IAHCSMM VIEWPOINT Improperly processed devices (again) make ECRI’s 2013 top 10 hazards list
by Julie E. Williamson W
hen looking at the newly-released 2013 Top 10 Health Technology Haz- ards list from ECRI Institute, some good and bad news bubbles to the surface, at least for those in the Central Service realm. The good news fi rst: improperly processed endoscopes, which have earned some of the top spots on the list for the past three years, are no longer ranking so high. Now for the bad news: scopes still made the list — com- ing in at number eight — and this time, they weren’t alone. Inadequately processed sur- gical instruments joined the oft-mentioned endoscopes, an addition that underscores the challenges processing professionals face when managing a wide array of devices. For the Top 10 list, ECRI identifi ed what it calls “generic hazards,” problems that result from the risks inherent to the use of certain types or combinations of medical technologies. The list, now in its sixth year of publication, is updated each year according to the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in ECRI’s medical device problem reporting databases; and the judgment, analysis and expertise of the organization’s multidisci- plinary staff.
“These trends point to the need for in- creased awareness, for remediating steps, or even for improved design for a class of devices,” the nonprofi t organization wrote in its 2013 report.
Pinpointing problems, solutions By most accounts, CS professionals shouldn’t be too surprised that inadequately processed endoscopes and other surgical instruments again found its way on the Top 10 hazards list. Although contaminated or malfunctioning medical devices have long posed a threat to patient safety, it seems 2012 was the year for raising awareness of such challenges. Reports on the dangers of contaminated instrumentation made national news — on television and in print — which helped put devices (and those who process them) un-
der the microscope. As a result, instrument processing, which had long taken place out of the public eye, is now in the community spotlight. And many believe it’s likely to stay there.
Certainly, that’s not a bad thing. While intensifying scrutiny may be unnerving to reprocessing professionals, including those who do their very best each day to provide their healthcare customers with the cleanest and safest instruments possible, the greater focus on device quality can only mean good things for patient care.
“Knowledge is power,” assured Natalie
Lind, Educational Director for the Inter- national Association of Healthcare Central Service Materiel Management. “While we can’t change the fact that instrumentation is becoming more complex and diffi cult to clean, we can arm our CS professionals with knowledge and education to ensure that they are competent and confi dent enough to rise above those challenges.”
As ECRI noted in its report, a variety of factors can contribute to improper reprocess- ing of instruments. These include device complexity (narrow channels or movable parts to disassemble); lengthy, vague or unclear manufacturer instructions for clean- ing; time pressures placed on processing staff; after-hours requests for instrument processing, which may result in insuffi- ciently trained staff; lack of standardization of process among multiple processing areas; and coordination and cooperation issues between OR and reprocessing staff. Given those challenges, ECRI recommended a multi-pronged strategy for helping ensure effective reprocessing of endoscopes and other devices. These include: • Providing adequate space, equipment, staff, instructional materials, and resources for the reprocessing function to be per- formed effectively;
• Verifying that an appropriate reprocessing protocol exists for all relevant instrument models in a facility’s inventory;
• Ensuring that current documented proto- cols are readily available to staff and that
40 January 2013 • HEALTHCARE PURCHASING NEWS •
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staff are trained to understand and follow them;
• Monitoring adherence to protocols and quality of instrument cleaning;
• Periodically reviewing protocols to ensure that they are clear and compre- hensive, and that they refl ect the current environment (IAHCSMM note: it’s also vital that reprocessing-related proto- cols refl ect the most current industry standards, recommendations and best practices);
• Ensuring that endoscopy equipment in the facility’s inventory is compatible with the reprocessing unit (if in use) and its disinfecting/sterilizing agent;
• Seeking input from CS staff when assess- ing instruments for purchase to identify devices that may require additional time or resources to process safely and effec- tively; and
• Fostering communication and collabora- tion between reprocessing personnel and the department they support (i.e., OR, endoscopy department, pulmonary lab), so each group understands the others’ needs.
It’s important to note that the aforemen- tioned recommendations have been sum- marized for space purposes and do not refl ect the depth and detail of the strategies included in the ECRI report. The complete, 24-page report may be downloaded at no cost at
www.ecri.org/2013hazards. While device reprocessing risks may continue to appear on the ECRI Top 10 list (and realistically should), their inclusion — or exclusion, for that matter — should not serve as a full barometer for heightened hazards or broadscale improvements. As Lind explained, safe, effective instrument reprocessing is a responsibility that should always be a top priority.
“The importance of safe, effective, con- sistent instrument processing cannot be overestimated. Reprocessing professionals may never come in direct contact with a patient, but the products they deliver cer- tainly do.” HPN
IAHCSMM VIEWPOINT
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