Proper Disinfection of Robotic Platforms

Here’s what you’ll need to consider before investing in a surgical robot to ensure it will remain safe and contaminant-free for use on your patients.

Surgical robots, once only affordable to the largest hospitals and health systems, are now finding their way into a growing number of outpatient surgical facilities as patents expire, competition among an expanding number of vendors intensifies, and more options become more affordable to smaller organizations.

Purchasing, installing and using a surgical robot is one thing. But what about the most important bit of maintenance in terms of patient safety and infection prevention? Specifically, what exactly goes into cleaning and reprocessing these robotic platforms so they are safe for use on patients? How does a facility ensure that its robotic platform is free of bioburden and other contaminants that could result in patients with surgical site infections?

To find out, we consulted a sterile processing expert who knows this topic inside and out: Damien Berg, BA, BS, CRCST, AAMIF, vice president of strategic initiatives with the Healthcare Sterile Processing Association.

Growing usage and applications

One thing is clear: surgical robots are assisting surgeons and their perioperative teams in numerous specialties that are core to the realm of outpatient surgery.

“Robotic surgery has been around for some time, and the surgical interventions continue to evolve and advance to provide better and safer patient care,” says Mr. Berg. “Robotics are now commonly used in many types of surgery, including general, urology, cardiovascular, OB/GYN, ENT and orthopedic procedures.”

No matter what types of procedures might be assisted by your facility’s robotic platform, there are certain aspects of properly caring for and disinfecting these devices that transcend the specialties in which they are used or an individual vendor’s platform.

Tips of the trade

HOW DEEP? HOW WIDE? Sinks and other equipment in your SPD must meet the robot manufacturer’s requirements in order for components of the robot to be safely reprocessed.

Mr. Berg shares these key aspects of surgical robotics reprocessing.

• All hands must be on deck, working in the same direction. Mr. Berg says interdepartmental, interdisciplinary coordination within a facility where a surgical robotic platform resides is crucial to ensure that patient safety, infection prevention and protocol compliance regarding the robot are consistently maintained and remain top-of-mind priorities every day for administrators, clinicians and support staff alike.

“One of the primary factors that prevents a safe and successful robotic program, regardless of the instrument and equipment manufacturer, is insufficient communication between the C-suite, OR, sterile processing department, manufacturer and others as appropriate,” he says. “When a decision is made to start or expand a robotics program, these stakeholders need to collaborate proactively to understand the need, current state of equipment, training and workflow so everyone understands what is required and how long processing will take for each surgery.”

• Reprocessing robots properly requires a certain amount of time. Sterile processing departments are intimately familiar with the sometimes unreasonable or unfeasible demands of surgeons and perioperative staff who expect instruments and other equipment to be safe, sterile and ready to go in the operating room on their own timelines. As any sterile processing professional who works in a busy and, in some cases, completely overworked and overburdened sterile processing department will tell you, however, that’s just not always possible.

Surgical robotics platforms may be shiny and new, but they’re no exception to that rule. Robotic platforms don’t clean themselves … at least, not yet. (Although who knows what the future holds?) Back to the present day, however. The cold reality is that reprocessing elements of surgical robotic platforms is not as rapid of a process as some providers would prefer, but the time that is spent on properly reprocessing these platforms is absolutely necessary to ensure patient safety and prevent SSIs.

Mr. Berg stresses that patience among providers who are itching to get the next case started is necessary and important.

“Processing robotic instruments and accessories takes time and, like every other device type or specialty, each step in the process must never be rushed,” he says.

That process should be clearly laid out in the manufacturer’s instructions for use (IFU) and understood by staff in both the SPD and the ORs. “Manufacturer’s IFUs are very specific about processing times, steps and sequences,” says Mr. Berg.

Invest in SPD

The good news is that if sterile processing staff are provided all of the things they need to do the job right, following those IFUs to the letter shouldn’t be a big issue. If that isn’t possible, however, perhaps the facility should reconsider acquiring a robot. “As long as IFUs are followed meticulously and technicians have the proper resources – time, training, supplies and decontamination setup – processing should not be very difficult,” says Mr. Berg. “That said, it is critical to never add or expand a surgical robotics program without first ensuring that the sterile processing area is equipped with the proper training, equipment and supplies to perform it safely, consistently and according to the IFU.”

What will the sterile processing area need to ensure safe and effective reprocessing of robotic platforms? Mr. Berg says recommendations can vary greatly depending on the device and manufacturer, but some key factors to consider across the board include:

• The required size of the sink or soaking station
• Manual or mechanical flushing devices
• Time requirements
• Sonic recommendations
• Wash rack recommendations
• Lighted magnification needs
• Disinfectant recommendations
• Lubricant recommendations
• Container or wrap type

Given the increasing number of surgical robot suppliers, it’s important not to assume that one manufacturer’s recommendations will be identical to another’s. So before you go down the road with any single vendor, be sure you have all of the information you need regarding these requirements and more.

“If there are any doubts about what is required to process robotic instruments and accessories, the sterile processing leader should contact the manufacturer(s) directly for written clarification,” says Mr. Berg. “No new devices or equipment should be put into use without first ensuring they can be safely and effectively processed.”

If a surgical robot is purchased, of course, there’s one other thing that will require investment and commitment: educating and training everyone at the facility who comes into contact with the robot on its safe and proper use, handling and maintenance. OSM