Decontamination
Time for a revolution in sterile services?
High on the agenda at the Central Sterilising Club’s Annual Scientific Meeting was the theme of “risk and revolution”. How should we review current approaches, drive innovation, and ensure patient safety? What questions should we ask, when implementing ‘a revolution’, and what are the challenges that we need to overcome? Louise Frampton reports.
Experts from a broad spectrum of disciplines - including decontamination, infection prevention, microbiology and theatres – recently gathered at Chester’s Crown Plaza to exchange ideas and solve mutual problems. During the two-day CSC Annual Scientific Meeting (ASM), delegates were invited to consider whether “improvements we have traditionally made, need to be revolutionised”. As always, the CSC committee developed a programme designed to provoke discussion, share expert knowledge and raise awareness. This year’s ASM looked at why we need
to report decontamination incidents; the challenges in theatres and how these impact sterile services; whether automated manual washing is a ‘risk or revolution?’; and provided an insight into the implementation of ‘a revolution’ in endoscope cleaning. Ultimately, attendees at the meeting were
prompted to consider the question: can we embrace risk as being a legitimate avenue for action with scope for fundamental change, and revolutionise the delivery of efficient solutions within the decontamination sector?
Risk and revolution John Prendergast, CSC Chair, set the scene with a conundrum: “Risk and revolution; what does that mean? The word ‘risk assessment’ always makes me quiver. Does that mean, if we risk assess, we are going to accept lower standards? In the right context, the answer is ‘no’. However, we all know individuals that ‘risk assess’ to save their budget…In terms of revolution, we are going to put some things forward over the next two days…You should revolutionise over the next few years,” he exclaimed.
Why you need to report decontamination incidents The Kelsey Lecture was established in 1980, through a donation generously provided by Dr. Jos Kelsey, to enable a guest lecturer of
international reputation to be invited to speak at the CSC Conference. This year, Sulisti Holmes provided the Kelsey Lecture on ‘Why you need to report decontamination incidents.’ As the Head of the Decontamination and
Incident Reporting Investigation Centre, Sulisti Holmes is acting as the strategic lead for medical device safety and decontamination in NHS Scotland. “Why do we need to report decontamination
incidents? In Scotland, they will probably say, ‘because the government has instructed us to report medical device incidents to the incident reporting investigation centre’. And if you ask the rest of the UK, they will probably say, ‘because the MHRA has told us to report medical device incidents’… And if you ask me, or my family, there will be another reason – and I’m going to tell you a story as an example,” commented Sulisti Holmes in her opening remarks. She set the scene for a personal account of
how her 93-year-old mother experienced an infection after undergoing a cataract operation, interspersed with light-hearted references to Jackie Chan movies – her mother’s passion. Her delivery was entertaining, full of affection for her mother, and engaged the audience with
some unexpected twists and turns and witty anecdotes. However, the underlying message was impactful and serious, reminding the audience that behind every incident and statistic is a patient – a mother, a daughter, a family – who suffer when decontamination and medical device incidents occur. “Three days after the operation on the left
eye, my mother’s eye was inflamed red and looked extremely painful. It was the first time ever that I had seen tears in her eyes,” she commented. “Have you ever seen your mother cry? How did you feel?” she asked the audience. It took several months and further treatment for her mother to recover, she explained. She pointed out that over 40,000 cataract
procedures are performed each year, and most patients benefit from the surgery. However, in 2009, five patients at a hospital contracted endophthalmitis (one of the most dreaded complications of modern cataract surgery), leaving one of the patients – a 75-year-old – visually impaired. “How devastating, to lose your sight after a simple operation,” she commented. The root cause of the incident, she explained, was due to contamination of three phacoemulsification (phaco) hand pieces.
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