DECONTAMINATION SERVICES


Technical apprenticeships The current skills shortage is possibly due to a combination of these factors, plus the generic problem that the engineering industry does not promote technical apprenticeships as we once did. Recent years have seen a drive to promote such development, but – when looking to develop skills and expertise – should we focus on the core technical skills needed at the coalface, or should the decontamination industry look at something itself?


So, subsequently as Authorising Engineers, how can we improve standards and support, and subsequently reduce the risk to the patient? Well, firstly as Authorising Engineers (Decontamination), we must ensure that we advise our clients correctly, promoting the highest of standards, and escalating any concerns to the executive boards of the organisations we represent. We must work with site/facility-based partners to ensure that systems are managed in accordance with best practice, healthcare guidance, health and safety, and the medical device regulatory framework.


Systems that the profession can influence


The systems that we can influence are as follows: n Ensure that our clients manage all maintenance/validation activities as per HTMs, WHTMs, and SHTMs.


n Present the annual report and escalate findings/concerns to the executive board of the organisation (as per HTM 00).


n Link with on-site engineering management personnel, to ensure that documentation is managed appropriately, and provide guidance where it is not.


n Ensure that communication is always open, and that the AE(D) is an active part of the decontamination team/structure. Attend routine meetings of the organisation to understand the difficulties and present ideas to improve.


n Assist with development of specifications for maintenance/service contracts, specifying the need to supply competent personnel when working on decontamination equipment. Key Performance Indicators, linked to financial penalties, are key to this; organisations should review and act when repeatable faults, or poor response and performance outside the specification, are experienced.


AP(D) services available So, what would be expect/anticipate when we attend site?


Each site/facility should have Authorised Person (Decontamination) services available. The AP(D) should be


22 Health Estate Journal October 2020


‘Good old-fashioned methodology’ communicating work activities on engineering plant – HMS Belfast.


Glossary of terms n Definition of validation


A documented procedure for obtaining, recording, and interpreting the results required to establish that a process will consistently yield product complying with predetermined specifications


n The Authorised Person (Decontamination)


The AP(D) will be an individual representing a healthcare organisation possessing adequate technical knowledge and having received appropriate training, appointed in writing by the healthcare organisation [in conjunction with the advice provided by the AE(D)], who is responsible for the practical implementation and operation of Management’s safety policy and procedures relating to the engineering aspects of decontamination equipment.


n The User


The User is defined as the person designated by Management to be responsible for the management of the decontamination process within a department. Within healthcare organisations, the User may be the SSD manager, the Endoscopy Unit manager, or the Laboratory Safety officer.


n The Authorising Engineer (Decontamination)


The AE(D) is defined as a person designated by Management to provide independent auditing and advice on washer-disinfectors, sterilisers, and sterilisation, and to review and witness documentation on validation. The AE(D) shall review permit to work documentation as part of the annual organisational report and periodic AP(D) assessments.


n The Competent Person (Decontamination)


The CP(D) is defined as a person designated by Management to carry out maintenance, validation, and periodic testing. The CP(D) maybe employed by the organisation, or by a service-provider to it.


Note: These views are my personal interpretation, and do not represent the policy of my employers.


appointed in accordance with the HTM/WHTM/SHTM. The individuals fulfilling this role must manage the tasks appropriately, and not simply look at its importance in terms of completing a ‘tick box’. If the AE(D) is not satisfied that the AP(D) is managing the safety systems correctly, constructive assistance should be supplied. What, however, if there is no AP(D)? Well, you would expect the presiding management to have sufficient


knowledge to manage the engineering systems at first hand? Organisations are at risk if service-providers are reporting direct to unit managers, and are not monitored by engineering managers.


Permits to work


Safety rules and procedures are necessity to ensure that the integrity and performance of the relevant


decontamination systems are maintained, hence ensuring that good standards of patient safety are achieved. A Permit to Work should be operated, to ensure that all engineering activities are managed and traced. The permit should cover ancillary items such as ventilation and water purification systems supplying washer- disinfectors.


Examples of common issues we see that often compromise, or indeed jeopardise, good machine performance include: n Air detector adjustments on porous load sterilisers without the necessary validation to verify.


n Three-phase pumps being installed incorrectly on equipment and ancillary services.


n Chemical dosing adjustments without the necessary knowledge of the concentrations required for effective process.


n Servicing of equipment where required components are not changed at recommended frequencies.


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