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Archive October 2017 XVIII, No. 10

Infection Prevention: Help Your Reprocessors Do the Right Thing

Give your techs the training and the tools they need to bust those bugs.

Weston "Hank" Balch

Weston "Hank" Balch, CRCST, CIS, CHL


decontamination area STOCKED, LOCKED + LOADED Is your decontamination area stocked with every processing tool your techs need to do their jobs?

One unseen Fogarty insert that makes its way back to the OR can cost your facility upwards of $10,000 if it's discovered on the sterile field, not to mention the unthinkable possibility of the instrument being reused on an unknowing patient. But how do you ensure that your first line of defense against processing breakdowns — your central sterile area — will stop these dangers in their tracks? If you make it easy for your reprocessors to do the right thing, more often than not, they will. Here are some ways to do just that.

1Stock the armory: it's tool time! As a decontamination technician, nothing's more frustrating than to be asked to do a job, but not have the tools you need to do the job well. Flush every cannula. But how? Brush every suction. With what? When your team walks into the decontamination area to start the day, it should be fully stocked with every processing tool they'll need to complete the task laid before them: mass microbial destruction. At the very least, you should have the following: brushes of proper style, diameter and length (including pass-through brushes), adequate flushing technologies (a low-tech hose or high-tech flushing system), sinks of adequate height, width and depth, the proper chemicals, appropriate PPE, a sharps container, pre-processing equipment (such as standalone ultrasonic washers), and any other supplies needed to safely restring and sort stainless steel instruments. Back to the brushes for a moment: Make sure these are organized and easily identifiable. Many an internal scope channel has been damaged by incorrect or compromised brush usage.

2Ensure OR ownership: first things must be first. As important as the proper tools are in the hands of a competent, well-functioning decontamination team, the SPD department is actually the second set of eyes to guard against possible microbial mistakes. The first opportunity to tackle potential processing pitfalls actually happens immediately post-op, before the instruments ever leave the OR. Ensure your nurses and techs in the room are aware of the necessity of post-op prep of their instrument trays, such as removing any inserts (such as Fogarty clamps and Brainlab tracking balls), disposing of (ahem) disposables (such as plastic/rubber attachments, suture and single-use towel clips), removing gross bioburden (blood, fat, tissue, bone), restringing of ring-handled instruments (on a low-tech stringer or high-tech restringing technology), flushing any suction devices (such as Frazier, Andrew or abdominal suctions), and finally, pre-treating the instruments with a low-tech damp towel or high-tech pretreatment solution). To win this war on decontamination oversights, we need our partners in the OR to begin the process as soon as possible. Every minute counts.

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