SELF-STUDY SERIES


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Automated Equipment Items to Know


• Maximum load weights • Dissasembly and loading instructions • Openings face down


• Place lids and retainer plates in loading slots


• Correct cycle choice


increase the water pressure to apply force that dislodges residual soils. The pro- grammed cycle used for containers is typi- cally labeled “container” or “utensil,” but may vary depending on the equipment’s cycle names.


Cart washers come in an array of sizes to accommodate the needs of various sized facilities, from small ambulatory surgery centers to large hospitals. Using a cart washer to reprocess containers enables the department to improve its reprocessing workows by not tying up smaller washer disinfectors with bulky containers. This frees up the washer disinfectors to be used for medical device sets and surgical acces- sories, which assures greater efficiency and throughput overall.


Quality inspections


Inspecting rigid containers after clean- ing and disinfection is as important as the cleaning itself. Inspection checks for residual soils and cleaning chemistry, wear and tear, and mechanical disfunction that could potentially interfere with steriliza- tion or could fail to maintain sterility of the contents. If inspection identifies dam- aged containers or accessories, they need to be repaired or replaced. Items to inspect


include (but are not limited to) gaskets, valves, interior baskets, mating surfaces, reusable filters, filter retainers and latches. Damaged containers and accessories must be removed from the use inventory and the manufacturer needs to be consulted. As part of a thorough quality system for containers, a routine preventive mainte- nance schedule should be established and documented; this assures that tools are in place to detect and/or avoid potential problems. Containers are not meant to last forever, so the container vendor can pro- vide information about the expected useful life of each type of container. The depart- ment or purchasing manager should then budget accordingly for timely replacement of compromised or aging rigid containers.


Space constraints Regulatory inspectors will not allow space constraints as an excuse for skipping reprocessing steps or not fully following manufacturers’ IFU. They will expect departments to maximize the space they have by performing proper planning that includes workflow, case demands and calculated expected throughputs. It’s worthwhile to consider automating the container cleaning process. Automation allows consistent proper practice while freeing staff to focus on case sets and other instrumentation.


Tight reprocessing spaces, like those in


ambulatory surgical centers, require equip- ment with small footprints. In addition to the washer, it’s important to have the cor- rect number and types of racks needed to


Container System Inspection Item Examples GASKET BASKET


MATING SURFACES


REUSABLE FILTERS LATCHES


• No fraying, cuts or missing pieces


• Broken or missing handles • Sharp edges or broken wires


• No dents, chips, cracks • Filter retainer fits with no gaps


• Within its use limit


• No missing components • Securely attached • Lid secures with even latch pressure


30 January 2021 • HEALTHCARE PURCHASING NEWS • hpnonline.com


process the containers in use at the facility. Depending on the case load, it may also be wise to invest in a small cart washer, which would allow the washer disinfector to be dedicated to instrumentation and the larger cart washer to case carts. This would enable a better use of space and equipment, and would support a continuous, more efficient workow and throughput for both instru- ments and container systems.


Avoid container woes No one wants to be the person standing in front of the auditor explaining why con- tainers are not being properly processed. Rigid sterilization container systems are Class II medical devices and are cleared by the U.S. Food and Drug Administration (FDA) for use. Per FDA and other regula- tory guidance, facilities must adhere to the container manufacturers’ IFU, which pro- vide all the necessary information for cor- rect use, care, cleaning, inspections, routine maintenance, sterilization methods, and storage. Facilities must develop policies and a standardied workow that support these instructions, and confirm staff com- petency through training, education and regular evaluation of staff performance. Be the one who finds and corrects any problems in container processing, before the auditor does. HPN


References


1. ANSI/AAMI ST41: 2008/(R)2012 Ethylene oxide sterilization in health care facilities: safety and effectiveness. Arlington, VA: Association for the Advancement of Medical Instrumentation


2. ANSI/AAMI ST58: 2013 Chemical sterilization and high-level disinfection in healthcare facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation


3. ANSI/AAMI ST77: 2013. Containment devices for reusable medical device sterilization. Arlington, VA: Association for the Advancement of Medical Instrumentation.


4. ANSI/AAMI ST79: 2017. Comprehensive guide to steam ster- ilization and sterility assurance in healthcare facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation.


5. Association of periOperative Registered Nurses: 2020. Guide- lines for Perioperative Practice; Packaging Systems.


6. Shaffer HL, Harnish DA, McDonald M., et al. Sterility mainte- nance study: Dynamic evaluation of sterilized rigid containers and wrapped instrument trays to prevent bacterial ingress. American Journal Infection Control. 2015; 43; 1336-41


Pamela Carter, BSN, RN, CNOR, AGTS, CRCST, CER is a clini- cal education specialist for STERIS Corporation. She is a certified perioperative registered nurse with over 27 years of experience in a variety of specialties includ- ing nursing management,


surgical nursing, sterile processing education and OR/SPD infection prevention and quality. In addition, Pamela has written articles for HPN and AORN, and is an active member of AAMI, AORN, APIC, ASCA, ASQ, IAHC- SMM, and SGNA.


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