DECONTAMINATION SERVICES
Quality of validation reports Quality of validation reports is another area of concern; some reports that I have seen actually inform the user that they are not meeting HTM/WHTM/SHTM criteria. Most providers have moved to dedicated software to present reports. While the reports are concise if compiled correctly, in some ways this way of working has taken the skill out of interpreting data to assess equipment performance. Data is there, but CP(D)s are often in a rush, and do not assess as they should. If technical software systems are used, training and awareness on the systems is imperative for engineers using such systems. Calibration is also an area of misconception. Systems have changed, and the modern test equipment, and associated software, are designed to be set up on site. Where systems are configured, there has to be knowledge of the system set-up, to include the stabilisation times, positioning of the sensor in the heat blocks, verification of temperature/pressure range, awareness of environmental conditions to prevent instability, traceability of reference devices to UKAS standards, awareness of uncertainties, and more. The traditional guidance documents do not promote unnecessary adjustments on site, but where required, knowledge and training should ensure that engineers are aware of the requirements to meet the tolerances specified for the equipment. The AP(D)/ AE(D) should advise accordingly, either through on-site review, or as part of report review.
Conclusions
So, where do these concerns leave us, and what can we do to minimise the risks as an industry, as AE(D)s, and as other professionals associated with the decontamination of medical devices? Do we, as a Decontamination Technical Platform (IHEEM), need to review the training matrix, to include guidance on pre-training experience prior to attending courses (possibly online provision), along with the instigation of routine refreshers? As AE(D)s we must promote regular training and review organisational plans as part of routine assessments/annual reports.
The AE(D) must work with the AP(D) to ensure that documentation is correct within the organisation, to include a review of CP(D) competency assessments, equipment registers, maintenance log- books, Permit to Work protocols, and review of validation reports etc. As providers of services, we must invest in education for our CP(D)s. They are an asset, and if trained appropriately, can reduce costs and enhance patient safety. There needs to be routine CPD training to cover specific topics such as steam principles, calibration, chemical disinfectants, and our old friend, rinse water quality.
24 Health Estate Journal October 2020
Evidence of damage on a door mechanism on a porous load steriliser.
Benefits of specialist teams Where services are retained in-house, the formation of specialist teams working within organisations has significant benefits. In NHS Wales we have examples of this model, and it works very efficiently. Can this model be a shared internal resource across health boards/Trusts? Why can’t two organisations share the costs of a specialist team?
Should we as organisations review the pay structures, to ensure flexible salaries, based upon the skills matrix. The NHS (A4C) is possibly the worst culprit for such inflexibility, which often leads to staff leaving for positions elsewhere. Do we develop in-depth diplomas in decontamination engineering? Such
John Prendergast
John Prendergast is the senior Decontamination engineer working within the specialist team at NHS Wales Shared Services Partnership / Specialist Estates Services (formerly named Welsh Health Estates), that is dedicated to all aspects of decontamination and reprocessing techniques of medical devices. He works within the team that provides validation services, advice, and guidance, to Health Boards/Trusts within Wales, and works closely with Welsh governmental departments to deliver policy and strategy in this unique and often complex field.
He has worked within the NHS in Wales for the past 34 years, and was initially employed by Gwent Health Authority (currently Aneurin Bevan University Health Board) as an engineer working within the Operational Estates department. He joined Welsh Health Estates in 2000, and undertook a more global role working throughout all the acute NHS Health Boards/Trusts within Wales. His role has developed to encompass the strategic duties associated with decontamination of medical devices, including Sterile Services, Endoscopy, Microbiology/ Pharmaceutical services, and Primary Care. In 2012 he completed the ACIST course (the qualifying course for Authorised Engineer – Decontamination), and was formally accepted onto the IHEEM register as an Authorised Engineer (Decontamination) in late 2013.
He is an active member of the IHEEM Welsh Branch, and is also a member of the Central Sterilising Club committee.
qualifications could link from the current week-long validation courses, possibly all the way through to the AE(D) framework and beyond. The framework is there, has been created, and is working well. It is just a question of linking things together to produce education at all stages for CP(D)s, AP(D)s, and ultimately AE(D)s. Should IHEEM hold a national register for AP(D)s and CP(D)s along with the current AE(D) register? As an industry we have much to think on, and we need to evolve training to meet ever-changing needs. There is much to learn from the past, it is key to utilise the best of the present, and also to look at visionary systems to meet the changing requirements of the future.
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