Clinic Equipment, Instrument Sanitation & Hygiene
Care of Clinic Equipment
The equipment in the Clinic is subjected to long and hard use. Care must be taken to ensure the full life of this equipment.
Any malfunction, breakdown or missing equipment should be recorded on the module repair sheet in the module seminar room. This list is checked daily or repair requests may be emailed to the E-Team at email@example.com. If the equipment breakdown requires immediate attention or is dangerous to the Intern or patient, contact the staff in the Clinic Administration office immediately.
On a daily basis, our equipment and supply maintenance personnel (E-Team) will oversee the following:
- Check each examination room to make sure the necessary equipment and supplies are stocked.
- The supplies and the equipment in both the supply drawer and the glass cabinet in the module seminar room will be checked and restocked. The listing of equipment and supplies for these two areas is also attached.
- The equipment repair list in each module will be checked and the necessary actions taken to correct the problems.
- The senior members of the E-Team are responsible for ordering and maintaining proper supplies of equipment and materials.
Routine maintanence is done peridocially and on an as needed basis. Our E-team is equipped handle routine cleaning and service for:
- Slit lamps
- Examination mirrors
- Keratometers with calibration
- Acuity projectors
Care of Clinic equipment
All persons utilizing Clinic equipment are requested to exercise care and concern in order to reduce equipment malfunction. Student responsibility prior to use of each room:
- The counter tops should be wet or dry-cleaned, ready for the next patient.
- Sterilization of all instruments in contact or near contact with the patient should be cleaned with the OSHA approved solutions, such as Cavicide.
- Check all electrical equipment for operational readiness.
- Check ophthalmic instruments stand for elevation and depression.
- Check ophthalmic chair for elevation, depression and rotation.
- Check projector for focus.
- Check refractor cross cylinders and prisms for alignment.
- Make sure a near point rod is available.
- Check that tonometer mount is secure; check alignment.
- Student responsibility before leaving the room:
- Return refractor lens power to zero and replace dust cover.
- Turn off all electrical equipment and lights (unless otherwise specified for a particular instrument).
- Lower stand and chair to lowest position, lock chair, and turn off all switches.
- Remove near point rod and place on a service cabinet.
- Replace dust cover on every piece of equipment.
- Return any checkout equipment.
- Lock slit lamp base.
- Replace mirror covers.
- At the end of the day a post-sterilization of the room should be done on all instruments.
- Auxiliary equipment should be returned and module equipment such as field testers and auto-refractors should be turned off and covered.
Clinical Faculty responsibility before leaving the room:
- At the close of each Clinic session, the supervising Clinical Faculty member is to survey all rooms used by students in their section. The Clinical Faculty is to counsel and report, if necessary, any clinicians that fail to observe guidelines for care of equipment and facilities.
- DO NOT force a knob or switch or instrument that appears to be stuck. Ophthalmic equipment is made to operate smoothly.
- DO NOT move equipment from room to room. If your room is not functional, report the problem and then move to another room. This is essential to maintain an equipment inventory.
- DO NOT leave instruments on when they are not in use.
- DO NOT leave any room without replacing dust covers.
- DO NOT leave any room until it is clean enough to bring your own patient into the room.
- DO NOT alter the physical location of the exam chairs and stand. Their position must be properly aligned and calibrated to the mirrors.
- DO exercise extreme care in providing your patients with a hygienically safe clinical experience.
- DO wash hands before each patient contact, and as needed during the exam.
- DO replace face and chin shields before each patient or wipe off with an OSHA-approved disinfectant.
- DO cover each chin and/or forehead rest with tissue for the patient.
- DO replace bulbs and make minor adjustments yourself.
- DO inspect your room thoroughly before and after each patient.
- DO make sure all locks and threads are properly disengaged before changing any instrument’s position.
- DO exercise gentle care and concern for Clinic equipment.
- DO sterilize the Goldmann tonometer probe each time after it has been in contact with a patient’s cornea.
- Act accordingly by leaving your room clean and by reporting all malfunctioning equipment immediately.
- DO lock your examination chair. In light of the potential for injury and legal liability, it is essential that ALL EXAMINATION CHAIRS BE MAINTAINED IN A LOCKED POSITION. If you need to rotate the chair, immediately lock the chair after you have turned it.
- DO lock slit lamp to base before covering it.
Equipment and supplies provided in the Clinic (permanent items)
For each exam room
- Slit lamp
- Phoropter with near point rod
- Projector with visual acuity slide or automated projector
- Goldmann tonometer prism and disinfection well
- Sterile swabs
- 3% hydrogen peroxide
- Facial tissues
- Alcohol swab prep
- Sterile saline
- Blinx eyewash
- Fluorescein strips
- Contact lens solutions
- California State Legal DPAs
- Artificial tears
At the front desk
- Supply of alcohol prep pads
- One bulb each for: Slit lamp (Zeiss and Haag-Streit) Acuity projectors (AO-CAX bulb, autoprojectors)
- 60W bulbs
- Supply of fluorescein strips
- Mydriatic specs
- FDT Paper
- Ophthalmic Drugs including cyclopentolate, tropicamide, Fluress, proparacaine
In each instructor’s module (glass cabinet)
- One set of auxiliary lenses
- Cotton balls
- Mallett unit
- Amsler grids
- Dictionary of Visual Science
- Closed loop projector with film loop
Equipment to be purchased by students
Students are encouraged to purchase this equipment during their first or second year. Most items are REQUIRED.
- Ophthalmoscope (direct and binocular indirect)
- Trial frame
- Trial lens kit
- Occluder with Maddox Rod
- Seg. – Height Measure
- Color Vision Test
- Stereo Test
- Pen light
- P.D. rule
- Near point reading cards
- Tape measure (mm. and in.)
- Loose prisms
- Basic dispensing equipment
- Lens for Binocular indirect ophthalmoscope
- Lens guage
- Amsler grids
- Contact lens inspection equipment
- Contact lens modifying equipment
Additional equipment required for third or fourth year:
- Contact lens diagnostic set
Equipment available with at our Eye wear Center for daily check-out
- TIB infinity balance slides
- Hand held Perkins tonometers
- Hand held slit-lamps
- Binocular indirect ophthalmoscopes
- Gonioscopy lenses
- Direct Patient Care Kits
Emergency Kits available in EyeWear Center
- Acute Angle-Closure Kit
Out-of-Clinic use of equipment
Under no circumstances may the School equipment be used by students, staff or Clinical Faculty for personal or off-campus use. In situations where the School is participating officially in a visual screening program, equipment may be loaned for that event at the discretion of Clinic Administration. However, a Clinical Faculty member must be directly involved and personally supervise the transportation, care and use of the equipment. The faculty member must submit in writing the instruments being requested. UNDER NO CIRCUMSTANCES is equipment loaned out for non-University sponsored activities.
Instrument Sanitation and Hygiene
As health care providers, we should be projecting the highest standards of cleanliness and hygiene to our patients. We must follow or exceed minimum standards of sanitary procedures.
Any instrument that is to be used on a patient should be wiped down with alcohol rinsed and dried, at a minimum, or soaked in Cavicide as directed by the manufacturer. This practice should be extended to tonometer probes, hand-held instruments, chin rests, etc. Any of us would be somewhat startled if a dentist or hygienist were to pull an instrument from their pocket that might be contaminated from any number of sources, and then be applied to sensitive areas of our body or mucous membranes.
A clinician should wash their hands in front of the patient several times during the exam. This should be done shortly after greeting your patient and several stages through the exam, particularly where you will be making contact with their eye or appendages.
It is critical that gloves be used, when you feel it is appropriate, due to your own acute health problem or that of the patient.
Specific standards or sanitary protocols, such as the rigorous protocols applied to Dentistry have not yet been set for Optometry. However, it is likely that Optometry will continue to be reviewed in this regard by regulatory agencies and certainly in the perception of our patients.