Leadership
Raising standards in decontamination
CSJ spoke to the new chair of the Institute of Decontamination Sciences (IDSc), Trevor Garcia, about the organisation’s direction for the future, its ambitions to drive standards in the sector, and the need for culture change in decontamination science. He believes there is a need to ‘get back to basics’.
Challenges around decontamination persist within the health service – as the findings of a major national investigation by the Healthcare Safety Investigation Branch (HSIB) clearly demonstrated, last year. The need for a specialist body, focused on standards and education is as pertinent today as it was when the Institute of Decontamination Sciences (IDSc) was first initiated. Today, the routine undertaking of disinfection,
sterilisation and decontamination of reusable medical devices by trained professionals in dedicated controlled environments is an essential measure that manages the risks associated with healthcare-associated infections (HCAI) and ensures the safety of patients and staff. Yet prior to the late 1950s, healthcare facilities in the UK did not have central sterile services departments (CSSDs). While CSSDs had been successfully pioneered by the British Army at home and abroad, it
wasn’t until the publication of two key Nuffield Trust reports in the late 1950s1-2
that the concept
of CSSDs was put forward as a necessary requirement on a national scale. The Nuffield Trust’s study of sterile supply arrangements in a number of hospitals highlighted the full extent of the challenges – including open windows in decontamination facilities allowing dust to ingress, extreme build-up of scale on stainless steel from the use of hard water in sterilisers, and the cleaning of instruments by simply washing devices under a tap. The findings acted as a catalyst to driving improvement in decontamination practice.2 During the early years of CSSD implementation, individuals interested in infection control began to come together to discuss the rapid developments that were occurring in the sector. In 1967, department superintendents formed the Association of Sterile Supplies Managers (ASSM), the
predecessor to the Institute of Sterile Services Management (ISSM), which came into being in 1984.
By 2004, the ISSM had evolved far beyond its original remit: its membership consisted of professionals from all aspects of decontamination, as well as allied professions, and its professional development training programmes were renowned for achieving and maintaining standards of excellence in the sterile services. Also instrumental in fostering and leading active debate, research and development within the field of decontamination sciences, the Institute underwent an official name change to better reflect the breadth of its work: the Institute of Decontamination Sciences (IDSc).
In 2017, the IDSc celebrated its 50th anniversary. Since its initial inception, as the ASSM in 1967, the IDSc has become recognised as a key professional body in the UK framework that manages risks associated with HCAI in medical devices reprocessing – therefore playing a fundamental role in achieving effective patient outcomes. The organisation has actively engaged with and helped to lead the major review of traditional standards and practice in all areas of decontamination that occurred in response to the emergence of CJD and the complexities of prion deactivation.
Decontamination in hospitals has come a
long way, during decades of oversight by the organisation, but there is still important work to be done. More recently, the IDSc has been involved with a project of work, following the publication of the HSIB report in 2022. The national investigation was prompted by an incident in which ‘black material’ was seen coming out of the end of a surgical instrument. This was later confirmed to be dried blood and, as a result, the patient had to be tested for bloodborne viruses.
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www.clinicalservicesjournal.com I April 2023
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