Summary: It is a recognized risk of exposure to unidentified microorganisms that reprocessing personal endure during the decontamination, reprocessing, and cleaning of surgical instruments. Our goal is to minimize the amount and degree of reprocessing personal exposure to this risk and provide reprocessed surgical instruments that are clean: safe to handle, safe for patient care, are cleaned, decontaminated reprocessed at the lowest cost. Optimal decontamination cleaning-reprocessing of surgical instruments will secure the prerequisite for disinfecting surgical instruments and/or sterilizing surgical instruments.
Typically, Healthcare Facilities manually clean [hand-wash] surgical instruments: with dried on or excessive debris, surgical instruments that are cannulated, surgical instruments with working channels and/or surgical instruments with lumens. Healthcare Facilities also manually clean [hand-wash] surgical instruments, when a surgical instrument washer decontaminators or washer disinfectors is not available. Hand washing surgical instruments places the reprocessing personnel at risk. In the decontamination area, surgical instruments are received that are contaminated with variable amounts of debris and unidentified microorganisms. In the Clean Side reprocessing area, surgical instruments requiring further reprocessing are handled by unprotected reprocessing personnel.
CLEANING SURGICAL INSTRUMENTS BY HAND CAN LEAD TO INJURY AND INCREAESED EXPOSURE TO HERPATITIS.1 T HE CDC BELIEVES THAT AS MANY AS 18,000 HEALTH CARE WORKERS PER YEAR MAY BE INFECTED BY THE HBV,” AND “AS MANY AS 300 DEATHS MAY RESULT ANNUALLY.”2
Workers at Risk Reprocessing Surgical Instruments
Inherent in the manual cleaning-decontamination-reprocessing of surgical instruments is power spraying, splashing, and the creation of contaminated aerosols. The manual cleaning-decontamination-reprocessing of surgical instruments presents the risk of infectious puncture wounds. The handling of each individual surgical instrument device is time consuming, labor intensive, renders limited through-put and has high overhead costs.3
Exposure Contained by Automated Surgical Instrument Washer Decontaminators Disinfectors
Surgical Instrument Washer Disinfectors
In the United States manufacturers of Surgical Instrument Washers are not approved by the FDA to market their products as Washer Disinfectors. However, many of the Surgical Instrument Washers are manufactured to produce the times and temperatures that can effectively deliver disinfected surgical instruments. If it is your preference to have cleaning reprocessing results of a "washer disinfector", refer to the Surgical Instrument Washer Specifications for assurance that the times and temperatures available are those you consider to be appropriate for disinfecting surgical instruments.
Automated Surgical Instrument Washer Decontaminator Disinfectors can safely contain within their chambers the cleaning-decontamination-reprocessing functions, removal of debris, and contaminated aerosols. The batch treatment of reprocessing surgical instruments using automated Surgical Instrument Washer Decontaminators Disinfectors saves time, increases material through-put, improves surgical instrument turnaround times, provides for FTE reduction, and lowers cost for surgical instrument cleaners. 7 8 It has been demonstrated that a properly designed Surgical Instrument Washer Decontaminator Disinfector, that is used to manufacturer’s specifications, will consistently and repeatedly remove all microorganisms from surgical instruments. 9 10
Surgical Instrument Washer Decontaminators Disinfectors should be used in accordance with the manufacturer’s direction for use, to secure the most consistent and efficacious results. Worker safety and reprocessing efficacy can be compromised by violating the manufacturer’s recommendations. Examples of such recommendations are: Keeping the cannulated surgical instrument working chambers and lumens exposed during cleaning-reprocessing and the use of purified water final rinses.
A Clean Surgical Instrument Device is Safe to Handle 11
It is critical that devices are cleaned properly to secure the safety of reprocessing workers in the Clean Area. During the steps of inspection, sorting and packaging of devices, the unprotected reprocessing personnel are repeatedly at risk from a surgical instrument that has remained contaminated with microorganisms.
Within the implementation of the Universal Surgical Instrument Reprocessing Decontamination Precautions, it is our goal to eliminate exposure and reduce the risk to Reprocessing personnel whenever possible.
Clean is Safe Conclusion
The use of proper hand washing surgical instrument reprocessing decontamination methods can render surgical instruments that are clean, but requires the continual exposure of the Reprocessing Staff to contaminated surgical instruments. The Reprocessing Staff performance is influenced by skill level, knowledge and work load. This may impact the efficacy of the process. The use of a properly designed surgical instrument washer decontaminator disinfector reduces the: overhead cost of reprocessing, risks to the Reprocessing Staff and provides consistence removal of all microorganisms from soiled surgical instruments. Once a surgical instrument is clean, it is then safe for further reprocessing and handling. Proper cleaning is the prerequisite for disinfecting and/or sterilizing surgical instruments. Optimal cleaning can render surgical instruments that, at the end of decontamination, cleaning, and reprocessing, are sterile.
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Clean is Safe References
1. Bryan P. Simmoms, MD. Et. Al., Guideline for Hospital Environmental Control and Guideline Ranking Scheme, Center for Disease Control, (Feb. 1981), Section 2, pp.1-10.
2. Letter from the secretary of Labor, U.S. Department of Labor, Oct. 30, 1988.
3. Peggy Ryan, RN, “concepts of Cleaning Technologies and Processing,” Journal of Healthcare Material Management, (Nov./Dec. ’87), pp.20-27.
4. Bertha Y. Litsky, PhD, “Microbiology Sterilization,” J. AORN, Aug. 1977.
5. CDC, MMWR, Aug. 21, 1987.
6. Ryan, op. cit.
7. Training manual for Central Services Technicians, American Society for Central Service Personnel of the American Hospital Association, (Chicago, IL, 1986).
8. Ryan, op. cit.
9. L.P. Jette’and N.G.Lambert, “Evaluation of Two Hot Water Washer Disinfectors for Medical Instruments, “ Infection Control Hospital Epidemiology, Vo.1 9, No. 5, (1988), pp. 194-199.
10. Interview with Charles A. Reed, Washington University School of Medicine, Washington University medical Center, Dec. 1985.
11. Simmons, op. cit.
John Temple
Product Development
