Sterile Processing

Learning how to use new healthcare technology is a complex challenge, and success hinges on high-level support at any organization, according to nurses, vendors, and other experts who attended the AAMI Foundation’s first Industry Council meeting. This diverse group-which included representatives from BD (formerly CareFusion), Connexall, Hospira (a Pfizer company), Masimo, and Medtronic, as well as patient safety advocates and healthcare professionals-met at AAMI’s headquarters in Arlington, Va. recently, to discuss the current state of training, identify challenges, and describe what they would like to see in the future.

Q: Recently our facility was cited for disinfected laryngoscope blades that were found unprotected from re-contamination in storage. What is the recommended practice for these items?A: This question has many implications. CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) says laryngoscope blades are “semicritical” items, which are defined as, “Items that directly or indirectly contact mucous membranes of the respiratory tract. They should be sterilized or subjected to high-level disinfection before reuse.”  After they are cleaned according to the manufacturer’s IFU, there are several options for processing laryngoscope handles and blades. Many laryngoscope blades can be high-level-disinfected. If high-level disinfection is used (check the manufacturer’s IFU for compatible chemicals), the blade must be protected from recontamination after processing. One way of accomplishing this is to place the blade in a zip-lock bag and then apply a “Clean Not Sterile” label to the top of the bag. (Make sure that you clean your hands first.)  If anyone opens the bag, the label will be damaged indicating the blade could be contaminated. At some facilities, laryngoscope blades are sterilized, which is acceptable but not necessary (CDC, 2003). Packaging blades requires the package to be opened if nursing must test the laryngoscope bulb on the blade. This results in a blade being replaced inside an open paper-plastic pouch.  The opened pouch does not protect the blade from contaminates.

Biofilms -- formed by bacteria that stick to each other on living tissue and medical instruments, making them harder to remove -- can be tricked into dispersing with the targeted application of nanoparticles and heat, researchers have found. The University of New South Wales study, jointly led by associate professor Cyrille Boyer of the School of Chemical Engineering and deputy director of Australian Centre for NanoMedicine, appears in today's issue of Nature's open access journal Scientific Reports.

Biofilms frequently coat the surfaces of catheters, and of various medical implants and prostheses, where they can cause life-threatening infections. New research at the Sahlgrenska Academy show that coating implants with a certain "activator" can prevent Staphylococcus aureus, the leading cause of hospital-acquired infections, from forming biofilms.