When it comes to the reprocessing of surgical instruments and other medical devices, standardization—strict adherence to the current standard of care―is essential to protecting patients from risk. Contaminated instruments can cause healthcare-associated infections, including surgical site infections, leading to disease or even death.
All perioperative personnel share responsibility for seeing that items used in surgery are effectively cleaned, sterilized, or disinfected. Having a system of standardized policies and procedures in place across all relevant departments—from the operating room to sterile processing areas—and at each level of the decision-making process can help ensure that this responsibility is met.
Proper preparation of today’s complex instruments and devices can be challenging for perioperative personnel, especially given the variety—such as the wide range of flexible endoscopes used for various clinical settings and frequencies. Before these items can be effectively sterilized or disinfected, they must first be properly prepared and pre-cleaned. Decontaminating instruments so that they are safe for both healthcare personnel and patients requires the use of the correct tools, techniques and knowledge. But difficult-to-clean areas, microbial challenges and uncertainty about the correct use of cleaning solutions can create barriers to the process. Biopsy forceps, laparoscopic instruments and other devices can harbor biofilm and debris that are invisible to the naked eye.
Overcoming these and other barriers to cleanliness requires vigilance, education and a team commitment to follow evidence-based practices as well as manufacturers’ written instructions for use. Policies and procedures should include processes for containing contaminated instruments and minimizing airborne or contact spread of microorganisms. Key steps that should be standardized include pre-cleaning, transport, decontamination, and manual or mechanical cleaning.
The Centers for Disease Control and Prevention, the Healthcare Infection Control Practices Advisory Committee, the Food and Drug Administration, the American Society for Gastrointestinal Endoscopy and the Society of Gastroenterology Nurses and Associates are among the organizations with published guidelines and standards. Reputable, nationally recognized references include ANSI/AAMI ST79: 2017 Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities, the Association of periOperative Registered Nurses (AORN) Guideline for Cleaning and Care of Surgical Instruments, and the International Association of Healthcare Central Service Materiel Management Central Service Technical Manual, 8th edition. Additionally, all personnel involved in reprocessing should follow the Spaulding classification system, which classifies endoscopes and other surgical instruments as critical, semi-critical or noncritical based on the degree of infection risk in their use.
Today’s healthcare administrators are more focused than ever on the need to meet established standards, and more aware than ever of the consequences of not doing so. Media coverage and increased scrutiny by regulatory and accreditation agencies have elevated these issues. Achieving best practices will require stakeholders across the full spectrum of involved disciplines to work together to establish standardized policies and procedures, as well as educational activities and competencies to ensure that those policies and procedures are effectively carried out.
Ruhof, the pioneer in instrument and scope care, is committed to helping you meet and exceed your decontamination and materials management challenges. From cleaning chemistries and instrument and scope reprocessing products to cleaning verification and detergent delivery systems, Ruhof can serve as a valuable resource for your team. And because the company understands that ongoing education, training and mentoring are critical to the success of any clinical department, Ruhof offers a program of free accredited continuing education for nurses and CS/SPD techs at both local facilities and national association trade shows.
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Ruhof is offering continuing education courses at this year's virtual AORN Global Surgical Conference & Expo May 1 - July 31. We will be presenting "Endoscope Reprocessing: Why the Critical Steps are Critical" and "Instrument and Scope Reprocessing: A Closer Look at Proper Cleaning and Verification," each worth two credits.
AORN members can find our courses by clicking Exhibitor Education in the Expo Hall. Not an AORN member? Register for access to this year's Expo virtually.