a high level disinfectant.
- In the exam room/procedure room where this examination is performed there must be a covered container ready and available for the dirty specula.
- A detergent solution/enzymatic cleanser should be in the transport container. This will help to loosen the bioburden prior to cleaning.
- After the procedure, place the specula in the container, close the lid, and transport to the decontaminating area.
- The staff member should don gloves, or other PPE if sprays and splashes are anticipated and wash the specula using a brush while holding the instrument under the water in the cleansing solution. Rinse well under running water.
- Dry the specula and proceed to sterilize in an autoclave or follow the manufacturer’s instructions for high-level disinfection.
- If you are using Glutaraldeyde, comply with the required OSHA regulations for vapor levels, eye wash stations, PPE, and room air exchange recommendations.
- Once the specula have been disinfected, store it in a clean, dry area, not in a drawer with dust balls, staples, or thumb tacks!