STERILE SERVICES
Processes, where the microbial population is established in respect of both numbers and susceptibility to inactivation; and a one size fits all approach. “If a sterilisation process fails,” he observed, “the items haven’t been sterilised, so are they contaminated? If there is even a minor discrepancy they must not be used. “Wrapping is impervious to microbes
when dry. However, if wet it’s transparent to the possibility of the passage of microbes through it. Nevertheless, it’s impossible to say what volume of water constitutes what level of risk.
“Bioburden testing is of no real relevance in SSDs that use a standard process and the heat susceptibility of the contamination is not fastened in. There is an increasing use of alternative sterilisation processes, but this remains an unknown area. “There are many reasons why instrument cleaning before steam sterilisation is a patient safety issue but sterilisation failure is not one of them.” Peter highlighted prions as the most infectious hazard and warned that chemical disinfection is a very real risk to patients. Similarly, with TOE/TEE probes only the tip is submersible, indeed in one probe incident, for which there had been a reported history of cleaning failures, the same instrument was used on source patient and one who acquired hepitis B. No tracking procedure had been put in place.
“If there is a reasonable amount off
within Trusts.“Human performance within a given clinical system, and factors that can influence people and their behaviour, mean that human error is not absolutely preventable,” he asserted. “Cleaning is extremely important and, especially for patient room cleaning, is very much a collaborative process. It is often undertaken by people who are low paid and are trained, or higher paid staff who aren’t. This is a challenge, due to the repetitive nature of patient room cleaning tasks which means people get bored and tired. There also the issues of clutter and high workloads under time pressure.”
So who is responsible? Graham Stanton
suspicion of infection,” continued Peter, “only then contact the patient. Do not scare them. If there is some suspicion then alert their GP and if this causes further concerns, either recall the patient for assessment or look through their records for blood borne virus transmission. “Overall, careful consideration of what happened, or may have happened, is vital.”
Human factors: culture and why things go wrong
Martin Kiernan, visiting clinical fellow, Richard Wells Research Centre, University of West London, focused on human factors
Martin highlighted one Trust which has created a simple pictorial manual, providing information on who did what and the time it took. “This enabled the Trust to redefine the responsibilities and tasks of those who clean using principles of job enrichment/ enlargement,” he added.
“Environment modification is a good
idea. For example, for alcohol dispensers, even putting a mirror above gives people the feeling that they’re doing something good! There are also reports of increasing cleanliness by 80% by sticking a fake fly in a urinal so men would increase accuracy trying to spray it off!”
Organisational culture is important to
Martin, who compared the system of shared vision to that used by corporations
Belimed UK Shipley West Sussex RH13 8GQ
Email:
sales.uk@
belimed.com Tel: +44 (0) 1403 738811
NOVEMBER 2018
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