DECONTAMINATION
When talking about the reasons for preventing endoscope contamination, Spencer said he believed that they were all of equal importance. “If we don’t protect our staff from disease and they start going sick, then we can’t deliver the care that we need to. If we don’t have the right staff because we’ve got a poor reputation or we don’t have sufficient funding to address the issues that may be in our hospitals then we cannot protect our staff. In a way I think they’re all equal, but they all lead to one thing and that’s to protect the patient.” Later in his presentation, Spencer highlighted legislation that’s relevant to healthcare professionals working in the sector. He told attendees: “We have a legislative background that we need to comply with.” Legislation includes: Consumer Protection Act 1987: Part 1 implements EU Council Directive 85/374/EEC (product liability) providing compensation to be paid to persons injured by a defective product. There may also be civil liability violations with payment for damages.
Health and Safety at Work Act 1974: Section 3 makes it a criminal offence if a Trust fails to conduct its undertaking in such a way as to ensure that patients are not exposed to health or safety risks. This is a very high standard of care with a reverse burden of proof (i.e. it is for the Trust to prove that it did take all reasonably practicable steps). Sanction: Unlimited maximum fine.
Criminal offence of manslaughter: If a patient dies as a result of an infection passed on through inadequately decontaminated surgical instruments, then the criminal offences of manslaughter (for individuals) and corporate manslaughter (for Trusts) can also apply. Spencer continued: “Many
decontamination convictions for processes around decontamination in the past have been brought against the Health and Safety at Work Act. The reverse burden of proof means it’s easier to get a conviction. Rather than the patient having to prove that the Trust didn’t do decontamination properly, they didn’t protect their staff or patients when they were on their premises, the Trust has to prove it did. That’s much more difficult.” The Health Technical Memorandum (HTM) 01-06 Decontamination of Flexible Endoscopes was also explained by Spencer: “It requires that you have a decontamination policy as an organisation. Within that policy it must include provision for decontamination of reusable medical devices taking place in appropriate facilities designed to minimise risk, that you follow appropriate procedures for maintenance, validation and use of decontamination equipment. Staff are trained in cleaning and decontamination processes and hold appropriate competencies for their role.”
SEPTEMBER 2017 Highlighting risks
The ‘What’ theme was covered by Tina Bradley, laboratory manager, Hospital Infection Research Laboratory at the Queen Elizabeth Hospital, Birmingham. During her presentation, which was entitled ‘Endoscope decontamination: what are the risks?’ she outlined the following: l Failure to clean and disinfect. l Incorrect connectors. l Failure to irrigate all channels. l No leak testing. l Rinsing with tap water. l Contaminated endoscope washer disinfector.
l Contaminated water bottle. l Biopsy forceps not sterilised. l Cross contamination from hands or environment.
l Inadequate storage.
UK guidance over the cleaning of endoscopes suggests that they need to be reprocessed
before reuse if they have been stored for more than three hours because of bacterial growth in damp lumens.
Bradley had the following advice for attendees: “Best practice is that as soon as it (an endoscope) comes out of storage is that it’s used. How do you monitor how long it has been out of the cabinet? From a microbiological perspective it shouldn’t be contaminated. The only contamination is likely to be the external surfaces. But I don’t want to stand here and say it’s perfectly safe because I could then be encouraging people to take it out of the cabinet and leave it for however long and not use the scope. Ideally, endoscopes are removed from a cabinet and used straight away.”
Bradley also highlighted the importance
of departmental design when it comes to decontaminating endoscopes: “Having the right flow within the department is important. Preferably you’d have a two room scenario where you’ve got your dirty tasks
We are Getinge One brand, one promise: Passion for life
With brands like Maquet, Lancer, Atrium, Pulsion, Datascope, Steritec and Stericool – just to name a few - we are now a global market leader in many healthcare and life science segments.
Our identity has changed - our commitment to improve every-day life for people remains.
www.getinge.com
This document is intended to provide information to an international audience outside of the US.
WWW.CLINICALSERVICESJOURNAL.COM I
57
t
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72
