August 3, 2023

Instrument Reprocessing and Care

By: Outpatient Surgery Editors

Published: 8/2/2023

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THIS WEEK'S ARTICLES

A Simple Way to Bolster Bedside Cleaning

Reprocessing Staff Benefit From Hands-on Education

Discover an Innovative Solution for Instrument Sterilization That Increases Efficiencies and Flexibility - Sponsored Content

Planting the Seeds of Sterile Processing Careers

Outpatient Infection Preventionists and Sterile Processing

 

A Simple Way to Bolster Bedside Cleaning

Make the most of this common teachable moment.

PrecleaningHEAD START By precleaning instruments to remove bioburden before it hardens, OR staff make manual cleaning quicker and easier for sterile processing techs while better ensuring full sterilization.

Organic matter is discovered on critical, regularly used instruments. Do you: a.) Ask sterile processing what happened, or b.) Reach out to your surgical techs to learn if precleaning was missed among their laundry list of tasks, and then reiterate the importance of this crucial but too-often neglected practice?

If you answered "b", Frank Myers, MA, CIC, FAPIC, assistant associate director of infection prevention and clinical epidemiology at University of California, San Diego Health, appreciates your knowledge and understanding of the full scope of instrument cleaning. Mr. Myers has seen sterile processing departments take the blame on many occasions for a missed step in the instrument cleaning process that truthfully is the responsibility of surgical techs.

When this happens, Mr. Myers suggests taking a step back and using it as a teachable moment, as it’s a prime opportunity to revisit communication between the sterile processing department and the OR. When organic material is discovered in sterile processing, he says, institutional leaders should first reach out to surgical techs. Such discussions also provide great opportunities to uncover workflow issues.

"You need to have a discussion with your techs and find out how the precleaning is missed," says Mr. Myers. "Maybe it’s just ignorance or not knowing, but maybe there’s a bigger issue. Maybe the techs are multitasking too much and need to let leadership know, "I’m running three ORs and…’"

Regardless of whether any major changes are made, investigating these problems provides you another opportunity to reiterate the absolutely essential importance of precleaning. "One of the most basic tenets of instrument care is making sure precleaning takes place at the bedside by OR staff," says Mr. Myers. "They should be removing gross debris and organic matter in the OR, and the instruments should be wet when they make it back to the sterile processing department."

Reprocessing Staff Benefit From Hands-on Education

A training regimen combining lectures with real-time practice improves understanding, retention and confidence among sterile processing techs.

BorescopeAscension St. Vincent Mercy Hospital
TOTAL EXPERIENCE A new study finds that by complementing classroom education with real-life handling of borescopes, reprocessing techs were better able to retain what they learned.

A recent study of a unique training model for sterile processing professionals showed that participants in the program not only were able to master complex skills related to borescope inspection of endoscopes, but also retain what they learned while showing the ability to take actionable steps to address issues that emerge during the endoscope processing cycle.

The pilot program was developed and tested by the Healthcare Sterile Processing Association (HSPA) Foundation and Ofstead & Associates, a research and consulting firm that bills itself as offering evidence-based solutions to challenging issues. The program supplemented traditional lectures and follow-ups with pre- and post-testing, real-time opportunities to practice what was learned immediately after the lectures as well as a "training booster."

A review of the program was published in the American Journal of Infection Control. Cori L. Ofstead, MSPH, president and CEO of Ofstead & Associates, characterizes the results as both encouraging and sorely needed. Inadequate processing and inspection are believed to be factors in cases that result in infections and other injuries.

The study group excelled by combining lectures with time for firsthand practice that cemented what they learned. The level of effectiveness was confirmed by testing the sterile processing professionals before and after the curriculum, which revealed that their knowledge and skills regarding visual inspection of endoscopes among the group improved greatly after the training. Pre-study test scores of 41% improved to 84% afterward, and follow-up tests given two months later produced an average score of 90%, with trainees reporting higher levels of confidence and satisfaction with their technical knowledge.

"After the workshop, all trainees identified actionable visible defects on patient-ready endoscopes in their facilities," notes the study, lauding the efficacy of a training regimen consisting of pre-testing, lectures, hands-on practice, a training booster and post-testing. "Their new knowledge and technical skills allowed them to identify real-world issues like damaged devices, residual substances and retained fluid that impact sterile processing effectiveness and place patients at risk of injury or infection."

Discover an Innovative Solution for Instrument Sterilization That Increases Efficiencies and Flexibility
Sponsored Content

As ambulatory surgery centers take on more surgeries, a high efficiency surgical workflow is critical for keeping patients and staff safe.

One TrayONE TRAY®
An example of an EZ-TRAX™ tray inside of a ONE TRAY® sterilization container.

Ambulatory facilities serve communities across the nation by offering surgical procedures that are safely and efficiently carried out by OR teams who work seamlessly together to prepare patients for their pre-op, intra-op and post-op journey. A major part of that process is the critical sterilization step needed for instruments of all shapes and sizes to be used in the wide range of surgeries offered in these same-day organizations.

The ultimate goal is to keep patients – as well as staff members – safe.

OR consultants that work closely with surgeons and surgical teams need to educate themselves about the options available. In fact, such partnerships with ambulatory facilities are of paramount importance as OR leaders look for the most efficient, cost-effective solutions to their reprocessing needs. As more cases move to the outpatient environment, workflows have changed dramatically in the pandemic and post-pandemic years. Providing new solutions, collaborating and educating the entire staff have become more critical to successful sterilization as surgery volumes across a wide range of specialties has grown.

ONE TRAY® has transformed the approach to sterilization for ambulatory centers by providing a solution – the Total Solution. This approach allows facilities to meet demands head on by processing instrumentation in a fraction of the time it takes sterile wrap or other rigid containers and in less trays. American made and backed by a Lifetime Warranty, ONE TRAY® is committed to patient safety and providing years of effective and reliable service.

In the orthopedic environment, in particular, partnering the ONE TRAY® sterilization container with the EZ-TRAX™ surgical set customization tray maximizes the reprocessing of orthopedic sets with the ability to take 6 to 8 trays down to approximately 2 to 3. This saves around 3 hours (depending on your sterilizer) in reprocessing per case resulting in approximately a 75% reduction in cost and labor to process surgical instrumentation.

The use of this solution has given surgeons more flexibility and the ability to treat more cases in less time and with less trays. Notes Robert Marchand, MD, an orthopedic surgeon and total knee expert, "The use of the ONE TRAY® and EZ-TRAX™ solution allows me to use less equipment and offers much more rapid turnover." With this solution, facilities can add more cases each day and mitigate delays – ultimately leading to overall patient satisfaction.

Education is key to the success of any new program, so the team at ONE TRAY® have worked to develop a network of support. A full staff of educators is available to work directly with facilities that choose to implement ONE TRAY® and EZ-TRAX™. According to the company, "We take pride in being one of the only companies that offer a full staff education team that works directly with facilities to educate… providing industry experts to facilitate the transition of new technology."

This education team and clinical staff supports a variety of staff members ranging from the Sterile Processing Department (SPD), operating room staff, infection control personnel, surgeons and more for an efficient transition and follow up support. ONE TRAY® even has a past surveyor on staff that can help prepare, and even be on call, during a survey to address any questions regarding the ONE TRAY® technology. Additionally, free online Continuing Education Credits (CEs) are available at the company’s CE Page.

Note: For more information go to onetray.com.

To see a LIVE case timelapse showing the time savings of ONE TRAY®/EZ-TRAX™ verses sterile wrap, please go to https://www.youtube.com/watch?v=xflI4mDGWyg&t=59s

Please follow the product IFU’s for use. Condoc 496

Planting the Seeds of Sterile Processing Careers

A hospital’s collaboration with a local community college aims to expand the talent pool in a tight labor market.

The healthcare industry is still struggling to staff facilities with qualified providers. This continuing crisis is leading many organizations to "think outside the box" when it comes to their recruitment techniques.

The realm of sterile processing is no exception. If your center is currently struggling to grow its team of sterile processing technicians through standard recruiting efforts that aren’t paying off, consider following in ProMedica Monroe Regional Hospital’s footsteps.

The facility, located in Monroe, Mich., is partnering with neighboring Monroe County Community College (MCCC) to host an open house designed to attract students to the college’s Sterile Processing Technician course. The 12-week medical career training track, which grants continuing education credits upon completion, prepares students to succeed as sterile processing professionals in multiple healthcare settings, with those who complete and pass it then equipped to sit for the Certification Board for Sterile Processing and Distribution Technician Certification Exam.

The open house is intended as a way of funneling local jobhunters and education seekers into signing up for the college’s course. While those who attend the open house, of course, aren’t yet ready to assume positions in the facility’s sterile processing department, it allows the hospital to initiate relationships and build awareness among those who might become qualified techs months down the road.

ProMedica Monroe establishes itself as a valuable educational resource while also branding itself as a potential employment option for the soon-to-be-certified techs-in-training who visit and decide to sign up for the college course.

The hospital’s open house includes a presentation on sterile processing technology, information on employer expectations and employee salaries in the field, and a tour of ProMedica Monroe’s Sterile Processing Technology Lab, as well as an outline of the course’s curriculum and information about tuition assistance for eligible students. Presenters include the hospital’s director of inpatient surgery, ambulatory surgery and post-anesthesia care, the college’s course instructor, and the director of the Michigan Works! Monroe American Job Center.

"There is a local need for sterile processing technicians, and successful completers can expect to earn a starting hourly wage between $16 and $20 per hour or more," says Barry Kinsey, MCCC’s director of workforce development. "Most of the students who have attended previous training sessions are actively employed in the field. This is a great opportunity for a student to train and begin a career in health care."

Such a collaboration with a local school can be an especially appealing option for outpatient facilities who are battling with local hospitals for sterile processing techs. An ASC that engages in such an event can make a lasting first impression on techs in training that could factor into their own employment search and decision down the road. At the very least, even if none of the students eventually join your ASC, your facility will help expand the sterile processing labor pool.

Outpatient Infection Preventionists and Sterile Processing

Even if it’s not their full-time job, someone at your facility should be monitoring reprocessing practices through this patient safety lens.

Does your outpatient facility have an infection preventionist on staff? Many ASCs don’t, and instead assign this crucial safety task to an employee who also carries other duties. One saving grace that makes these situations workable is that full-time infection preventionists who work at inpatient hospitals have much more on their plate than do their outpatient counterparts.

"An infection preventionist’s role at an ASC is a little different than at an inpatient hospital, in that the role is often more observational," says Pam Falk, MPH, CIC, FSHEA, FAPIC, president of Pamela S Falk Consulting in Atlanta and a veteran of more than 40 years in infection prevention. "You must physically get into the operating rooms and the sterile processing areas to see what is going on to make sure people are following the protocols that are identified. Outpatient infection preventionists do track SSIs like their inpatient counterparts, but a lot of their practice is process-oriented, such as assuring the surgical prep was done correctly, the antibiotics were given in a timely manner and the instruments were sterilized according to correct protocol."

Ms. Falk shares some practices about which outpatient infection preventionists should take note.

"Something I find a lot of people do not understand is how to properly assess a peel pack," she says. "It needs to be sealed properly and it needs to have a chemical indicator inside of it that’s labeled appropriately."

Another common issue is proper handling of surgical instrument caskets. "These caskets have little vents in them that also house a paper filter," she says. "The vents should not rock; the air should go through the paper vents. Caskets get damaged every so often, so you need to know how to spot this problem."

One overriding task for an outpatient infection preventionist, says Ms. Falk, is simply to get everybody on the same page. "People in sterile processing need to know how to clean and sterilize the instruments, but often people want to take shortcuts that can result in patient infection and harm," she says. "Instituting standardized processes will help prevent staff from taking these shortcuts or thinking they have a better way of doing things. As the infection preventionist, it is your job to understand the instructions for use for everything that needs to be cleaned, disinfected and sterilized, and to make sure the staff understands them as well."

Ms. Falk says outpatient infection preventionists should keep learning as much as they can while seeking external support. "Allow your infection preventionist to get the necessary education to succeed in their role, and to develop a system of networking," she says, noting that the Association for Professionals in Infection Control and Epidemiology (APIC) and the Association of periOperative Registered Nurses (AORN) are great resources for both. APIC offers an Outpatient Infection Prevention course to help providers learn how to be outpatient infection preventionists. "The module covers around 20 different very tangible aspects of the job," she says.

Ms. Flak firmly believes outpatient facilities should allow their infection preventionists to attend meetings and belong to professional societies like APIC and AORN. "Give them access to continuing education because infection prevention changes so much," she says. "You want your infection preventionist to be prepared and confident when an accreditation agency comes in and asks them the infection prevention issues with a particular piece of equipment, like an autoclave. The role of an infection preventionist is an important one and a big responsibility, so whoever tackles this job should feel prepared and capable to help keep the facility, its staff and its patients safe." OSM

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