CS CONNECTION


healthcare professionals monitor the effectiveness of both cleaning and disin- fection/sterilization procedures.” The CS/SPD team at NorthShore University HealthSystem based out of Evanstan, Ill. was one of these proac- tive organizations, designing standard decontamination workows and cleaning pathways based on ANSI/AAMI ST79 and the Association of periOperative Registered Nurses (AORN) Guideline for care and cleaning of surgical instru- ments. The leaders of the initiative, Courtney Mace Davis, MBA, CMQ/OE, CHL, CRCST and Joan M. Spear, MBA, RN, CNOR, CRCST, published a sum- mary of their work in the August 2021 AORN Journal. o confirm that the proposed standard decontamination workows and cleaning pathways were effective, the CS/SPD team performed cleanliness verification tests on sets that contained complex instruments, including a laparoscopic gynecology set and a sinoscopy set fol- lowing extended time between point of use (POU) and decontamination steps. After set decontamination in compliance with the proposed standardized work- ow, the sterile processing manager per- formed cleanliness testing on instruments from each of the test instrument sets. Of the nine instruments tested, all passed the test. Periodic cleanliness testing followed implementation of the new workows as a part of the Quality Systems in place.4 Mace Davis comments on their work, stating:


“Most of us in sterile processing departments understand the impor- tance of following instrument IFUs in decontamination. However, this can be challenging to do and the IFU review must be based on each department’s own medical devices/instruments, equip- ment, cleaning agents, and POU process. dditionally, the workow epectations of frontline SPD staff can be varied and complex. As leaders our job is to make steps easy to follow so our technicians can follow the processes each and every time. Using data obtained from clean- ing verification tests, such as borescope inspection and residual protein detection, give us confidence we are following our processes and that the devices/instru- ments are clean.”


Two separate but vital tasks As Hilbert explains, cleaning and dis- infection are two separate tasks, and it


is during the cleaning process that CS/ SPD team members must do the hard work of removing organic material (aka bioburden) from surfaces. She states: “Disinfectants are not designed to remove organic material, whether bacte- rial, viral or other debris. Instead, dis- infectants are made to ensure that clean surfaces stay microbe-free. Disinfectant application needs to follow a good cleaning of the surfaces with enough


force to thoroughly remove most of the unwanted material. Even after clean- ing, surfaces can have gaps that might harbor potential pathogens. Therefore, it is critical to not only clean but also to disinfect and test areas to confirm they are free of contaminants.”


Hilbert says visual inspection is not enough to determine if a surface is clean and microbial tests (swabbing surfaces and then testing for growth in a lab)


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