DECONTAMINATION SERVICES
Better training pathway for decontamination engineers
With the advancement of technologies, and the need for greater accountability, John Prendergast, senior Decontamination engineer, NHS Wales Shared Services Partnership – Specialist Estates Services, discusses the current training systems for engineers working on equipment used to decontaminate medical devices. He asks: ‘How can we, as professionals, assist, and how do we consider raising standards to ensure that we educate the next generation of engineers working within the decontamination industry?’
Back in the day each hospital had engineers on site, trained through industry apprenticeships – who could maintain steam sterilisation plant and much more – that a were positioned within Sterile Service Units and the wider hospital network. Many of these engineers, who had an empathy with such equipment, migrated to manufacturers, and formed the knowledge base for our industry over many years. Machinery was mechanical or electrical, with basic control systems that could often be overridden by maverick personnel (both engineers and users). Guidance was basic, although in some ways more practical, with better explanations (HTM 10). However, it is fair to say the governance and accountabilities were far less than in today’s litigation-fired society. Since those days, decontamination has grown to become a science in its own right, medical equipment has become more technical, with improved safety systems, and the equipment used to
decontaminate surgical and medical instruments has become highly complex, as standards, guidance, and requirements, have increased. Additional equipment has come into being, all of which requires maintenance and validation to precise standards.
Perennial skill shortages issue In parallel, and as with many other industries, we currently find significant skill shortages among many of the engineers who work on decontamination equipment. The days of a multi-purpose engineer covering all elements of the healthcare facility are coming to an end. Many suppliers of decontamination services rely on manufacturers or third- party providers for maintenance /validation services. We see good, bad, and indifferent engineers appearing within our departments. More than ever, in fact, in my view, the engineer now poses one of the biggest risks to devices being decontaminated appropriately.
Equipment not functioning to its correct purpose can render devices unsafe for re-use.
Where does the problem lie? There are a number of key factors: n Lack of training, out-of-date training, or not enough ongoing training (CPD).
n Engineers taking job opportunities outside their skills matrix, often with no apprenticeship to support the basic theories of engineering.
n A training structure within the decontamination sector not aligned to current demands and equipment?
n A lack of supervision or competency assessment by the Facilities Management Department. Often this is because of lack of an AP(D), or little or no communication with the AE(D).
n Organisations seeking the cheapest solution, without considering quality or consistency of service. Changing providers each year, without the thought of consistency or developing the skills from within the organisation.
A temporary/permanent solution noted under a porous load steriliser.
The ‘technical underside’ of an endoscope washer-disinfector.
An air detector set up during commissioning of a porous load steriliser.
October 2020 Health Estate Journal 21
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