Training activity information
Details
Clean the environment and equipment following anorectal physiology investigations and endoanal ultrasound scanning
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What does success look like?
- Identify what is expected of you in relation to thoroughly cleaning the room and equipment following both anorectal physiology investigations and endoanal ultrasound scanning.
- Consider how the learning outcomes apply, specifically in relation to preparing and cleaning the room and equipment, ensuring all infection control procedures are followed.
- Discuss with your training officer to gain clarity of what is expected of you in relation to the specific steps involved in cleaning the room and equipment, and the correct procedure for safely removing and disposing of the anorectal manometry catheter.
- What is your prior experience of this activity?
- Think about what you already know about cleaning clinical environments, equipment decontamination, and following infection control procedures.
- Consider possible challenges you might face during the activity, such as safely handling bodily fluids, ensuring all parts of complex equipment are thoroughly cleaned, or adhering to specific disposal requirements for waste.
- Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if you encounter unfamiliar contamination (e.g., blood spillage) requiring specialised cleaning agents, or if a piece of equipment requires decontamination beyond routine procedure.
- Acknowledge how you feel about undertaking this cleaning activity. How confident are you in ensuring full infection control procedures are followed?
- What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as applying strict infection control and personal protective equipment (PPE) protocols, and mastering the detailed steps involved in equipment cleaning.
- Identify the specific insights you hope to gain into the importance of thorough cleaning in preventing infection and the precise requirements for equipment decontamination.
- What additional considerations do you need to make?
- Consult actions identified following previous experiences of technical cleaning procedures or adherence to infection control guidelines.
- Identify important information you need to consider before embarking on the activity, such as reviewing department protocols for cleaning and infection control, ensuring the necessary cleaning supplies and PPE are ready, and checking specific disposal requirements for medical waste.
In action
- Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst cleaning the environment and equipment?
- Are you encountering situations such as:
- A specific piece of reusable equipment (e.g., endoanal probe sheath) is difficult to decontaminate thoroughly, challenging adherence to infection control protocols?
- You are unsure about the required disposal procedure for complex clinical waste, conflicting with standard guidelines?
- A component of the equipment requires specialised cleaning that is unfamiliar or potentially hazardous, requiring consultation of material safety data sheets.
- How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately?
- Are you adapting or changing your approach to the cleaning sequence or the use of cleaning agents?
- Consider the steps you are taking in the moment, such as:
- Immediately stopping the cleaning procedure to consult the department protocol for specific decontamination procedures
- Seeking advice from ward staff or your Training Officer regarding the safe disposal of unexpected biohazard waste
- How are you feeling in that moment? For instance, are you finding it difficult to ensure all surfaces and equipment are contamination-free? Is it affecting your confidence in adhering strictly to infection control standards?
- What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully adapting cleaning agents and techniques to ensure safe decontamination? Or are you needing support because the equipment requires maintenance beyond routine cleaning, necessitating reporting to the technical team?
- What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for dismantling complex equipment for cleaning? Or gaining insight into the critical steps of equipment decontamination for reuse?
On action
- What happened?
- Begin by summarising the key steps you took when safely removing and disposing of single-use items, meticulously cleaning and decontaminating reusable equipment e.g., transducers, catheters, and ensuring the entire clinical environment was clean and ready for the next patient.
- Consider specific events, actions, or interactions which felt important, such as how you ensured compliance with the department’s infection control protocol, or how you handled the safe disposal of clinical waste.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately seeking clarification on the appropriate disposal route when unexpectedly faced with a complex item of contaminated waste.
- How did you feel during this experience, e.g., did you feel diligent in applying infection control protocols or stressed by the responsibility of handling potentially contaminated equipment?
- How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding the critical importance of post-procedure cleaning in maintaining a safe clinical environment.
- What strengths did you demonstrate, e.g., meticulous adherence to cleaning protocols?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the detailed decontamination steps required for a newly introduced reusable piece of equipment?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved?
- Has your practice improved in the speed and thoroughness of equipment cleaning?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding the required strength of the cleaning agent for a specific piece of equipment, and how you reacted to this.
- What will you take from the experience moving forward?
- Identify the actions you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to consistently applying stringent cleaning and infection control procedures.
- What will you do differently next time you approach cleaning the environment and equipment, for instance, by proactively reviewing the manufacturer’s decontamination guide for all transducers immediately following the procedure?
- Do you need to practise any aspect of the activity further, such as correctly setting up the cleaning station or key learning outcomes related to cleaning the room and equipment?
Beyond action
- Have you revisited the experiences?
- How have your subsequent experiences of using cleaned equipment or performing maintenance since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, observing corrosion on a delicate transducer component during calibration, forced you to re-evaluate the diligence of the cleaning agents and protocols applied immediately after use during your first attempt at this training activity.
- Considering what you understand about infection control, safety protocols, and proper disposal of medical items now, were the actions or considerations you identified after your initial reflection on this training activity sufficient?
- How have you since implemented or adapted improvements in your adherence to cleaning protocols and efficiency based on further learning and experiences? For example, how you proactively integrated updated guidelines on cleaning protocols specific to the endoanal ultrasound scanning transducer.
- Has discussing challenges encountered during cleaning or the impact of adherence to safety protocols with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a near-miss where disposal procedures were almost violated, refined your understanding of the critical nature of adherence to safety protocols and detailed procedures for handling medical items.
- How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent technical experiences, contributed to your overall confidence and competence in cleaning and infection control and maintaining a safe environment, particularly in preparing for assessments like Direct Observations of Practical Skills (DOPS)? For example, how your accumulated ability in applying appropriate infection control precautions now enables you to confidently apply appropriate infection control precautions when carrying out an anorectal physiology investigation during a DOPS assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to handling equipment and ensuring patient safety?
- How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from the Training Officer or infection control lead immediately when uncertainty arises regarding the cleaning protocol for a new piece of equipment, recognising this falls outside routine cleaning procedure scope.
- Looking holistically at your training journey, how has this initial cleaning experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to preparing and cleaning the room and equipment? For example, how this foundational experience has supported your development in practicing safely by providing the necessary knowledge base for the subsequent learning outcomes focused on safely performing the procedure itself.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 2 |
Outcome
Prepare the room and equipment for anorectal physiology investigations and endoanal ultrasound scanning and clean the room and equipment following the completion of investigations. |