Stay on Top of Water Quality

Avoid contaminants with careful testing and vigilance BY ROBERT KURTZ


hat you do not know about your ASC’s water could harm patients and damage devices, says Barbara Ann Harmer, RN, director of clinical services for Innovative Steril- ization Technologies in Dayton, Ohio, a company that developed and markets a sealed sterilization container system. “Water quality is an often over-

looked factor in disinfection and ster- ilization processes,” she says. “You may think you are doing a great job with reprocessing and using the right disinfection agents, but if you have organic and inorganic compounds as well as any other microorganisms in your water that you do not properly address, you may end up with a repro- cessed device that has more junk on it than when you started.” Water accumulates these “impuri- ties” from the time it falls as rain to the time it

is used in reprocessing, 10 ASC FOCUS MARCH 2017

says Herbert Kaiser, senior manager of analytical services and develop- ment for STERIS Corp., a provider of infection prevention and surgical products and services based in Men- tor, Ohio. Examples of impurities he cites include hardness ions, e.g., cal- cium and magnesium carbonates, from rocks in the ground; total organic car- bon from decaying organic matter; and iron, copper, zinc and aluminum from pipes, water heaters and brass fittings. “All of these impurities can deposit

on instruments during reprocessing,” he says. “Many of them can cause or promote corrosion of medical instru- mentation. This shortens the life and functionality of the instruments while providing a safe haven for microbio- logical contamination. It also has been shown that hardness ions can form crystals that occlude spores. This pro-

tects the spores from steam and ethyl- ene oxide sterilization processes.” Harmer says there is the poten- tial for many different adverse patient events to occur as the result of inad- equate water quality. “You can expe- rience a device malfunction during a patient procedure, toxic effects and tis- sue irritation resulting from residuals on a device and patient infections from the use of contaminated devices.” ASCs must make understanding and addressing water quality issues a high priority, says Darlene Hinkle, RN, director of perioperative services for Fairgrounds Surgical Center and Chil- dren’s Surgery Center, both Lehigh Valley Health Network ASCs in Allen- town, Pennsylvania. “I think water quality can be a hid- den issue of reprocessing for ASCs,” she says. “When I started working at Fairgrounds Surgical Center close to 30 years ago, I assumed our water was acceptable since it is treated munici- pal water. But this was not the case. We have had to work to get our water

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