DAS 2024 Review
effects of the procedure. Therefore, the patient may not go to the doctor with their symptoms and, even if they do, they are most likely to visit their GP – not the hospital where they had the procedure. The HSSIB were told ‘by healthcare staff that the current systems that they work within are not mature or integrated enough to identify whether the source of a BBV was a contaminated surgical instrument’. Furthermore, do SSDs actually contribute to surgical site infection investigations by the IPC team? With regards to preventing risks, Helen went
on to consider some of the human factors and barriers that can lead to mistakes. A technician may be located in a rushed area, interrupted while carrying out important tasks, or put under pressure by people coming onto the department to make ‘their set a priority’. Everyone is working under pressure.
What staff need to know She went on to outline what technicians, team leaders and managers need to know: Technicians are tasked with understanding
the following: l Checks to be carried out on thousands of different instruments: l Identify the different instruments from checklists.
l Assemble/disassemble for cleaning/ sterilisation.
l Cleaning process – manual, AWD, specific carriage, pre-wash, ultrasonic clean.
l Checks in IAP – assemble/disassemble, specialist checks, correct sterile barrier, limited life, electro checks.
l Identify correct sterilisation process, low temperature, steam, endo washer disinfector.
l Send to correct location, all within agreed turnaround times.
l Daily test and checks on equipment.
Team leaders’ additional roles include: l In process quality checks. l Monitoring daily checks carried out by technicians.
l Staff rotation. l Manage workload of the department and their own.
l Main contact with customer. l Train new staff. l Basic audits. l Raising non-conformances.
Managers’ additional roles include: l Quality system. l Standard Operating Procures (SOPs). l Demands of the customer. l Increased activity. l Short notice extra lists. l Monitor testing and maintenance of the processing equipment and environment.
l Reviewing and signing off all reports. l Acting on non-conformances. l Action plan management.
How do we expect our staff to say instruments are fit for use, if we have these figures? Around 70% are in some way damaged. Will this affect how they are washed and sterilised?
No wonder staff make errors. Helen Campbell, IDSc.
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www.clinicalservicesjournal.com I April 2024
l Staff recruitment. l Microbiologist. l Engineer. l Ensuring the patient is safe!
Challenging questions While outlining these requirements, she also raised some difficult questions: l Daily checks of equipment - is it just a tick box exercise or do staff really look at the equipment?
l Can staff continue to work at an increased pace or will quality suffer?
l How often do SSDs get a call from theatre demanding a set and it is still in the washer, and they are asked to cut corners to get the set to them quicker? Are staff strong enough to have tough conversations about why a set cannot be safely reprocessed in the timeframe they are demanding?
l How do we train new staff? The majority of new staff have packed a set in their first week, but how quickly should they be expected to wrap sets and empty machines? What should the training period be for a new member of staff – one months, two months, six months, or a year?
l There are thousands of instruments that new staff need to know. In three months are they going to be able to identify all those instruments? How long does it take to learn all those instruments, including how they come apart, and to identify problems with them?
Competency and training Helen said that it is probably two years before a technician will have this knowledge. Should the training period be two years for a technician, therefore? If this is the case, is it right that a Band 2 is paid the same as a person cleaning hospital corridors? She pointed out that the latter is another important job, but is it the same skill set? Helen also invited the audience to consider
the following:
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