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Calls to support education and competency in decontamination
The Institute of Decontamination Sciences’ annual conference recently took place at the Hilton Birmingham Metropole Hotel, bringing together decontamination scientists and experts from across the UK. IDSc Chair, Trevor Garcia, emphasised the vital need for education for the decontamination sector and the importance of attending events such as the annual conference, in order to update knowledge and share experiences. In the wake of the findings of the HSSIB report on a serious failure in decontamination, continuous professional development to ensure competency has been identified as an essential requirement for the sector. With this in mind, Trevor revealed that the organisation had been tasked with the development and introduction of NETB/2024/1 version 2.0 – the new competency framework for staff working in sterile services and decontamination departments, which was issued in May 2024. Sadly, in 2024, the decontamination sector lost some high profile and well-respected individuals who were well known for their contributions to promoting learning, and professionalism within the sector. Trevor paid tribute to Graham Stanton, Wayne Spencer, John Harrison, and Gillian Sills – who all made their mark on the world of decontamination with a shared passion for raising standards. Each of these individuals left behind an impressive legacy, through their contributions to ensuring patient safety, and will be sadly missed. “In 2024, we have lost so much experience and
knowledge,” Trevor commented. “It is a timely reminder to us, that we need to work hard to develop and encourage the new generation – we need to ensure they are competent, that they have the skills and knowledge to take over the running of decontamination services, and that they can keep these services safe,” he continued. Helen Campbell, Director of Education for IDSc,
his discussion, he highlighted ‘Kremer’s cleaning classification’ - a risk-based approach based on device features. He suggested that this could complement the Spaulding classification and enable clearer guidance for manufacturers’ instructions for use. Another hot topic raised at the event was
Trevor Garcia, IDSc chair
provided an insight into the new Endoscopy Technical Certificate, which will be available in the first quarter of 2025. Following a recall of 3,000 patients, the Hine Report revealed that decontamination staff were unaware of how many channels some scopes had – resulting in a channel not being cleaned. The report consequently recommended that there should be competency-based training of all staff. With this in mind, the new qualification will help staff understand: the basic microbiology, infection prevention and control, the design of the endoscopes, the composition of chemistries used in the manual decontamination process, the potential problems that may occur during cleaning, the importance of IFUs, aspects of health and safety; receipt, tracing and traceability (including the requirements and the use of documentation upon receipts of endoscopes); the limitations of the 3-hour rule, the validation required on the storage systems, and the effects of pathogens on humans. Some of the hot topics explored at the event
included discussion of whether it is time to review the Spaulding classification. Dr. Gerald McDonnell, Vice President, Microbiological Quality and Sterility Assurance at Johnson & Johnson, has produced a number of papers on the topic in recent years, which he highlighted during his session. During
the problem of biofilms in flexible endoscopes – discussed by Rob Warburton, Group Decontamination Lead at Manchester University NHS Foundation Trust. Biofilms are extremely challenging, once established. He pointed out that we need to review manual cleaning processes – brushing may not always be effective. It has been suggested that automated pre-cleaning devices could provide a possible solution to the ongoing challenge of biofilm. Currently, these automated pre-cleaning devices include technologies that use nano particles/ nano metals or high-pressure air and water. We also know that residual moisture stimulates bacterial replication and can lead to biofilm formation. The 3-hour rule for scope drying may also need to be reviewed. Rob concluded that more research into biofilms and identification methods is required. Instructions for Use (IFUs) also proved to be the subject of lively discussion at the conference, prompting an engaging Q&A with delegates. Stuart White, Decontamination Lead for East Suffolk and North Essex NHS Foundation Trust, reviewed the current challenges facing decontamination units related to the design of medical devices and IFUs and discussed ‘risk, liability and mitigation’. He gave some examples of some ‘hard to clean devices’ and encouraged delegates to take an active role in challenging the procurement of devices that cannot be cleaned effectively. If IFUs are not fit for purpose and devices cannot be safely reprocessed, “we have got to be strong and push back!” he warned. Visit:
https://idsc-uk.co.uk/
HSSIB report highlights impact of medication failures in the ED
HSSIB has published a report examining the case of a patient who did not receive time critical Parkinson’s medication while attending an emergency department. The report charts the first in a series of investigations exploring patient safety events in NHS organisations to understand why patients may not receive medications as planned. This particular investigation explored the
systems and processes in place to support staff to recognise, prescribe and administer time critical medications in the emergency department (ED).
It also explored the role played by electronic prescribing and medicines administration (ePMA) systems in supporting care in this area. In the case they examined, an 85 year old patient attended the ED following an outpatient appointment and stayed in the ED for three days. The patient usually took his medication at home four times a day.
During this time in the ED, he should have received
a total of 18 doses of his Parkinson’s medication. However, seven doses were not given and three doses were given late. This meant that only 8 of 18
doses of Parkinson’s medication were provided to the patient on time. The patient was transferred to a medical ward where his Parkinson’s symptoms deteriorated and he lost the ability to swallow. The patient died four weeks after his admission to the ward. The coroner reported Parkinson’s as a factor leading to the patient’s death. This is the first in a series of investigations by
the HSSIB exploring medication related harm – full details are available at:
https://www.hssib.org.uk/ patient-safety-investigations/medication-related- harm/
January 2025 I
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