Decontamination: testing
Bioburden retained in cannula
integrated into preventative maintenance schedules rather than being applied to every single cycle.
Concerns that additional testing might slow
down throughput are understandable, but experience suggests that it is achievable when the implementation is thoughtful. The key is prioritisation. Not every instrument requires every form of testing; instead, risk stratification, based on device complexity, usage frequency, and clinical impact, allows resources to be directed where they are most valuable. Training is equally important, as tools that generate images or data still depend on professional interpretation. Structured competency frameworks help ensure that findings are assessed consistently and proportionately. By establishing clear escalation pathways, agreed thresholds, and multidisciplinary oversight, departments can avoid overreacting to minor variations while ensuring that genuine concerns are always addressed.
When used constructively, this data becomes
a powerful driver for improvement. Trend analysis can inform procurement discussions, highlight recurring design flaws, and support more targeted engagement with manufacturers. Rather than simply adding another compliance burden, objective testing becomes part of a continuous improvement cycle. The impact of these technologies is often quiet
rather than headline-grabbing. They reduce the reliance on assumption and provide stronger documentation for audits and regulatory reviews. Ultimately, they support earlier intervention before clinical disruption occurs, while significantly enhancing professional confidence within sterile services teams. Objective testing doesn’t replace professional judgement – it strengthens it. In that sense, objective testing represents a necessary evolution. It acknowledges the natural limits of what can be seen and complements the deep skill and experience already present within sterile services. As reusable devices become increasingly complex, the gap between assumed
References 1. Ofstead CL, Heymann OL, Quick MR, Eiland JE, Wetzler HP. Lumens 2.0: Persistent debris identified inside reprocessed surgical instruments using borescopic inspection. American Journal of Infection Control. 2025. Available at:
https://www.ajicjournal.org
2. Hopkins KL, Coole D, Whittaker P. Residual contamination in complex suction tips and arthroscopic shavers following standard reprocessing: a pilot evaluation. Journal of Hospital Infection. 2024. Available at: https://
www.journalofhospitalinfection.com
3. Health Services Safety Investigations Body (HSSIB). Decontamination of surgical instruments: contamination identified during surgical procedure. HSSIB Investigation Report. 2022. Available at:
https://www.hssib.org.uk
4. Van der Wal AC, et al. Insulation failure in minimally invasive surgical instruments: prevalence and potential patient risk. Surgical Endoscopy. 2007. Available at: https://link.
springer.com/journal/464
The Nutrace Mole
condition and verified condition will only widen unless our inspection methods evolve at the same pace. Objective testing technologies won’t eliminate risk entirely, nor should they be adopted without critical evaluation. However, when introduced proportionately and integrated carefully into existing workflows, they offer a way to bring hidden degradation into view. In sterile services, visibility is safety. Moving
from assumption to assurance isn’t about abandoning established practice; it’s about reinforcing it. It ensures that our confidence in a device’s readiness is grounded not just in process adherence, but in demonstrable evidence. CSJ
5. NuTrace Medical. Borescope inspection in sterile services: developing the role of the trained borescopist. Technical White Paper. 2024. Available at:
https://www.nutrace.co.uk
6. Dovideq Medical Systems. Objective optical performance testing for rigid endoscopes. Technical Report. 2023. Available at: https://
www.dovideqmedical.com
7. Hopkins KL, Coole D, Whittaker P. Design-related barriers to effective cleaning of lumened surgical instruments. Journal of Hospital Infection. 2024. Available at: https://www.
journalofhospitalinfection.com
About the author
Dan Coole is the Managing Director of Surgical Holdings, a UK-based specialist in high-quality surgical instrument manufacturing and repair. With a strong focus on sustainability, circular repair models, and education within sterile services, he champions innovation, workforce development, and patient safety across the NHS and international healthcare markets and supply chains.
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