Summary of evidence-based best practice guidelines relating to nebuliser hygiene in CF
| New nebuliser parts should be washed and disinfected before first use (recommendation 2) During hospital admission and at home, wash the nebuliser parts after each use (recommendation 3) Nebulisers should be washed and re-disinfected immediately prior to use after greater than 24 h of inactivity (recommendation 4) | |
| At-home recommendations | Inpatient recommendations |
| Wash hands thoroughly with soap and water and use hand disinfector gel before starting the cleaning process (Recommendation 1) | Wash hands thoroughly with soap and water and use hand disinfector gel before starting the cleaning process. |
| Gloves should be worn by healthcare professionals with hand hygiene performed after removal of gloves (recommendation 1) | |
| Disconnect nebuliser from the compressor unit and dissemble into constituent components (recommendation 11) | Disconnect nebuliser from the compressor unit and dissemble into constituent components (recommendation 11) |
| Washing Wash nebuliser components in a solution of warm tap water (recommendation 12) and dishwashing liquid in accordance with the detergent manufacturer's guidance (recommendation 14) | Washing Wash nebuliser components in a solution of warm tap water (recommendation 12) and dishwashing liquid in accordance with the detergent manufacturer's guidance (recommendation 14) |
| Location Do not wash nebuliser parts directly in kitchen or bathroom sinks (recommendation 8) or the dishwasher (recommendation 9) This should be done in a dedicated plastic, glass or metal bowl in the patients' kitchen (recommendation 10) | Location This should be done in a disposable bowl, metal bowl or basin (not directly in a sink; recommendation 5) in the patients' room (recommendation 6) |
| Rinsing Sterile water must be used during a final rinse when immediate disinfection is not possible (recommendation 13) | Rinsing Sterile water must be used during a final rinse, when immediate disinfection is not possible (recommendation 13). |
| Disposal of waste water Disposal of waste water should be via the toilet, ensuring the toilet lid is closed prior to flushing (recommendation 17) | Disposal of waste water Metal bowl and waste water should be sent to the ward sluice (recommendation 15). Waste water should be disposed of here and the metal bowl should be sterilised by autoclaving (Recommendation 16). |
| Disinfection Washed and rinsed nebulisers should be disinfected after each use (recommendation 7) using an electric baby bottle steam disinfector, (recommendation 18) | Disinfection Washed and rinsed nebulisers should be disinfected immediately after each use (recommendation 7) using an electric baby bottle steam disinfector (recommendation 18), or reusable nebulisers may be autoclaved, where the nebuliser manufacturer states that the device can be safely autoclaved (recommendation 19) |
| Storage Leave the disinfected nebuliser parts undisturbed in the disinfector until the next use (within 24 h) Should the parts be disturbed (i.e. lid lifted off for any reason) then the disinfection process should be repeated and the parts left undisturbed until the next use (within 24 h) (recommendation 20) | Storage Leave the disinfected nebuliser parts undisturbed in the disinfector until the next use (within 24 h) Should the parts be disturbed (i.e. lid lifted off for any reason) then the disinfection process should be repeated and the parts left undisturbed until the next use (within 24 h) (recommendation 20) |
| After disinfection Wash hands thoroughly with soap and water, and use hand disinfector gel after the cleaning and disinfection process prior to reassembling the nebuliser device (recommendation 1) | After disinfection Wash hands thoroughly with soap and water, and use hand disinfector gel after the cleaning and disinfection process prior to reassembling the nebuliser device (recommendation 1) |