How to properly wash the refrigerator in medical institutions: products, standards and step-by-step instructions

In medical institutions, refrigerators are used to store medicines, vaccines, biomaterials and food for patients. Their cleanliness directly affects patient safety and compliance with sanitary standards. Unlike household conditions, where ordinary detergents are sufficient, hospitals and clinics require specialized disinfection taking into account strict regulations SanPiN 2.1.3.2630-10 and MU 3.5.1877-04.

Incorrect processing can lead to the growth of pathogenic microorganisms, damage to expensive drugs, or even fines during Rospotrebnadzor inspections. In this article we will look what products are allowed for cleaning refrigerators in medical institutionshow often this needs to be done, and what mistakes staff most often make. We will pay special attention to the nuances of processing refrigerators for storing immunobiological medicinal products (IMP) and blood.

Regulatory requirements for cleaning refrigerators in medical institutions

Disinfection of refrigeration equipment in hospitals is regulated by several key documents:

• 📜 SanPiN 2.1.3.2630-10 —sanitary and epidemiological requirements for organizations engaged in medical activities. Clause 12.6 directly states that refrigerators for storing medicines and biomaterials are subject to SanPiN 2.1.3.2630-10 daily cleaning and weekly disinfection - guidelines for disinfecting surfaces in medical institutions. The exposure time for different types of contaminants is prescribed here. daily cleaning and weekly disinfection.
• 🧪 MU 3.5.1877-04 — guidelines for disinfecting surfaces in medical institutions. Registered here concentrations of disinfectants and exposure time for different types of contaminants.
• 💉 Order of the Ministry of Health No. 646n (from 2012) - rules for storing ILP, which states that refrigerators for vaccines should processed alcohol-containing solutions at least once every 7 days.

Important: if your institution stores blood and its components are required, additionally apply requirements SanPiN 3.5.3327-16, which stipulate separate standards for refrigerators in transfusion departments. For example, after each case of chamber depressurization, unscheduled treatment with a 3% solution of hydrogen peroxide with an exposure of 60 minutes.

⚠️ Attention: Requirements for disinfection may be tightened by regional orders or internal instructions of a medical institution. Always check the local regulations of your hospital!

Violation of these rules is fraught with:

• 🦠 Development Listeria monocytogenes or Pseudomonas aeruginosa bacteria resistant to many antiseptics and dangerous for weakened patients.
• 💰 Fines from Rospotrebnadzor (up to 50,000 rubles for gross violation of sanitary legislation under Article 6.3 of the Code of Administrative Offenses of the Russian Federation).
• 🚨 Suspension of the activities of the department or the entire medical institution for repeated violations.

Approved detergents and disinfectants

Not all household detergents are suitable for medical refrigerators. Only certified disinfectants those with confirmed activity against viruses, bacteria and fungi are allowed in medical institutions. Here is the approved list:

For refrigerators with vaccines (for example, ILP-refrigerators "Birus" or "Dometic") it is recommended to use 70% ethyl alcohol or specialized tools like "Septodore Forte". They do not damage seals and do not leave marks, which is critical for equipment with precise temperature conditions.

Strictly prohibited:

• 🧼 Household Fairy, Mr. Muscle —do not have a virucidal effect.
• 🧽 Abrasive powders (Pemolux) - scratch internal surfaces.
• 🌿 Natural remedies (vinegar, soda) - ineffective against Clostridium difficile i norovirus.

Step-by-step instructions for cleaning a refrigerator

The process of cleaning a medical refrigerator consists of 5 mandatory steps stages. Skipping any of them can negate the entire disinfection.

1. Preparation:
   • 🔌 Unplug the refrigerator (unless it is a medical refrigerator with backup power).
   • 📦 Remove all contents, placing medications in thermal containers with cold elements.
   • 🧤 Wear protective equipment: gloves, mask, apron.
2. Preliminary cleaning:

   Remove visible dirt with a damp cloth with soapy water (for example, 0.5% solution of laundry soap). Pay special attention to:

   • 🧊 Drainage hole (located at the back or on the back wall).
   • 🔄 Sealing gum - it needs to be cleaned with a toothbrush, soaked in a disinfectant solution.
   • 📦 Shelves and containers (remove them and wash separately).

Disinfection:

Apply the disinfectant solution (see table above) to all internal and external surfaces. Use fine spray spray. Exposure time is not less than that specified in the instructions for the product!

Rinsing:

After disinfection, wipe the surfaces with clean water (for chlorine-containing products) or 70% alcohol (for HOURS). will remove residual disinfectant that can damage the seals.

Drying and turning on:

Dry the refrigerator clean paper towels or leave the door open for 15-20 minutes Only after complete drying, return the medications and turn on the power.

Make sure the refrigerator is unplugged|

Prepare thermal containers for temporary storage of medicines|

Check the expiration date of the disinfectant|

Wear personal protective equipment (gloves, mask)|

Prepare labels to mark the cleaning date-->

For refrigerators with a system NoFrost (for example, Liebherr MKes 4310), cleaning the ventilation grilles is mandatory special brushas dust and condensation accumulate there - an ideal environment for mold.

⚠️ Attention: If blood, urine were stored in the refrigerator biological fluids after disinfection, be sure to carry out efficiency control using test strips for residual chlorine or a fluorescent lamp for HOUR.

Errors when washing refrigerators in medical institutions

Even experienced medical personnel sometimes make mistakes that are nullified all efforts to disinfect. Here are the most common:

• 🕒 Failure to comply with the exposure time. For example, if the instructions for Virkon indicate 30 minutes, and you wipe the surface for 5 minutes, the bacteria will survive.
• 🧴 Use of expired disinfectants. The shelf life of an open solution is only 7 days! data-i="196">Use the same cloth for all surfaces. Whiteness - only 7 days!
• 🧽 Use the same cloth for all surfaces. This leads to cross contamination.
• ❄️ They forget about the freezer. In medical refrigerators (for example, Sanyo MPR-215F), the freezer is often used to store plasma - it also needs to be disinfected!
• 📝 Lack of a cleaning log. Without records, it is impossible to confirm compliance with standards during inspection.

Another critical error - ignoring the sealing gum. According to research, on the rubber seals of refrigerators in 80% of cases are found Staphylococcus aureus and Escherichia coli. You need to clean them toothbrushmoistened in 3% peroxide hydrogenand then wipe 70% alcohol.

What will happen if you do not wash the drainage hole?

Condensation with organic residues accumulates in the drainage hole, which leads to:

1. Development black mold (Aspergillus niger) —its spores can cause aspergillosis in immunocompromised patients.

2. Clogs and leaks - water will accumulate at the bottom of the refrigerator, creating puddles with a high concentration of microbes.

3. Unpleasant odor that can be absorbed into medications (especially critical for injectable drugs).

Features of caring for different types of medical refrigerators

Refrigerators in medical institutions are divided into several categories, and each has its own cleaning nuances:

For refrigerators with a remote temperature monitoring system (for example, B Medical Systems) you cannot use aggressive products that can damage the sensors. In this case, suitable 0.5% solution HOUR or hydrogen peroxide.

If your institution uses cryogenic equipment (for example, for storing stem cells at −150°C), its disinfection is carried out only by specialized services using ozone gas or formaldehyde vapor.

How to check the effectiveness of disinfection

Just washing the refrigerator is not enough - you need to confirm that the treatment was successful. The following control methods are used in medical institutions:

• 🔬 Microbiological culture. Wains from surfaces are taken for CCHABP (Escherichia coli), Staphylococcus aureus and Pseudomonas aeruginosa. Norm: no more than 1 CFU/cm².
• 🧪 Test strips. For chlorine-containing products - strips "Aquachlor", for HOURS - "Quattest".
• 💡 Luminescent control. After processing HOUR surfaces are illuminated with a UV lamp: if there are untreated areas left, they will glow.
• 📊 Log keeping. Fix the date of cleaning, the product used, the name of the person responsible and the results of the control.

For refrigerators with vaccines additionally carry out thermography after disinfection to make sure that the treatment has not damaged the thermal insulation. For example, if after washing 70% alcohol the seal has lost elasticity, this can lead to violation of the temperature regime and spoilage of drugs.

If microbiological parameters are exceeded:

1. Repeat disinfection with a 2-fold increase in exposure time.
2. Replace the disinfectant with a stronger one (for example, with chlorine-containing peroxide).
3. Notify the sanitary and epidemiological service of the institution for an unscheduled inspection.

How to wash the refrigerator in the treatment room or dressing room

Refrigerators in treatment rooms and dressing rooms are in contact with blood, pus and other biological fluids, therefore, particularly strict requirements are imposed on their processing. Standard disinfection is not enough here - it is required to use complete. sanitary treatment using funds virucidal and sporocidal actions.

Recommended algorithm:

1. Immediate treatment when contaminated. If blood gets on the shelf, immediately wipe the area 3% chloramine solution with an exposure of 60 minutes.
2. Daily disinfection. Use 0.5% solution "Septodora" or 1% solution of "Virkon".
3. Weekly general cleaning. Disassemble the refrigerator (remove shelves, drawers), soak the parts in the disinfectant solution, then rinse under running water.

For such refrigerators (for example, Indel B Medical) it is necessary to:

• 🩸 Use disposable napkins for cleaning - reusable rags can become a source of infection.
• 🧤 Change gloves after each stage of processing.
• 📋 News separate journal indicating the type of biomaterial that was stored in the refrigerator.

⚠️ Attention: If materials from patients were stored in the refrigerator with hepatitis B/C or HIV, after disinfection, be sure to carry out steam treatment at +100°C for 30 minutes or use formaldehyde gas.

FAQ: Frequently asked questions about disinfecting refrigerators in medical institutions

Can household bleach be used for cleaning medical refrigerator?

Yes, but only if it contains at least 5% active chlorine (indicated on the label). Dilute it to concentration 0,1–0,2% (approximately 10–20 ml per 1 liter of water). However, for refrigerators with vaccines, it is better to choose specialized products without chlorine, for example Septodor.

How often should you wash the refrigerator at the pharmacy?

According Order of the Ministry of Health No. 646n, refrigerators for medicines in pharmacies are washed daily (wet cleaning) and disinfected once every 7 days. If stored immunobiological preparations, disinfection is carried out 2 times a week.

How to treat the refrigerator after spilling blood?

First remove the blood with a cloth soaked in 3% hydrogen peroxide. Then wipe the surface 0.5% chloramine solution (exposure 60 minutes) or 1% Virkon solution (exposure 30 minutes). After this, rinse with clean water and dry.

Is it possible to use a steam cleaner for disinfection?

Yes, but only if the refrigerator non-electric (for example, thermal containers). For electric models, steam may damage seals and electronics. An alternative is ultraviolet lamps (for example, "Desar"), but they are effective only with direct irradiation of surfaces.

Is it necessary to disinfect a new refrigerator before first use?

Absolutely! Even a new refrigerator could be contaminated during transportation or storage. Rinse it 0.1% Deochlor solutionthen wipe 70% alcohol and ventilate for 2 hours.