CS SOLUTIONS by Ray Taurasi, Principal, Healthcare CS Solutions.
editor@hpnonline.com
Precleaning instruments; proper use of container signage
Q A
Currently we handwash all instruments that come from the operating room (OR) prior to running them through the washer decontaminator. Unused instruments, which the OR sends back to decontamination, are visually inspected and if any soil is found then the instruments are manually washed and then put in the washer. If no visual soil is found, then the unused instruments go directly into the washer. Does this practice meet the current standards for cleaning instruments?
et me start by reaffi rming that the manufacturers instruc- tions for use for cleaning each specifi c instrument or other medical device is to be consulted and followed. Some may specify that manual precleaning be done before placing instru- ments into the automated washer, but youll likely fi nd that most do not require this.
As a rule, for personnel safety, we should strive to minimize the excessive handling of contaminated items. Guidelines and standards do state that gross soil should be removed from surgi- cal instruments at the point-of-use and that soiled instruments should be maintained in a moistened state in transit and prior to the start of the decontamination/cleaning process. If excessive or dried-on organic matter is observed on instruments. which may present too great of a challenge to the washer, then some additional manual precleaning or treatment may be necessary.
Q
am the clinical director of infection control and preven- tion at a large medical center. We have centralized all reprocessing and sterilization functions to our central processing department . e have over patient-care units, clinics and offi ces that now send all their soiled instruments back to for reprocessing. We have established a very strict protocol for the safe transporting of soiled instruments from patient or procedure rooms to soil utility rooms located at each unit where they are held until picked up by or returned to CPD.
We have invested in all new special containment devices for holding and transporting contaminated materials. These con- tainers comply with all reuirements including the ap- propriate biohazardous labeling. Instruments from a procedure or treatment room are placed in a small transport container and carried to the utility room and transferred into a larger container where they are held until the larger container of soiled items are returned to . The smaller containers are cleaned and identi- fi ed as clean with a green band; they are then placed on a supply cart in the clean utility room. ecently a manufacturers representative was conducting an in-service and noticed the soiled bins with biohazard symbols stored amongst clean and sterile supplies. He stated that TJC would have an issue with that practice and suggested I consider an alternative. really dont see why they would have an issue as the bins do have the green band on them, which staff under- stands means the bins are clean see fi gure . e also store our
34 June 2019 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
red biohazard plastic bags in that area, and I have never had an issue with TJC in the past. Do you see an issue with this?
A
I do believe that your current method of identifying the container as clean could very well result in a negative re- sponse and citation from a surveyor. Signage needs to be clearly understood and precise. Having both a biohazard and “clean” marker present is contradicting and confusing and could leave the viewer to guess whether it is biohazard or clean. Further, having biohazard material in a clean and/or sterile storage space would be a breach in technique. agree that you should consider a more appropriate alter- native. An easy fix would be to attach a specially designed N stick-on label over the biohazard symbol on the con- tainer (see figure 2). The label, while adhesive, can easily be removed when the container is in use holding contaminated items. Once the label is removed no adhesive residual remains on the container.
Figure 1
Figure 2
Ray Taurasi is Principal, Healthcare CS Solutions. His healthcare career spans over three decades as an Administrator, Educator, Technologist and Consultant. He is a member of AORN, AHA, SGNA, AAMI and a past president of IAHCSMM. Taurasi has been a faculty member of numerous colleges teaching in the divisions of business administration and health sciences.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80
