ECRI PSO Issues Top 10 Essentials for Effective Instrument Cleaning

Each day, healthcare facilities sterile processing departments manage the preparation of countless surgical instruments for upcoming procedures. This was demonstrated in the February 2013 issue of PSO Monthly Brief which explored inadequately reprocessed devices. If devices are not properly cleaned before they are disinfected and sterilized, tissue, bone, or other organic material can remain in or on the instrument.

Consequences of inadequate reprocessing can be relatively minor, such as a delay in surgery while new instruments are sought if the contamination is identified before a procedure begins, or more significant, such as possible infection.
Healthcare staff members often mistakenly believe that sterilization alone adequately prepares equipment for reuse; this is simply not true. In fact, reprocessing is a multistep practice that includes thorough cleaning as well as disinfection or sterilization. Part of the increase in reprocessing complexity may be contributed to advances in technology. Todays instruments have complex, movable parts that are difficult to disassemble and clean thoroughly, says Gail Horvath, MSN, BS, RN, CNOR, CRCST, a patient safety analyst at ECRI Institute PSO.

Facility leadership must be aware of processes and challenges within the sterile processing department and view them as part of the delivery of safe patient care. Changes in equipment, personnel, or procedures can affect the organizations ability to provide properly reprocessedand safeinstruments. Therefore, ECRI Institute PSO has created a list of its Top 10 Essentials for Effective Instrument Cleaning:

1. Provide adequate trained staff, facilities, and resources for the sterile processing department.

2. Standardize and simplify procedures in all areas where instruments are reprocessed.

3. Monitor the quality of instrument reprocessing through postcleaning inspections.

4. Seek input from reprocessing department staff on instrument and equipment purchases.

5. Limit the operating rooms dependence on immediate-use sterilization.

6. Establish delivery criteria for loaned instruments and prohibit immediate-use sterilization of them.

7. Require regular competency assessments of staff who reprocess instruments.

8. Foster collaboration and teamwork among reprocessing department and operating room staff.

9. Recognize and respect the contribution by reprocessing staff to patient safety and quality care.

10. Encourage prompt reporting of events or near misses involving contaminated instruments.

Source: ECRI Institute