INTRODUCTION

Background

The disinfection of acrylic monoplace chambers is done with caution because many commercial biohazard-cleaning agents contain alcohol. While alcohol is adequate to kill many pathogens, it is destructive to acrylic and can produce flammable fumes and vapors creating a fire hazard in the chamber and the immediate area. Therefore, only manufacturer approved cleaning products are used for disinfection of the hyperbaric chamber and accompanying equipment. Manufacturer approved cleaning products that contain bleach solution will be used for surfaces contaminated with clostridium difficile (C-Diff). See topic "To treat or not treat a patient with C. Diff: That is the Question".

Each cleaner or disinfectant has a material safety data sheet (MSDS) that contains information regarding safe handling and use of the solution; refer to it as necessary. Particular cleaning and disinfecting tasks are divided among staff from environmental services, equipment or biomedical device services, respiratory services, nursing, and other departments of the health care team.

EQUIPMENT

• Manufacturer approved -Environmental Protection Agency (EPA)–registered Facility-approved disinfectant. May come in form of a wipe or liquid.
• Gloves
• Personal Protective Equipment as needed
• 100% cotton, lint free cloth (pillow case) or 100% cloth baby diaper

Caution:

• Wipe the outer cylinder with soft, 100% cotton, lint free, water moistened cloth, daily and as needed to maintain free of dust. 
• Avoid abrasion of the polished Acrylic Cylinder during cleaning. 
• Do not use oil, oil based solutions or alcohol based substances on the Acrylic Cylinder. 
• Do not allow water to accumulate on the bottom of the chamber while cleaning. The water could drain into and contaminate the supply piping system.
• Clean up any spills as soon as possible. 
• Follow the manufacturer's recommendations for dilution, material compatibility storage, shelf life, and safe use and disposal of each disinfectant. 

After each HBO patient treatment:

• Gather appropriate supplies and equipment 
• Perform hand hygiene.
• Put on gloves and other personal protective equipment, as needed.
• Inspect the chamber and equipment for breaks in integrity that would impair cleaning and disinfection; if the integrity is compromised, report to the Safety Officer and Nurse Manager immediately.

Cleaning the chamber:

• After each patient treatment, use a manufacturer approved cleaning product. 
• Staff to lie on cart and roll into the chamber. Once inside, clean the foot plate and all internal surfaces with the cleaning solution wipe or dampened towel. Remember to clean the bottom of the chamber beneath the cart as water from the patient’s water bottle may collect here if it has leaked.
• Clean the entire Gurney, to include stretcher, mattress surfaces, rails and handles
• Ensure proper contact time of “kill time” is observed for manufacturer approved chamber cleaners 
• If linen was used to disinfect the patient care equipment, place it in a laundry bag for laundering. If a disposable cloth or wipe was used, dispose of it in the appropriate receptacle.
• Remove and discard gloves and other personal protective equipment, if worn.
• Perform hand hygiene.
• Novus Polish #1 is to be used to polish the chamber acrylic surfaces as needed (consider monthly). Novus Polish #2 is to be used to eliminate minor scratches on the acrylic surfaces.

SPECIAL CONSIDERATIONS

• If potential for infectious material or condition is present, use manufacturer approved disinfectant cleaner, allowing for the required drying time “kill time”.
• If potential or actual contamination with Clostridium Difficile (C-Diff) is present, use Sani-Cloth Bleach Wipes or other manufacturer approved disinfectant cleaner, allowing for the required drying time.
• After use on patients with infectious conditions / indications, disinfect the chamber and equipment with the appropriate HBO approved disinfectant, and then purge the chamber at 3.0 ATA for 15 minutes. Purging will remove any latent odors.

WHEN CHAMBER NOT IN USE

• Keep chamber covered with clean blanket
• Keep chamber door closed 
• Do not place or store item on or around the chamber that could fall onto or damage the acrylic

COMPLICATIONS

• Improper technique may lead to transmission of pathogens to other patients and subsequent infection.
• If disinfecting agent comes in a spray bottle, do not take bottle into the  chamber and spray directly onto the chamber surface. Spray the disinfectant into a 100% cotton linen such as a pillow case or baby diaper to avoid inhalation of substance.

DOCUMENTATION

• Document on daily chamber check list