HEALTHCARE
PURCHASING EWSN SELF-STUDY SERIES
September 2020 The self-study lesson on this central service topic was developed by STERIS. The lessons are admin- istered by Endeavor Healthcare Media.
Earn CEUs After careful study of the lesson, complete the examination at the end of this section. Mail the completed test and scoring fee to Healthcare Purchasing News for grading. We will notify you if you have a passing score of 70 percent or higher, and you will receive a certifi cate of completion within 30 days. Previous lessons are available at
www.hpnonline.com.
Certifi cation The CBSPD (Certification Board for Sterile Processing and Distribution) has pre-approved this in-service for one (1) contact hour for a period of fi ve (5) years from the date of original publication. Successful
completion of the lesson and post-test must be documented by facility management and those records maintained by the individual until recertifi cation is required. DO NOT SEND LESSON OR TEST TO CBSPD. For additional information regarding certifi cation, contact CBSPD - 148 Main Street, Suite C-1, Lebanon, NJ 08833 • www.
sterileprocessing.org.
IAHCSMM (International Association of Health- care Central Service Materiel Management)
has pre-approved this in-service for 1.0 Continu- ing Education Credits for a period of three years, until August 4, 2023. The approval number for this lesson is STERIS-HPN 200408. For more information, direct any questions to Healthcare Purchasing News (941) 259-0832.
LEARNING OBJECTIVES
1. List standards for drying and how to meet those standards
2. Identify the types of air required to dry medical devices and where they are located in a reprocessing area
3. Explain the multiple consequences of inadequate drying
Sponsored by:
Do your medical device drying processes meet the standards?
by Tamara Behm and Pamela Carter R
esidual water creates opportuni- ties for the growth of many types of organisms, in many environ- ments. For example, have you ever left wet clothing or towels in the washer until they became smelly from mildew? Did you know that water left in your ear after swimming creates a perfect environment for bacteria to proliferate, which can cause a bacterial infection called swimmer’s ear? In healthcare reprocessing environments, such as gastroenterology (GI) departments and sterile processing departments (SPDs), wet reusable medical devices can be even more dangerous than laundry mildew and swimmer’s ear. They can interfere with sterilization and/or disinfection processes. They can also cause device damage and can contribute to the formation of biofi lm that contains infectious agents. iofi lm also can prevent effective disinfection or steriliza- tion of the surfaces it adheres to. All these factors can create a serious infection risk for the patients in whom the device is used. This article will review current recom- mendations for effective medical device drying, discuss the appropriate types of air to use and explain how to complete drying steps safely in SPD and GI repro- cessing areas.
Current standards and rationales
The Association for the Advancement of Medical Instrumentation (AAMI) has numerous standards for decontaminating and sterilizing medical devices. Many of these standards stress the importance of thorough drying and explain the reasons. For example, ANSI/AAMI ST79 dis- cusses steam sterilization as one of the most commonly used methods in healthcare facilities. Since steam cycles use water to sterilize devices, it may seem counterin- tuitive that wet reusable devices could hinder the process. However, as ANSI/ AAMI ST79 explains, excess moisture can
40 September 2020 • HEALTHCARE PURCHASING NEWS •
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lead to wet packs that supply a pathway for microbial invasion into the pack. It can also lead to device corrosion.
Gas and vapor sterilization processes are even more susceptible to moisture. Ethylene oxide reacts with water, creating a hazardous byproduct called ethylene glycol (ANSI/AAMI ST41). This byprod- uct can harm patients. In addition, water can prevent vaporized hydrogen peroxide from reaching a device’s surface, thereby preventing sterilization (ANSI/AAMI ST58).
Drying is also a critical function when performing high-level disinfection (HLD) or liquid chemical sterilization (LCS) on endoscopes. As ANSI/AAMI ST91 explains, the failure to completely dry endoscopes after processing creates an opportunity for waterborne organisms, like Pseudomonas aeruginosa, to colonize in the scopes and potentially form biofi lms. This can lead to the transmission of infection to the next patient the endoscope contacts. Thorough drying is a requirement of all disinfection and sterilization processes. AAMI’s standards discuss several meth- ods for drying devices after cleaning and rinsing: • Air dry: placing devices in an area of limited access allowing moisture to evaporate from the device
• Towel dry: using a non-linting towel to absorb moisture from the surfaces of devices
• Mechanical drying: removing moisture with heat or forced air from device sur- faces and lumens n addition some standards defi ne an optimal location to perform drying. For example, ANSI/AAMI ST91 states that endoscopes should have a designated area for drying. This standard also stresses the importance of endoscopes being dry before sterilization, storage and patient use. The point in the process at which drying is required depends on the process. Always
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