Manual Cleaning

A manual cleaning log book should be used to establish what each member of staff needs to keep an eye on no matter who is performing the task.

Manual Cleaning Guidance

Manual cleaning is the least effective method of cleaning instruments, the hardest to validate, and caries an increased risk of ‘sharps injury’.

Manual cleaning is still accepted as a method under HTM 01-05 (England), WHTM 01-05 (Wales) and SDCEP (Scotland) allowing you to comply with essential quality requirements.

Manual cleaning is not an accepted method in Northern Ireland (DHSSPSNI) and a Washer Disinfector must be used.

This process should only be considered if you have no alternative cleaning methods available in your practice, or if it has been recommended as the only method of cleaning by a manufacturer.

Manual cleaning must be carried out in dedicated sinks that are not used for any other purpose.

HTM 01-05 2013 Edition, Section 16 contains a detailed protocol for manual cleaning. This should be adapted as necessary to reflect local facilities. It would be beneficial to have a laminated copy of the practice protocol attached to the wall above the manual cleaning area.

Manual Cleaning Brushes

Instruments are to be scrub using long-handled brushes with soft bristles. To minimise aerosol risk, fully immerse the instruments in the solution and keep under water during the cleaning process.

It is important to avoid damage to instruments during the cleaning process. Avoid the use of items that may damage instruments, such as wire brushes.

Brushes ideally should be single use. Where they are reusable, after every use, brushes should be cleaned using hot water and the manufacturers recommended detergent, and stored dry with the head up. When cleaning brushes, before drying, visually inspect the brush to ensure that any visible soil is removed.

Process Temperature & Detergent

Using a mercury-free thermometer, monitor the temperature of the water throughout the cleaning procedure to ensure the temperature of the water is below 45°C.

Cleaning above 45ºC may lead to coagulation of protein, making any deposits even harder to remove. The temperature of the fluid should be as recommended by the detergent manufacturer.

You should only use an enzymatic detergent. Household cleaning products are not suitable as they are not designed to clean surgical soiling.

How is it Done?


Perform hand hygiene prior to donning PPE


Apply PPE – Refer to PPE Protocol for Manual Cleaning


Submerge the instruments with a measured amount of water. Water temperature should be as required for the detergent used, but below 45ºC
Isopharm Tip: Cleaning above 45ºC may lead to coagulation of protein, making any deposits even harder to remove.


Add the amount of detergent for the correct concentration

Isopharm Tip: You should only use an enzymatic detergent. Household cleaning products are not suitable as they are not designed to clean surgical soiling.



Use a thermometer to monitor the process temperature.


Clean the fully submerged instruments, using long handled brushes with soft plastic bristles


Drain any excess cleaning solution prior to rinsing 


Are any further cleaning processes to be carried out?


Yes


No


Go to ULTRASONIC CLEANER or WASHER DISINFECTOR as required


Fill rinsing sink with enough satisfactory potable (drinkable) water to cover instruments, and rinse


Go to Instrument Inspection


Are cleaning brushes reusable?


Yes


No


Wash and store dry, with the head up


Dispose of cleaning brushes


Remove PPE – Refer to PPE Protocol for Manual Cleaning


Complete Logbook record

Page Version 1.0