Archive Infection Control 2006

The Economics of Decontamination and Sterilization

When it comes to reprocessing, you can't have one without the other.

Steve Johnson


Imagine this: In the OR, an orthopedic surgeon finds that the cannulated drill bit she is using has a guide wire stuck in it from a previous case. Now flecks of hardened, autoclaved blood from another patient have just contaminated her patient's wound. She stops the case to provide treatment for wound contamination. Suddenly the procedure is taking longer, the surgeon is angry, the patient is compromised and your cost to do that case has rocketed. All this because the 30-second step of checking and cleaning the lumen of a drill bit - a task that would have cost all of 20 or 30 cents to do right in the first place - was neglected.

Or: Surgical staff are setting up for a procedure and, while preparing instruments on the back table, the surgical technician discovers what looks like blood or tissue in the serrations of a clamp. He has touched other sterile supplies when he discovers this. The patient is in the holding room, anesthesia is almost ready for him and the surgeon is scrubbing. Now the grim task of fixing the problem begins. Staff alert the surgeon and anesthesia that they consider the room and sterile supplies to be contaminated because of the dirty instrument found in the set. Staff begin the process of tearing down and then setting up the room again. All the opened supplies, gloves, gowns and suture, now become part of the waste stream - they must be thrown out. Depending on the procedure, they could be looking at hundreds if not thousands of dollars wasted. Not to mention the embarrassment and poor relations this can create with the patient, surgeon and the teams subsequently scheduled for that OR. All because of a simple oversight in the cleaning of an instrument.

Prevention of incidents like these can be traced to your investment in labor, training and equipment for your facility's reprocessing area. Taking decontamination and sterilization seriously can save you tens of thousands of dollars annually; but part of taking these processes seriously is supporting them financially.

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