PRODUCT & SERVICE LINE REPORTS “We’ve held training sessions to talk
through the benefits of allowing the instruments to soak for the full length of time required before start- ing any manual cleaning efforts,” Kimsey added. “This allows the enzymatic and water to loosen biobur- den and improves the efficacy of the cleaning process and reduces retained bioburden.” Kimsey likens dirty instruments to dirty dishes sitting in a sink for a period of time with ketchup or other food items drying on them. As he explains, trying to scrub off dried-on food without soaking the dish first takes a lot of force and brushing to clean it off. But if the dish is soaked in water for 5 to 10 minutes, it is much easier to remove the food because the water has loosened it. “We use this example to then talk about bioburden you can’t see inside lumens or other areas of instruments, and how tech- nicians who don’t allow the full soaking time before manual cleaning often times do not spend adequate efforts to remove the dried-on bioburden,” said Kimsey. “If allowed to soak for the required time to loosen the bioburden, their efforts would be more successful. In summary, allow the instruments to soak and let the enzymatic and water solution to do its job before you start any manual clean- ing process.”
John Kimsey Identifying issues
For CS/SPD teams looking for ways to improve cleaning efficacy, efficiency and safety, Robert Leenan, Sr. Professional Consultant, Instrument Processing, STERIS, says identifying variation is a good place to start.
“Opportunities can be found in many key
areas from hospital operations to leadership tasks and routines,” he said. “One safety example is simply providing easier access to PPE. If non-compliance levels aren’t reduced, take the time to identify the reasons behind the trend. Then you can see if it’s a time issue, a training issue, a supply chain issue, or any number of other reasons. We often start with the basics and advance to more complex issues in a methodical manner. This process helps to ensure improvement to efficacy, efficiency and safety.
Leenan has seen a renewed focus on lean management techniques in the CS/SPD. perienced and qualified technicians are in short supply,” he said. “In some cases, hospitals utilize lean management techniques and concepts to develop and train staff to become SPD leaders. This can have the long-term benefit of creating lean operational managers that can focus on excellence rather
than just trying to maintain the minimum standards.”
STERIS Instrument Processing Solutions (IPS) offers solution-based modules that are specifically designed to improve comple practices and address problems within sterile processing departments. These solution- based modules provide standards and guid- ance for improving workflow, adhering to regulations, and enhancing the effectiveness of sterile processing activities.
Enhancing visualization ecause it can be etremely difficult, if not impossible, for technicians to see bioburden lingering on instruments and devices, Seth Hendee, CRCST, CIS, CHL, CER, CSPDT, CFER, HSPA Approved Instructor, Clinical Education Coordinator, SPD, Healthmark Industries, stresses the importance of enhanced visualization tools. “Enhancing visual inspection is the best
Healthmark Clamp for FIS-007
way to add quality to an SPD’s cleaning processes,” said Hendee. “This can be done in two ways. First, utilizing a bore- scope to visu- alize internal spaces that can- not be seen, even with tabletop magnification, will inevitably show any defi- ciencies in the cleaning process. Second, utilizing a cleaning veri-
fication device, e.g., a swab or flush, to test for residual soils is also an excellent way to determine if those hard to reach/see areas are being effectively cleaned. This is not a new concept, for example, the FDA has cited both methods as ways to increase the safety margin while cleaning joint shavers.” “While borescopes are not new, the tech- nology continues to improve, and those improvements are worth noting,” Hendee added. “Advances in imaging technol- ogy allow borescope catheters to become smaller in diameter and longer length, while still providing detailed images and videos. Another advancement is the abil- ity to change out the imaging catheter. In previous versions, borescopes came in a specific length and diameter. f you needed a different size, the purchase of an entirely different unit was required. Now it is possible to buy a base unit to control the computer/display interface and select/ add catheter(s) separately depending on the department’s needs.”
Performing verification Because some instruments and devices can be challenging to clean, Nikki Kluck, BS, MS, Lead Technical Applications Specialist, 3M, recommends CS/SPD department profes- sionals employ a routine cleaning monitor- ing program, for example, one that employs Adenosine Triphosphate (ATP) monitoring, to verify the adequacy of the cleaning process. With devices and fleible endoscopes in particular, studies have shown that clini- cal soil can withstand the manual cleaning process and prevent high-level disinfection or sterilization from doing its job2
,” said
Kluck. “It’s impossible to accurately assess the instrument’s cleanliness with visual inspection alone. As a result, potentially deadly bacteria and pathogens can be passed on to patients.”
Kluck points out how the newly revised ANSI/AAMI ST91:2021 Flexible and semi-rigid endoscope processing in health care facilities standard includes a new defi- nition of high-risk endoscopes and requires that all high-risk endoscopes be monitored using cleaning verification tests after each cleaning. Endoscopes that are deemed not to be high-risk are recommended to be monitored with cleaning verification tests when new endoscopes are purchased and at established intervals.
“The 3M Clean-Trace ATP Monitoring ystem finds residual clinical soil consis- tently,” Kluck added. “The system uses ATP bioluminescence technology to ‘see’ contaminants. When ATP is combined with the reactants in the Clean-Trace test, light is produced — invisible to the naked eye, but easily read. Results are expressed in Relative Light Units (RLUs), which are representative of the amount of clinical soil on the surface or device.”
3M Clean-Trace ATP Monitoring System
Keeping a clean environment Keeping the decontamination area of the CS/SPD department clean is no easy task as technicians work to remove bioburden from instruments and devices. But Erica Smith, MBA, Surgical Solutions Specialist at Henry Schein Medical emphasizes the importance of the environment on infec- tion prevention.
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