SESSION NAME Reprocessing Complex Surgical Instruments SPEAKER Chuck Hughes SESSION NUMBER 0004 DATE/TIME Sunday, March 30, 2014, 8-9am REPEAT SESSIONS 0113, 0169 REPEAT DATE/TIME Sunday, March 30, 2014, 10:30-11:30am Monday, March 31, 2014, 7-8am CONTACT HOURS (CH) 1.0 SESSION OVERVIEW: Complex instruments, such as orthopedic sets, endoscopes, and ophthalmic instruments, are reviewed with detailed examples of manufacturers' validated reprocessing instructions for use (IFU). Issues and solutions regarding securing manufacturers' IFUs, training, and educating personnel to comply, eliminating immediate-use steam sterilization (IUSS) and sterile storage of sterilized devices, will be discussed referencing AAMI Standards and AORN Standards and Recommended Practices for the reprocessing of reusable medical devices. OBJECTIVES: 1. Identify where to find best practices for instrument reprocessing. 2. Discuss best practices for sterilization of surgical instruments. 3. Explain best practices for HLD of flexible endoscopes. SPEAKER BIOGRAPHY: Chuck Hughes is certified as a health education teacher who has worked over 25 years in the manufacturing industry in areas of research and development, regulatory affairs, microbiology, marketing, and sterilization training. A corporate member of AAMI, AORN, APIC, AST, CSA, IAHCSMM and SGNA, Chuck has extensive lecturing experience to medical device manufacturers and health care organizations around the world. SPEAKER CONTACT INFORMATION: Chuck Hughes VP, Infection Prevention Consulting Services Cantel Medical c/o SPS Medical Supply Corp Rush, New York [email protected]FACULTY DISCLOSURE: Chuck Hughes: 2. Cantel Medical Corp. COMMERCIAL SUPPORT: Gift-in-Kind: Cantel Medical Corp. (travel expenses)
11
Embed
SESSION NAME Reprocessing Complex Surgical Instruments...SESSION NAME Reprocessing Complex Surgical Instruments SPEAKER Chuck Hughes SESSION NUMBER 0004 DATE/TIME Sunday, March 30,
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
SESSION NAME Reprocessing Complex Surgical Instruments
SPEAKER Chuck Hughes
SESSION NUMBER 0004
DATE/TIME Sunday, March 30, 2014, 8-9am
REPEAT SESSIONS 0113, 0169
REPEAT DATE/TIME Sunday, March 30, 2014, 10:30-11:30am
Monday, March 31, 2014, 7-8am
CONTACT HOURS (CH) 1.0
SESSION OVERVIEW:
Complex instruments, such as orthopedic sets, endoscopes, and ophthalmic instruments, are reviewed with detailed examples of manufacturers' validated reprocessing instructions for use (IFU). Issues and solutions regarding securing manufacturers' IFUs, training, and educating personnel to comply, eliminating immediate-use steam sterilization (IUSS) and sterile storage of sterilized devices, will be discussed referencing AAMI Standards and AORN Standards and Recommended Practices for the reprocessing of reusable medical devices.
OBJECTIVES:
1. Identify where to find best practices for instrument reprocessing.
2. Discuss best practices for sterilization of surgical instruments.
3. Explain best practices for HLD of flexible endoscopes.
SPEAKER BIOGRAPHY:
Chuck Hughes is certified as a health education teacher who has worked over 25 years in the manufacturing industry in areas of research and development, regulatory affairs, microbiology, marketing, and sterilization training. A corporate member of AAMI, AORN, APIC, AST, CSA, IAHCSMM and SGNA, Chuck has extensive lecturing experience to medical device manufacturers and health care organizations around the world.
• Not allowing sterilized packs to cool to room temperature,
• Placing sterilized items to cool near AC vent.
If your facility reprocesses complex devices, then you
are probably dealing with “extended cycles”. As with
cleaning, it is important to know which and how many
of your devices require extended exposure time and/or
temperature settings.
STEAM Sterilization
Reprocessing Complex Instruments
7
25 min @ 270°F (132°C) Pre-vacuum
Do not FLASH
complex instruments!
Medical devices sterilized by immediate use steam
sterilization (IUSS), formerly called flash sterilization,
can increase the patient’s risk for acquiring a surgical site
infection. As we have shown, complex instruments can
take 4 to 5 hours to reprocess when following the MFG’s
validated IFU.
Be sure to schedule your cases with enough time to fully comply (terminal sterilization) with reprocessing IFUs.
Tips to Eliminate IUSS
1. Update Policy & Procedures to reflect national standards.
2. Clearly define “emergency situation” that justify IUSS.
3. Educate all personnel as to risks associated with IUSS.
4. Review sterilizer logs to identify what is being IUSS. Review
each of these MFG’s IFUs to understand validated reprocessing
steps. Use this info to justify need for terminal sterilization.
5. Purchase additional instruments for back - back case schedules.
6. Adjust steam sterilizers to terminal cycles with dry time.
7. Hold all personnel (staff and vendors) accountable to comply
with Policy & Procedures.
Common errors in the
reprocessing of Surgical instruments
Storage
• Placing sterile items in a high traffic area,
• Improper ceiling tiles and/or storage shelves,
• Dust on storage shelves,
• Stacking wrapped items on top of each other,
• Putting clean items on top of sterile items,
• Exceeding temperature and/or humidity ranges.
KimGuard® and One-Step® Wraps(Directions For Use)
Caution: Do not stack trays. Stacking trays can
result in damage of the wrap caused by undue
pressure from the
weight.
® Trademarks of Kimberly-Clark Corp.
Poor storage
Sterile processing personnel play a critical role in your
infection prevention efforts and therefore must receive
training and continuing education.
Failing to follow reprocessing
“best practices” can result in
infections, which causes harm
to patients and increased costs
to the health care facility.
Training & Education
Reprocessing Complex Instruments
8
AAMI Standards
Supervisors should..
• be certified,
• be experienced,
• participate in CE
programs and courses,
• provide in-service training,
• participate in Infection Prevention and
Safety committees (member or resource).
AAMI Standards
Technicians should..
• be certified,
• be competent in Standard
Precautions,
• be knowledgeable in
worker safety,
• be knowledgeable in all aspects of
sterilization and the operation of their
facility’s sterilizers.
Certification
IAHCSMM
International Association of
Healthcare Central Service
Materiel Managementwww.iahcsmm.org
Mission StatementProvide the members of the Association and healthcare facilities with organized educational opportunities, professional development, a forum for information exchange, member services in response to member identified needs and priorities,; and to represent Central Service Materiel Management in the professional community.
Certification
CBSPD
Certification Board for Sterile
Processing & Distribution www.sterileprocessing.org
Mission Statement
To promote and encourage high standards of ethical and professional
practice through a recognized, credible credentialing program that
encourages the competency of personnel performing sterile processing
and distribution activities.
Reprocessing Flexible Endoscopes
Flexible endoscopes are some of the most challenging
medical devices to reprocess due to their unique design
and complex reprocessing steps.
Again, strict adherence to each
device manufacturer’s validated
IFU is required.
Association of periOperative Registered Nurses
“Recommended Practices for Cleaning and Processing
Flexible Endoscopes and Endoscopic Accessories”.
Flexible endoscopes manufactured
by different companies may require
different cleaning procedures as
described in their MFG’s validated
IFU.
Reprocessing Complex Instruments
9
SGNA Standards of Infection Control in Reprocessing of Flexible Gastrointestinal
Endoscopes
These updated (2012) Standards
are for use in all settings where
gastrointestinal endoscopy is
practiced.
They complement the 2009
SGNA document titled “Guideline
for the Use of High Level Disinfectants and Sterilants for
Reprocessing of Flexible Gastrointestinal Endoscopes”.
www.sgna.org
High Level Disinfection
Best Practices
Point of Use
• pre-clean to prevent soil from drying.
Reprocessing Area• perform leak test,• manual cleaning & rinsing,• high level disinfection (manual or automated),• rinsing, drying and storage.
Quality Assurance
• documentation & record keeping.
Best Practices (Similar steps and similar “challenges”)