Prioritizing Proper Instrument Care

Professionals in the sterile processing department (SPD) do their part to break the chain of infection by disinfecting and sterilizing the tools physicians use to provide safe patient care. SPD leadership must develop a program that is both effective and efficient, two keys to reducing infection risks and improving the overall efficiency of your facility. They do this by staying up to date on national standards and continually educating frontline staff on current best practices of instrument reprocessing.

In my experience, sterile processing technicians are thirsty for knowledge about how they can best perform their jobs, and how they fit into the patient care continuum. It’s our job as leaders to make sure they have the tools and resources they need to properly clean and sterilize instruments. That includes making sure they have easy access to instructions for use (IFUs), safety data sheets (SDS) and your facility’s policies.

Updates and reviews on proper instrument care should be ongoing and include refresher courses on how to find and access this information on your facility’s intranet. That way, when new processes or instruments come into the department, reprocessing technicians can assimilate them rapidly, and can find the references they need when necessary. Educated technicians are less likely to make mistakes.

In addition to a well-trained staff, pay close attention to your facility’s instrument flow. An effective SPD moves dirty instruments in one direction from the cleaning and decontamination area to sterilization and then finally into storage.

Each area of the SPD plays a critical role in ensuring your facility’s instruments are meticulously cleaned and free from infection-causing bioburden. For example, proper use of cleaning chemicals in the decontamination area ensures instruments are free of gross soil that prevents proper sterilization and safe to handle during inspection. Additionally, understanding the mechanics of sterilization helps your techs render instruments safe for use without damaging them in the process.

Standout SPDs also prevent efficiency problems by avoiding backlogs of instruments or shortages of technicians in any one area. That’s why SPD managers need to study instrument throughput during busy days and lulls in the action, and adjust their staffing levels accordingly.

Surgical instrument tracking platforms can help with that task and are among the best tools SPDs have at their disposal to improve overall efficiencies. There are many different products on the market, but their primary function is the same: tracking surgical instruments from use in surgery, through the sterilization process and the return to the ORs.

This technology helps SPD managers understand throughput and volumes, and how these numbers fluctuate significantly throughout days, shifts and weeks. They provide precise data on when the greatest volume of instruments arrives in the department, so they can staff up or down as needed.

If a typical day of surgery starts at 7:00 a.m., instruments may not enter the decontamination area until about 9:00 a.m. But when they do arrive, the area will become a bustle of activity. The inspection area will be busy next and so on. Efficient SPDs understand that the workload fluctuates in these areas by the hour and move technicians around to prevent bottlenecks from forming. Instrument tracking systems allow SPD managers to read and react to variations in instrument flows and place technicians where they’ll be most helpful during specific times of the day.

In addition, tracking technology makes it easier to justify investments in additional resources or staff. If SPD managers see a need to hire another technician, they can present data to illustrate how many instruments their department handles and use that information to make the case for adding to the team.

One piece of technology that many SPDs are adopting is a borescope, a flexible fiber-optic camera that is threaded through the small lumens or cannulae of flexible endoscopes. Borescopes can be used to visualize the instrument channel of an endoscope to see if residual moisture or gross soil warrants further cleaning of the instrument before high-level disinfection.

SPDs are using borescopes to visualize areas in instruments where the human eye cannot see. Regulatory and accrediting bodies do not mandate their use, however, and some SPDs haven’t yet decided on how to integrate borescopes into their programs so that the benefits outweigh the cost in time and labor.

The lack of universal borescope use shouldn’t be based on cost. The price point of the devices is wide, depending on the required application, and there are options most SPDs can afford. Used appropriately, a borescope can be an effective weapon in ensuring instruments are properly cleaned. But this tool must be brought in with a specific function or purpose in mind, and it must be supported with extensive training for users.