OPERATING ROOM
sterilization and can lead to surgical site infec- tions. Having a reliable water source should be the fi rst step in caring for your surgical instruments. The water will activate enzymes during the cleaning process and remove mineral deposits from the surgical instru- ments. Having the correct brushes is essential to preserving the instruments’ passivation layer. When instruments are cleaned using metal brushes, the passivation layer can be scratched, leading to pitting and corrosion.” Lemmons shares, “The use of a pre-treat- ment will make the difference between an increase or decrease of biofi lm formation and subsequent infection. Pre-treatment products act as a bacteriostatic wetting agent, many of which keep instruments moist for up to 72 hours, inhibiting microbial growth and preventing surgical soil from drying on the instruments. Pre-treatment products promote improved cleaning results during the manual cleaning process in decontamination. ddi- tionally, having a pre-treatment spray that features surfactants and emulsifi ers helps pull the surgical soils away from the instrument surface. Water is not enough when the risk of postponed decontamination is increased. vailability and use of pre-treatment prod- ucts are an absolute must.”
How can instruments be tracked, tested and protected taff and software may be used for instru- ment tracking, explains amos. “taff in the O and terile Processing are equally responsible for identifying instru- ments needing repair, taking them out of circulation as soon as possible and commu- nicating their daily challenges and struggles to the leadership team,” he stated. “When appropriately implemented and maintained, tracking software helps in the care and han- dling of surgical instruments. Most software on the market today allows for picture inte- gration, IFs and special instructions. ome software programs can be programmed to reject an item when a critical scan has been missed in the process. For example, an instru- ment set could be used to scan the O without a previous scan of the decontamination area and/or sterilizer. Instrument organizers can extend instrument life by securing and orga- nizing them.” Training helps support staff in the mainte- nance of devices, notes Matthews. “terile processing must receive the training
and tools necessary to identify early warning signs that a device might not function in the way the surgeon requires,” he emphasized. “In cases where early warning signs are diffi cult to detect, power tools for example, facilities should move to a preventative care plan this is best accomplished with a tracking system that can determine how many times a single device has been used since its last pre-
ventative maintenance. s surgical devices become more complex, they also break in more subtle ways. Enhanced visual inspection tools, such as digital microscopes and bore- scopes, should become a standard expectation in all sterile processing departments.” Protective supplies and testing equipment
help maintain use and safety of instruments, expresses Cheron oo, , CCT, CI, CE, CFE, CL, Clinical Educator Coordi- nator-SPD, Healthmark Industries. “One such new tip protection is the obotic
Tip uard,’ a specialized tip protector approved by INTITIE for robotic arms (Figure ),” oo said. “This low-linting tip guard protects the delicate instrumentation during sterilization, transport and storage.” e continued, “NI
I T7 recently pro- vided recommendations in their new amendment on the inspection of insulated instrumentation stating cablescords are also a source of concern and need to be inspected and checked for integrity and continuity’ (NII, 2020). It also recommends that instruments intended for use with electric current should be tested for integrity each time it is processed’ (NI I, 2020).5
Cheron Rojo The integrity of an insulated
instrument is conducting a test while using insulation tester equipment with the appro- priate accessories designed for that instru- ment (Figure 2). egarding the testing for continuity, another type of equipment is needed (Figure 3). continuity tester is used to test the unbroken connection between the two points from proximal to distal inside the cablecord. reusable cablecord may pass the integrity test with an insulation tester but may not pass the continuity test.” With fl exible endoscopes specifi cally, Fisher stresses, “having a working leak tester is criti-
Figure 1. Robotic Instrument Guard designed to protect the robotic tips. INTUITIVE approved.
cal. Leak testing should happen both before and after cleaning. Equally important is to have the correct size and length of cleaning brushes. brush that is too small will not be effective for reaching all areas of the working channel. brush that is too large can damage the working channel, leading to contamina- tion and a potential costly repair.”
Prepare for the future What is on the horizon for next-generation PD and instrument care
“I believe as instrumentation becomes more
complex, so will the cleaning, reprocessing and sterilization requirements,” Fisher envi- sioned. “It is important that as manufacturers and healthcare providers, we continue the dialogue about the importance of following the cleaning instructions and IFs. lso, we will continue to see single-use devices reach the market.” atthews foresees expanded partnerships, roles and education. “It is critical that sterile processing teams
Figure 2. Insulation testing equipment with accessories.
Figure 3. Continuity testing equipment.
and their vendor partners collaborate to create better solutions that enable proactive repairs and better training to identify early warning signs of device damage,” he said. “terile Processing Technicians themselves will see their positions become more technically com- plex, which will create a massive demand for innovative educational resources.” amos predicts growth in automated technology, staff certification and college programming. “With the transformation of terile Pro- cessing Departments worldwide, we see the continuous development of the DI and other forms of tracking technologies that would allow complete traceability for every instrument,” he stated. “achine learning and engineering development advancements will bring us closer to a more automated quality management system where instru- ments will be inspected for defects by a machine before assembly to ensure that they meet the expected quality standards. I also foresee advancements in the automation of sets assembly as healthcare systems understand and realize the value of standardization. s professional organizations continue to push for mandatory certifi cation at the state level, I see the sterile processing fi eld transforming. In a few years, we will see many community col- leges offering an associate degree program in sterile processing. The PD of the future is a hybrid of good manufacturing practices and
safe patient care.” HPN Visit
hpnonline.com/21213861 for references. 24 April 2021 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
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