How to Load a Medical Automatic Washer

Involve all of your customers in the process by explaining the important role they have in proper preparation of instruments for reprocessing

Combine all of the information from the various sources and adapt them to your process (instrument, cleaning solutions, equipment...) to load the trays correctly

Easy Stringer and six-inch wide stringer (notice the difference in the exposure of the instruments from 2 to 6 inches)

This system shows how the positions of the magnets will decide the type of cycle the instruments will be processed at.

This is an example of a bar code type system for programming.

An example of poor use and loading of equipment in a MAW.

Proper way to expose instrument to the cleaning process of a medical automatic washer; all instruments in the open position, entering the automatic washer.

Conclusion

“Washers can only be effective when they are properly used, loaded, and serviced in compliance with the manufacturers’ recommendation.”³⁵ These are words to live by for every CSD. As this article has demonstrated, implementation of current standards; close adherence to instructions from device manufacturers; comprehensive routine education and training of staff; and a program of quality checks including independent verification of the cleaning process are the keys to achieving proper loading of the MAW. The result will be a dramatically reduced incidence of dirty instruments. This in turn will provide better patient care and a better and more efficient CSD.

Stephen M. Kovach is director of education for Healthmark Industries in St. Clair Shores, Mich. Kovach is educational chairperson for the AORN Specialty Assembly for SP/MM. He is a member of AORN Lakeshore Chapter 2307, a member of IAHCSMM, and his State Central Service professional group MSHCSP, and is on many AAMI standards committees.

References:

1. IAHCSMM Forum; post 7; April 18, 2007, washing instruments in a container.

2. AORN J. March 2007. Vol. 85, No. 3; page 566.

3. Pennsylvania Patient Safety Authority 2006. Page 1.

4. Pennsylvania Patient Safety Authority 2006. Page 1.

5. Pilling Weck Surgical-Lit.99-1007. 1/99; 17M; page 364.

6. http://www.zimmer.com/web/enUS/pdf/Surgical_Cleaning_Instructions_Final.pdf

7. http://www.beeremedical.com/Prints/pdf/Guide-Instr.%20care.pdf

8. http://ortho.smith-nephew.com/us/node.asp?NodeId=3248

9. Coatesworth letter from SYNTHES®; Request for Cleaning Parameters. Nov. 23, 2004.

10. Ibid.

11. www.odtmag.com/articles/2007/01/case-closed-delivery-system.php

12. Technical Data Monograph: Decontamination of Reusable Medical Devices using FAST Cycles on Reliance®Synergy™ Washer/Disinfectors. STERIS®. Aug. 1, 2004.

13.Ibid.

14. AVENATECH, Inc. Washer/Decontaminators – In-Service Training Guide-Operation of The Belimed SM-100. Pages 18-19. 1998.

15. RELIANCE®777, Equipment Manual; 9/1/91-Rev2.

16. AORN Perioperative Standards and Recommended Practices, 2008. Page 423.

17. AORN Perioperative Standards and Recommended Practices, 2008. Page 434.

18. ANSI/AAMI ST 79:2006

19. Recommendations by the Quality Task Group (33) Mesh Trays and their Implication for successful Cleaning in the washer-Disinfector; Zentr Steril.

20. Basile R and Kovach S. A Thorough Cleaning part 2. Managing Infection Control. February 2003.

21. Zentr Steril Forum 2004. M.Wieder. Dosage and Control Mechanism in Validation of Automatic Cleaning and Disinfection Processes.

22. Basile R and Kovach S. A Thorough Cleaning part 3. Managing Infection Control. March 2003.

23. Basile R and Kovach S. The Cleaning Process. Managing Infection Control. July 2003.

24. Principles and Methods of Sterilization in Health Sciences, second edition. Perkins. Page 250.

25. IAHCSMM. Fundamentals of Cleaning for Decontamination. Self Study Series Lesson 42.

26. Proper Maintenance of Instruments, eighth edition. 2004. Page 20. www.a-k-i.org

27. Johnson S. Infection prevention: are those instruments sets ready yet? Outpatient Surgery.

28. Proper Maintenance of Instruments, eighth edition. 2004. Page 19. www.a-k-i.org

29. AORN 2006 Standards, Recommended Practices, and Guidelines. Pages 555-556.

30. Personal correspondence between D. Coatsworth and S. Kovach, Nov. 12, 2007.

31. Dec. 7, 2007 Greater Detroit Central Service meeting.

32. ANSI/AAMI ST79:2006. Page 1.

33. www.trucleaninnovations.com

34. www.hmark.com

35. IAHCSMM. Seventh edition Central Service Technical Manual. Page 145.