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Continuing EducationEach 1 hour web meeting is approved by IAHCSMM, CBSPD and is 3M Health Care Provider approved by the California Board of Registered Nurses CEP 5770 for one contact hour.
Post webinar email• Link to Course Evaluation• CS Tech CE Certificate Included• Forward eMail to others in attendance
• Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities.
• AORN 2016 Guideline for Cleaning and Care of Surgical Instruments
• AORN 2016 Guideline for Processing Flexible Endoscopes
Transport to Decontamination Area• Items are contained• Items are to be kept moist during transport • Containers must be leak-proof, puncture-proof, and
Have an expert/consultant asses reprocessing procedures to assure:• Reprocessing is performed correctly• Adequate time is allowed/taken• All steps from the IFU are followed
Which of the following competencies was given at your facility last year?Flexible endoscope processingSteam sterilizationWasher disinfectorUltrasonic cleanerCleaning laparoscopic instruments
Use critical water (e.g., deionized, distilled, or RO water) as the final rinse to prevent:• Instrument staining and contamination• Residues that can affect disinfection and sterilization
efficacy • Residues that can cause adverse patient reaction
• How often do loaner reps provide in-services to your CSS department?Hardly everOnce a yearTwice a yearThree or more times a yearWe don’t reprocess loaner instruments
The loaner(s) should arrive at the time agreed upon The healthcare facility should not accept loaner(s) if they do not arrive in sufficient time to follow its procedures (except in an emergency)
AAMI TIR63:2014 Management of loaned critical and semi-critical medical devices that require sterilization or high-level disinfection
Prior to use, all loaned medical devices should be reprocessed according to the manufacturer's written IFU and in accordance with the facility's policy and procedures.
AAMI TIR63:2014 Management of loaned critical and semi-critical medical devices that requiresterilization or high-level disinfection
What is the average time flexible endoscopes sit in the decontam room before they are processed?Less than 10 minutesBetween 10 and 30 minutesBetween 30 and 60 minutesMore than 60 minutes
• Should be conducted as soon as possible after use to prevent soil from drying on the device
• Scopes must be thoroughly cleaned to effectively kill or inactivate microorganisms and may allow for biofilm development
• If it is not possible to start the cleaning process immediately after use, the endoscope manufacturer’s written IFU for delayed reprocessing of endoscopes should be followed.
ANSI/AAMI ST91:2015 Flexible and semi-rigid endoscope processing in health care facilities
Flexible Endoscope Manual Cleaning• Fresh cleaning solution for each scope• Monitor the cleaning solution for IFU i.e., dose & temperature• Place endoscope completely within the solution • Use single use lint-free cloth or sponge• Clean all parts & scope with cleaning brushes of the length, width,
and material designated in the endoscope manufacturer's written IFU
• Flush with solution following IFUs
ANSI/AAMI ST91:2015 Flexible and semi-rigid endoscope processing in health care facilities
Flexible Endoscope Manual RinsingThe endoscope and accessories should be thoroughly rinsed with copious amounts of water. • Rinse all channels with adequate flow of water • Rinse all exterior endoscope surfaces with freely flowing potable water • Rinse all valves and other removable components according to the
manufacturer's written IFU • After cleaning, all detachable valves should be kept together with the same
endoscope as a unique set
ANSI/AAMI ST91:2015 Flexible and semi-rigid endoscope processing in health care facilities
Monitoring of Ultrasonic Cleaners* Verify efficacy of cleaning equipment• Verify sonic activity or effective cavitation• Verify ability of irrigators to clean lumens • Verify temperature using an irreversible
• “A major repair is a repair that is outside the scope of routine preventive maintenance and that significantly affect the performance of the equipment”
• Examples include replacement of:• Water pump(s)• Detergent delivery system • Heating system• Water delivery system• Water treatment system• Computer control • Upgrade of software
• Manual cleaning should be evaluated • When new types of instruments are
reprocessed • Periodically, at intervals
determined by the health care organization
• Evaluates personnel performance
AORN:2016, Guideline for Cleaning and Care of Surgical Instruments, Recommendation XVllANSI/AAMI ST79:2010 & A1:2010 & A 2:2011 & A3:2012 & A4:2013, Annex D.1
Protein Test• Can be used to detect protein residues left on surgical
instruments due to inefficient cleaning.• Where does protein come from?
• Blood, tissue, body fluids, microbes
• Several different methods: Biuret, Ninhydrin• Qualitative or semi-quantitative – colorimetric• Not real time• Recommended by ISO 15883-1:2006 Washer-
Disinfector as a method to assess cleaning efficacy
• ANSI/AAMI ST79:2010 & A1:2010 & A2:2011 & A3:2012 & A4:2013 Comprehensive guide to steam sterilization and sterility assurance in health care facilities
• ANSI/AAMI ST91:2015 Flexible and semi-rigid endoscope processing in health care facilities
• AAMI TIR63:2014 Management of loaned critical and semi-critical medical devices that require sterilization or high-level disinfection
• Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities.
• AORN 2016 Guideline for Cleaning and Care of Surgical Instruments
• AORN 2016 Guideline for Processing Flexible Endoscopes
References• International Association of Healthcare Central Service
Materiel Management. Central service technical manual. 7th ed. Chicago: IAHCSMM, 2007.
• The Joint Commission. High-Level Disinfection (HLD) and Sterilization BoosterPak.http://www.jointcommission.org/standards_booster_paks/
• CDC/FDA Health Update about the Immediate Need for Healthcare Facilities to Review Procedures for Cleaning, Disinfecting, and Sterilizing Reusable Medical Deviceshttp://emergency.cdc.gov/han/han00383.asp