2.3 Cleaning & Disinfecting Contaminated Tools, Pedicure Equipment & the Daily Workstation

The Three Targets on the PSI Outline

PSI's Domain 1 asks you to know the methods and procedures for cleaning and disinfecting three kinds of things: contaminated tools, machines and equipment, and the daily workstation. Colorado's Rule 1.7 supplies the legal requirements. The textbooks PSI uses supply the step-by-step procedures. Keep the two separate in your head: on the theory test you will be asked for the correct procedure, and in a Colorado salon you will be inspected against the rule.

What Colorado Rule 1.7(B) Requires

Licensees must clean and disinfect:

1. equipment, tools, implements and supplies, so that clean and disinfected implements are ready before each client's service;
2. common work areas and equipment at least daily, including chairs, treatment tables and nail stations, according to the manufacturer's instructions;
3. soiled or contaminated tools, implements and supplies before use on each client and at the end of each day;
4. all non-porous items, including multi-use items, before use, and equipment used on multiple clients between each client;
5. non-electrical items such as pushers, nippers and plastic or metal spatulas, according to the manufacturer's instructions;
6. electrical items, including nail files (electric files), according to the manufacturer's instructions; and
7. all pedicure bowls according to the manufacturer's label before each client.

Colorado defines the disinfectant as an EPA-registered bactericidal, viricidal and fungicidal disinfectant approved for use in hospital settings, used at the label's dilution ratio and contact time. A UV light box does not count, and the rules state that sterilization is not required.

Procedure 1: Contaminated Multi-Use Tools

Use this sequence for metal pushers, nippers, clippers, metal or glass files, plastic spatulas and similar non-porous implements:

1. Remove debris. Brush away nail dust, product and skin.
2. Clean. Wash with soap or detergent and warm water, scrubbing hinges and serrations with a clean brush. Colorado defines cleaning as removing visible debris so the item is ready for disinfection, and notes that cleaning alone "does not make multi-use items safe for use."
3. Rinse and dry. Water left on the tool dilutes the disinfectant.
4. Disinfect. Fully immerse the tool in the disinfectant, or keep it wet with a spray or wipe the label allows, for the entire contact time. Joints must be open and nothing may stick out above the liquid.
5. Remove without recontaminating. Use clean tongs or clean, gloved hands.
6. Rinse if the label says to, then dry with a clean towel.
7. Store in a clean, covered container labeled "disinfected," "ready to use" or "clean" (Rule 1.7(D)(5)).

Used tools wait in a closed, covered, clearly marked container with solid sides that can itself be disinfected and is disinfected daily. They may never go into clothes, aprons, pockets, bags or holsters (Rule 1.7(D)(6)).

Why Cleaning Must Come First

Organic matter such as skin cells, oils, product residue and blood does two things to a disinfectant. It physically shields microorganisms underneath it, and it can react with and use up the active ingredient. A disinfectant label's efficacy claims assume the item was pre-cleaned, so skipping step 2 is an exam trap and a real-world failure.

Procedure 2: Machines and Equipment

Disinfected electrical items cannot go into a closed "clean" container if they have a cord. Store them on a clean stand or hook, or on a clean towel covered with a clean paper or cloth towel (Rule 1.7(D)(5)).

Pedicure Equipment: Types and Risks

• Whirlpool (piped) spas circulate water through hidden pipes and jets. The plumbing gives debris and biofilm a place to collect where you cannot scrub.
• Pipeless units use a removable impeller or jet in the bowl with no internal pipes, so every surface can be reached.
• Non-whirlpool basins and portable tubs are the simplest to clean.
• Disposable liners are discarded after each client. Follow the bowl manufacturer's label for what cleaning is still required underneath.

Biofilm is a colony of microorganisms living in a sticky, protective matrix that attaches to wet surfaces such as pipes, jets and screens. Disinfectants struggle to reach organisms inside it. Mycobacterium fortuitum, an environmental bacterium, can live in pedicure-spa biofilm. In 2000, an outbreak linked to whirlpool footbaths at one California salon gave more than 100 clients painful boils on their lower legs. Many had shaved their legs shortly before the pedicure, and the shaving nicks gave the bacteria an entry point. This is why textbooks advise clients not to shave their legs in the day or two before a pedicure.

A Typical Spa Routine

Colorado's rule tells you to follow the manufacturer's label. Textbooks and manufacturers commonly describe this routine, which grew out of other states' rules:

• After each client: drain; remove visible debris; scrub the bowl, jets and screens with soap or detergent; rinse; refill with clean water and the correct dose of hospital disinfectant; circulate (for whirlpool units) for the label's full contact time; drain, rinse and wipe dry.
• End of day: remove the screen, footplate or impeller; scrub behind and inside them; disinfect the parts and the bowl; reassemble; circulate disinfectant; drain and dry, or leave as the manufacturer directs.
• Weekly or as directed: a longer disinfectant or chelating-detergent cycle that removes mineral buildup and film.

Colorado does not require a pedicure cleaning log. A salon can keep one as an internal control, but a Colorado inspector checks the result: clean, disinfected bowls and proper product use.

Procedure 3: The Daily Workstation

Before the first client: clean, then disinfect, the table surface, armrest, drawer pulls, lamp and chair according to the disinfectant's directions. Lay a fresh towel or new paper cover. Stock disinfected implements in labeled clean storage and single-use items in clean, covered containers or their original packaging. Check that hand sanitizer is available for clients (Rule 1.7(C)(1)).

Between clients: remove used towels into a closed soiled-linen container. Put used implements in the closed used-items container and single-use items in the trash. Clean and disinfect every surface that touched skin or body fluid (Rule 1.7(C)(3)). Replace the towel or table cover.

End of day: empty trash containers, which must have solid sides and a liner. Clean and disinfect the station and the used-implement container. Clean all tools and disinfect them for tomorrow. Clean the soiled-linen container daily and disinfect it weekly (Rule 1.7(D)(2)).