2-25. HOW ARE GLASS THERMOMETERS DECONTAMINATED?

Glass thermometers must be cleaned and decontaminated before they can be reused. If thermometers were not decontaminated before being reused, then they could transfer disease from one patient to another patient. The procedures for cleaning and decontaminating thermometers are governed by local SOP. If thermometers are to be sterilized by the Centralized Materiel Section (CMS), an element of the Department of Nursing in the hospital, they should be washed with soap and cold-water pads before they are sent to the CMS. However, if your unit is responsible for cleaning and decontaminating the thermometers, you should follow the instruction given in your local SOP. The instructions given below are typical of such instructions.

a. Gather Materials. You will need the following:

(1) Thermometer tray with marked containers (one "clean" and one "used").

(2) Covered oblong basin in which thermometers can lie flat, such as a catheter tray.

(3) Disinfecting solution, such as Wescodyne®.

(4) Soapy solution or germicide, such as providone-iodine (Betadine®).

(5) Gauze pads.

(6) Paper towels.

(7) Two containers for gauze pads.

(8) Tray (15" X 9" X 2") to carry the above items, if appropriate.

(9) Water source (cool and hot water).

(10) Waste container.

b. Prepare Disinfecting Equipment. Set up your equipment similar to the setup shown in figure 2-16.

A 15" X 9" X 2" tray.

B Covered basin containing disinfecting solution.

C Container with gauze pads soaked in soapy solution or germicide.

D Container with gauze pads soaked in cool water.

E Thermometer tray with "clean" and "used" thermometer containers.

Figure 2-16. Tray set up for disinfecting glass thermometers.

(1) Put the thermometer tray with "clean" and "used" containers and thermometers on the large tray.

(2) Pour the disinfecting solution into the basin until the basin is two-thirds full.

(a) The disinfecting solution may have to be mixed before pouring into basin. If so, follow the instructions on the label.

(b) The basin may already contain disinfecting solution. The solution may be used if it has not already been used to disinfect thermometers and if the solution has not been standing in the basin for more than 24 hours. Check your local SOP for additional information.

(3) Put gauze pads into the two containers.

(4) Pour the soapy solution or germicide into one of the containers so that all of the gauze pads in the container are soaked.

(5) Pour cool water into the other container so that all of the pads in that container are soaked.

NOTE: Containers with soaked gauze pads may already be on the tray.

c. Clean Thermometers. Thermometers are cleaned one at a time. All of the thermometers should be either oral thermometers or rectal thermometers. If a thermometer tray contains both oral and rectal thermometers, they must be placed in separate basins.

(1) Grasp the stem end of a thermometer and remove it from its container.

(2) Read the thermometer. If the thermometer reads 94.0º F (34.4º C) or higher, shake down the thermometer.

(3) With your free hand, pick up a gauze pad saturated with the soapy (or germicide) solution.

(4) Wrap the gauze pad around the thermometer near the stem end.

(5) Wipe the thermometer with a single downward twisting motion. Be sure to wipe the bulb since most of the contamination is in the bulb area. Do not retrace or backtrack since moving from bulb end toward stem end could contaminate the area of the thermometer that you have just wiped.

(6) Drop the gauze pad into the waste container.

(7) Pick up a gauze pad saturated with cool water.

(8) Wrap the gauze pad around the thermometer near the stem end.

(9) Wipe the thermometer with a single downward twisting motion. Do not retrace or backtrack.

(10) Drop the gauze pad into the waste container.

(11) Carefully, place the thermometer in the oblong basin. Do not drop the thermometer or splash the disinfecting solution.

(12) Repeat these procedures until all of the thermometers have been placed in the basin to soak. As you put the thermometers in the basin, place the thermometers so that the bulbs all point in the same direction.

d. Disinfect Thermometers. After all of the thermometers have been placed in the basin, make sure that the thermometers are completely covered by the disinfecting solution. Add additional solution if necessary. Then cover the basin and allow the thermometers to soak in the disinfecting solution for the proper amount of time. The amount of time may vary depending upon the solution used, but they must soak for at least 30 minutes. Check your local SOP for the time that the thermometers are to be left in the solution.

e. Clean Thermometer Containers. While the thermometers are soaking in the disinfecting solution, clean the two thermometer containers.

(1) Wipe the inside and outside of one container with the gauze pads that were soaked in the soapy (or germicide) solution.

(2) Drop the used pads into the waste container.

(3) Rinse the container with hot water.

(4) Dry the holder with a paper towel.

(5) Drop the paper towel into the waste container.

(6) Check the label on the container (the "clean" label or "used" label) to ensure that it is still in place.

(7) Put the container back in the thermometer tray.

(8) Repeat the above steps to clean the second container.

(9) Fill the container marked "used" two-thirds full with cool water.

f. Wash Hands. Perform a patient care hand wash.

g. Change Disinfecting Solution. After the required time for disinfecting the thermometers has passed, carefully pour the disinfecting solution from the basin into the sink. Then add new disinfecting solution to the basin. Make sure that the new solution covers the thermometers completely. (This new solution will remain in the basin after the thermometers are removed. The solution can be used to disinfect the next group of thermometers. If no thermometers are disinfected within 24 hours, discard the solution and make a new solution when needed.)

h. Rinse and Replace Thermometers in Container. Thermometers are removed from the basin, rinsed, and placed in the "clean" container one at a time.

(1) Pick up a thermometer at the stem end and lift it out of the disinfecting solution.

(2) Pick up a gauze pad that was soaked in cool water.

(3) Wipe the thermometer completely with the gauze pad. Begin at the stem end and proceed toward the bulb. Wipe the bulb thoroughly. All of the disinfecting solution must be removed because some patients are allergic to the solution.

(4) Drop the gauze pad into the waste container.

(5) Dry the thermometer (stem end to bulb) with a dry gauze pad or paper towel.

(6) Place the thermometer (bulb end down) into the container marked "clean." Make sure that oral thermometers and rectal thermometers are not placed in the same container. The thermometers are now ready for reuse.

i. Return Materials. Return disinfecting supplies to their proper storage place (see your SOP). Deliver the thermometer tray to the appropriate location so that it can be used (see your SOP).

Continue with Exercises