Archive August 2017 XVIII, No. 8

6 Secrets for Cleaning Lumened Instruments

Follow these tips to keep your central sterile processing department running on all cylinders.

Bill Donahue, Senior Editor

narrow-lumened instruments and endoscopes REPROCESSING CHALLENGE Narrow-lumened instruments and endoscopes have the highest risk of being improperly reprocessed.

There's no margin for error in your central sterile processing department, and that's a lot of pressure to contend with every day. Add in the challenges associated with flexible endoscopes, narrow-channeled phaco handpieces and other notoriously tough-to-clean lumened instruments, and it's no surprise that burnout and turnover are so common among reprocessing techs. These 6 "secrets" to cleaning lumened instruments may help to ease the pressure and eliminate some of the situations contributing to reprocessing failures.

1. Start the reprocessing sequence in the OR. In reprocessing, every minute matters, and epidemiologist Cori L. Ofstead, president and CEO of Ofstead & Associates in St. Paul, Minn., says the clock starts ticking in the OR, not central sterile.

"When an instrument sits up in the OR for a while, or if it's used early in the case and hangs around until the case ends, the residue will harden and create a situation that will require additional soaking and brushing," she says. Also, the amount of bacteria on an endoscope doubles every 20 to 30 minutes after use. That's why she endorses established guidelines that recommend OR staff pre-clean instruments right away; disposable bedside kits can help to prevent bioburden from drying and solidifying in endoscope channels.

"If there is any delay in getting the device to reprocessing, OR staff should have a mechanism to let the reprocessing department know so they can plan accordingly," she says. "Unfortunately, most ORs rarely communicate with central sterile about those kinds of things."

2. Use only water-based substances. Clinicians often resort to using lubricants, de-foaming agents and other substances — cooking sprays, for example — to facilitate certain GI procedures. These substances go against manufacturers' instructions for use and may be contributing to some reprocessing failures, in part because central sterile might not be aware that such substances are being used.

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