Facility Cleaning and Decontamination for HDs
Cleaning in an HD facility is a layered process, and questions test whether you know which layer does what. Deactivation chemically alters the drug to a less hazardous form; decontamination removes residual drug; disinfection kills microorganisms; and cleaning removes visible soil. These are not interchangeable, and the order matters: deactivate and decontaminate before disinfecting, and always clean from clean to dirty areas.
The candidate should know that HD surface contamination is widespread even when spills are not visible, so routine decontamination of work surfaces, floors, and equipment is expected. Spill kits must be available and stocked; a spill is handled by containing it, donning appropriate PPE, absorbing the material, cleaning with a compatible agent, and disposing of waste per policy.
Traps to watch: (1) treating a disinfectant as a deactivator - many disinfectants do not neutralize HDs; (2) assuming alcohol alone decontaminates all surfaces; (3) forgetting to clean the exterior of vials, bags, and pumps before they leave the hood; (4) skipping documentation of cleaning frequency and agents used. Questions may ask which agent or step comes first - anchor to the principle that chemical neutralization precedes microbial kill.
Worked example: a tech notices a powdery residue on the BSC work surface after compounding. The correct sequence is to don PPE, deactivate/decontaminate the surface with the facility's approved agent, then disinfect, then document. Rule of thumb: if the question asks about removing drug residue, choose decontamination; if it asks about killing germs, choose disinfection.