STERILE PROCESSING
observed. “Modern drying systems aid in the aeration process using controlled heat and exhaust air. When aeration and drying are complete, some drying chambers can also be part of a staging or storage plan. To be used in this way, the chamber must be sealed to prevent external contamination or protected with HEPA filtered circulating or continuous heated or room temperature air.” Radford acknowledges that each type of lumened or complex device presents its own challenges for drying and storage, so he advises a key step to initiate any changes in the process. “We suggest performing an inventory of
the devices used in your hospital and deter- mining what specific drying conditions are most effective for each one,” Radford said. “It might also be helpful to compare the vari- ous available drying systems and cabinets to determine which ones have the features that meet your needs best. Consult each drying chamber manufacturer to determine whether they have engineered their drying process to handle all of your devices, and whether they can share validated data to demonstrate drying effectiveness.
“In a quality-focused healthcare environ-
ment, the critical contribution of effective drying is becoming an even more important factor in the reprocessing cycle because of its contribution to the next safe use of each device,” he added.
Access to enough
product can make a dif- ference, according to Malinda Elammari, CST, CSPM, CSPDT, CFER, CSIS, CRCST, CIS, CHL, CER, CLSSGB, Clinical Education Specialist, Healthmark Industries. “While challenges occur in all facets of the process, the storage of extra instruments and devices is an important concept that is often overlooked but can have a negative impact on patient outcomes when done incorrectly,” Elammari noted. “The use of organizational items such as peg boards and bins are ben- eficial for helping with space constraints and easy instrument identification; however, they are not a set it and forget it concept. These items must be maintained and not serve as collection points for dust which act as fomites for microbes. If these items make it to the patient they can lead to complications for the patient.”
Malinda Elammari
Aaron Champion, Vice President,
Endoscopy Sales, Solaire Medical, recognizes the intensity of the SPD department and the clinical pressure to perform – particularly for minimally invasive devices.
“Endoscope sterile reprocessing depart- ments are often fast-paced environments that
require quick turnover of reprocessed scopes to meet the demands of a high caseload facility,” he said. “Repro cessing techni- cians need to feel confident that a stored endoscope has been through a drying cycle. Forcing air through the internal channels of the endoscope to promote dry- ing helps remove moisture that might not drain out by simply hanging the scope verti- cally in a cabinet. Removing this internal moisture with forced air can mitigate bacte- rial growth and contamination in a repro- cessed endoscope.”
Aaron Champion
Picking a pathway Quantity should not surpass quality such that shortcuts lead to slipups with dire con- sequences, according to Theresa Kunsman, Senior Product Manager, Cleaning/ Disinfection/Sterilization, Olympus Corporation of the Americas. “Controlling the human factor in repro- cessing is always a challenge,” Kunsman indicated. “The key to effective reprocess- ing is repeated and consistent execution of the device’s defined process each time the endoscope is cleaned. On busy days, some technicians may be inclined to ‘speed up’ a process. It is important to stress the quality of cleaning and put processes in place to keep external pressures from influencing technicians to hasten the cleaning or steril- ization process.” Kunsman advises that SPD implement dry- ing processes that should be dependent on whether the device is sterilized or disinfected before storage. “This is because drying occurs before
an endoscope is sterilized but occurs after an endoscope is disinfected,” she noted. “Separate drying devices should be desig- nated for sterilization and disinfection to avoid contamination of high-level disin- fected scopes. “Simply managing two distinct drying
processes in the same department can be challenging,” Kunsman recognized. “A workaround for this issue that is sometimes adopted is high-level disinfecting of the endoscope before drying and sterilization. This allows the same drying device to be used without the fear of contamination. In this sce- nario, the time for sterilization is increased by the length of the HLD process. Technicians must be educated on both sterilization and disinfection processes – unless the facility is able to designate experts for each area.” Kunsman advises that technicians need
to be able to identify the proper category each device requires – whether high-level disinfection or sterilization.
30 December 2022 • HEALTHCARE PURCHASING NEWS •
hpnonline.com “The ultimate challenge is selecting the
process that works best in the facility and evaluating the cost/benefit of maintaining separate drying devices against adding addi- tional time for sterilization,” she said. “In the case of sterilization, ensuring the device is completely dried is critical because moisture can impede most sterilization processes. For example, if moisture is present during steam sterilization, the sterilizer may experience condensation issues. Some sterilization units have a built-in abort mechanism if moisture is detected. Drying before sterilization may include the use of a clean lint-free cloth to wipe external visible moisture, pressure- controlled compressed air, and a drying device/cabinet.
“The drying process is also critical for high-level disinfected devices because any residual moisture left after disinfection can promote bacteria growth,” Kunsman con- tinued. “Drying a device after disinfection may include wiping the external surface of the device with a clean, lint-free cloth, and drying with highly filtered air, such as instru- ment air. Using a drying cabinet to complete the drying process provides a controlled environment for drying, limits exposure to external contaminates and helps protect the endoscope from damage.”
SPD should evaluate this process beyond
the confines of its departmental footprint as well, according to Kunsman. “Most SPDs do not store devices in that department,” she said. “In many cases, the devices are transported to a separate department. SPDs must develop a method of transport and storage that maintains the endoscope reprocessing status and protects the device from damage. Tracking meth- ods must also be included in the overall process. This enables device location, vali- dation of reprocessing status, and process management.”
Inside the lines While some areas to watch to ensure proper aeration and drying works may be overt, others are more covert and hard to find – and cannot be dismissed, ignored or missed, experts argue. “Surgical instruments can be very com- plex these days, and staff may not be aware of areas that may hold moisture or what needs to be disassembled for proper dry- ing,” said 3M Health Care’s Ostrander. “When acquiring new instrumentation, it is important to educate staff through in- services on proper cleaning and assembly methods to help ensure instruments aerate and dry properly.”
Ostrander lists several examples of areas
that may hold moisture or need to be disas- sembled for proper drying, such as depth
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