Ophthalmology Device Reprocessing: Aligning with the Spaulding Classification

Session Description: Ophthalmology devices that contact the ocular surface, a mucous membrane, are considered semi-critical devices and minimally require high-level disinfection according to the Spaulding Classification. The Spaulding Classification categorizes devices into 1 of 3 categories based on the level of risk of infection when used in patient care and based on the infection risk level, provides the minimum level of disinfection or sterilization required. Manufacturers of these diagnostic devices commonly list alcohol, or another disinfectant not considered a high-level disinfectant, as an approved disinfectant in their instructions for use (IFUs) section on cleaning and disinfection. Alcohol is also routinely used in clinical practice to disinfect diagnostic equipment, such as tonometer tips, ultrasound probes, and diagnostic lenses. Since outpatient ophthalmology clinics are not usually associated with a hospital or health system, the providers, technicians, and other clinical staff are not trained to and do not have infection prevention resources to identify gaps between IFUs and the Spaulding Classification for appropriate device reprocessing. A systemic practice shift is necessary to not only meet regulatory requirements of appropriate reprocessing but to also ensure the highest level of patient safety and prevent the transmission of pathogens. This presentation will teach the infection preventionist to identify and address gaps in their scope of practice by collaborating with their ophthalmology department and central sterile processing department. An overview of common diagnostic devices used in ophthalmology clinics will be provided before going in-depth on a change management roadmap to transition semi-critical devices from low-level disinfection to high-level disinfection, and identify the process from point-of-use through reprocessing. The roadmap developed and utilized by ophthalmology clinic staff and leadership, central sterile processing technicians, and infection preventionists may be applied to other outpatient ophthalmology settings and among ophthalmology consult services in the inpatient setting.