CS CONNECTION


instrument processing, and it removed the responsibility of instrument pro- cessing from the nurses, allowing them more time with their patients.” Back then, surgical instruments largely would be considered “non-complex” by today’s standards, Agoston continued. They consisted primarily of stainless steel devices used for cutting, grasping, dissecting, etc., along with basins and glassware.


“The staff for the newly created Cen- tral Sterile Processing Department often were promoted from dietary services since the functions of cleaning were seen as similar,” Agoston recalled. “Pay was a


Dissassembled scope reveals cleaning difficulties


skills needed for non-complex instruments. Instructions for Use (IFU) went from one page of cleaning instructions to 37-plus pages for a robotic instrument, and over  pages for a eible endoscope. “With hundreds of hospital- and vendor- owned instruments/sets being processed daily, the importance of a highly productive and effective SPD is just as important to the success of the surgical procedure as are the surgeons, anesthesiologists and nurses,” Agoston insisted. [Editor’s Note: Agoston shares his vision of a solution in the sidebar, Advance SPD to include higher-paid specialist teams on page 40]


Photos courtesy: Healthmark Industries


step up from dietary pay. Lost in this transition was the knowledge that the nursing staff had of how the instruments were used and their relative importance to the successful surgical procedure. SPD staff were expected have the capability to clean, inspect, assemble and sterilize all items that came through the department. This model worked primarily because of the simplicity of the instruments and relatively few instrument sets the department was responsible for.” Advanced surgical procedures began to emerge and grow, Agoston posits, and pressurized the 1940s SPD model. “Fast forward to today’s advanced surgical procedures that require complex instruments – endoscopes, cameras, power tools, robotic instruments, Orthopedic/Neuro/Spine, etc.,” he continued. “These procedures could only be dreamed about in 1940. The associated skills needed for cleaning, inspection and sterilization of these complex instruments is much higher compared to the


Others foresee a more pervasive embrace


of hybrid devices. In fact, a smaller segment (14.3 percent) argues that hybrids will be used by the majority.


“Endoscopes are becoming widely known as one of the most difficult medical devices to process, said eth endee, , I, , , , , linical ducation oordinator, , ealthmark Industries o. dd to this, our increasing awareness that they are a proven source of hospital-acuired infections Is makes me believe change is needed and inevitable. An endoscope’s complex nature of design factors must be considered, and if the design of the device is a problem, then a redesign is a logical solution.” ut endee stops short of recommending full conversion to disposable/single-use devices.


Seth Hendee Page 36


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