STERILE PROCESSING
STERILE PROCESSING
For safety, eff ectiveness, SPD’s endgame must be cut and dried
by Rick Dana Barlow Photo credit: sukan |
stock.adobe.com T
o aerate, dry and store or not to aerate, dry and store, there is no question. Endoscopes and other medical/sur- gical devices and instruments with lumens, niches, nooks and secluded recesses may be used to repair patients and steer them on the road to healing and recovery but they also potentially cause harm when they’re not completely cleaned, high-level disinfected or sterilized, aerated and dried in sterile storage. In fact, even if all organic material and residue from a procedure were removed successfully via reprocessing, but elements of moisture remained, the dangerous risk of contamination and infection to the next patient lingers. That’s what sterile processing and distribution (SPD) professionals know that makes aeration, drying and storage such important components of the reprocessing procedure – and they must be managed properly to prevent shortcuts during time crunches and turnover demands. After all, in many cases, shortcuts can lead to shortfalls, experts agree.
All told, problems in the aeration, dry-
ing and storage process, while an integral part of sterile processing at the end, may not only involve the process itself but other mitigating factors.
Staffi ng and supply “The primary challenge SPD staff face is having adequate amount of tray inven- tory,” noted Kayla Ostrander, Application Engineer, Device Reprocessing, 3M Health Care Business Group, Medical Solutions Division. “When a one-of-a-kind tray is
needed for more than one case in day, or you have two sets of a tray but they are needed for four different cases, these time crunches can cause staff to rush the process and not allow instruments to properly dry before ster- ilizing them. If possible, increasing inventory on
Kayla Ostrander
these types of trays or sets can help with allowing staff to take the proper steps when reproces sing them. “Another challenge has to do with staff- ing,” Ostrander continued. “Whether it’s high turnover rates or inadequate staffi ng that you’re facing, ensuring that staff are knowledgeable of the proper procedures to reprocess items that may harbor moisture can be tricky if you don’t have enough staff to help and you don’t take the time to help properly train incoming new hires.” Richard Radford, CEO, Cenorin LLC, points to another fundamental issue – the definition of “dry” that he contends is a “huge” challenge. “Historically it was sub- jective, like early defi nitions for ‘clean,’” Radford told Healthcare Purchasing News. “Fortunately, this clean endpoint has evolved to a more precise description from merely visual inspection to grams per square centimeter of debris. ‘Dry’ is moving on from estimating or observ- ing dryness (subjective) to a more scientifi c
Richard Radford
28 December 2022 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
condition of ‘clinically dry’ that has been established through a rigorous process with solid documentation.”
Radford refers to a disciplined study per-
formed in a clinical setting that demonstrated a way to determine drying times for specifi c instruments (in this case, robotic devices) to assure a clinically dry state. “Robotic sur- gical devices contain small lumens, com- plex chambers and tortuous pathways in which water can accumulate and must be removed to prepare for subsequent steps in the reprocessing cycle,” he said. “The study [found via Cenorin’s website] describes a precise, controlled methodology that helps provide greater assurance than a subjec- tive judgment.”
But Radford cautions that the presence of moisture is not the only barrier to clini- cal dryness. “Each medical device brings its own challenges,” he noted. “Device design and material aspects, such as interior and exterior surface shapes and textures, device compo- nent materials, and the shape, size and con- fi guration of ports, can all become challenges to successful drying. Robotics, endoscopes, CPAP circuits, sequential compression devices, nebulizers, LMAs and hundreds of other semi critical devices each present their individual challenges.”
Radford recommends looking at the mate- rials used to process devices, too. “Many devices are processed using liq-
uids or other chemicals that may leave a residue that penetrates the surface material of a device and may require aeration,” he
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