HEALTHCARE SELF-STUDY SERIES N
PURCHASING EWS
January 2016 The self-study lesson on this central service topic was developed by STERIS. The lessons are administered by KSR Publishing Inc.
Earn CEUs The series can assist readers in maintaining their CS certifi cation. After careful study of the lesson, complete the examination at the end of this sec- tion. Mail the complete examination and scoring fee to Healthcare Purchasing News for grading. We will notify you if you have a passing score of 70 percent or higher, and you will receive a certifi cate of completion within 30 days. Previous lessons are available on the Internet at www.
hpnonline.com.
Certifi cation The CBSPD (Certifi cation Board for Sterile Processing and Distribution) has pre-approved this in-service for one (1) contact hour for a period of fi ve (5) years from the date of
original publication. Successful completion of the lesson and post test must be documented by fa- cility management and those records maintained by the individual until re-certifi cation is required. DO NOT SEND LESSON OR TEST TO CBSPD. For additional information regarding certifi cation contact CBSPD - 148 Main Street, Suite C-1, Lebanon, NJ 08833 •
www.sterileprocessing.org.
IAHCSMM
(International Association of
Healthcare Central Service Materiel Management) has pre-approved this in-service for 1.0 Continuing Education Credits for a period of three years, until December 2018. The approval number for this lesson is HPN 151412. For more information, direct any questions to
Healthcare Purchasing News (941) 927-9345, ext. 202.
LEARNING OBJECTIVES
1. Identify and understand implementation of the AAMI TIR34 2014, Water for the reprocessing of medical devices guideline
2. Identify the different stages of rinsing and when they should occur during the process
3. Distinguish different water quality types and treated water rinses and when/how each one should be used
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Rinsing: the most misunderstood step in reprocessing
by Michele McKinley, LVN, CRCST, CIS, CHL, AGTS, Senior Clinical Education Specialist, STERIS
s we consider the reprocessing of medical devices, most facilities are diligent in following regulatory guidelines and manufacturer’s instructions for use for cleaning and sterilization of re- usable medical devices. While most of the reprocessing in a facility takes place in a centralized department, there are many an- cillary areas that perform the same functions e.g., Endoscopy, Respiratory, Anesthesia, Clinics, Outpatient Centers, etc. That being said, if you were to poll your departments and ask about the steps of reprocessing, would rinsing even be mentioned in the reprocessing cycle?
A Industry standards
Most of us are familiar with ANSI/AAMI ST documents but how many are familiar with AAMI TIR (Technical Information Report) documents, in particular AAMI TIR34 2014 Water for the reprocessing of medi- cal devices? As you build the resource library for your facility, this document should be included along with the ANSI/AAMI Guideline documents.
ANSI/AAMI TIR34:2014 states, “The objective of this TIR is to provide guidelines to personnel involved in medical device reprocess- ing on the quality of water that should be used in various stages of medical device reprocessing. It is also intended to provide guidelines to water service maintenance personnel on establishing and monitor- ing water treatment systems.”
Water quality
Let’s think about the pro- cess and how often water is a component of everything we do: manual cleaning, automated cleaning, steam sterilization; and while equipment does have spe- cific water requirements that should be followed, how many facilities focus
26 January 2016 • HEALTHCARE PURCHASING NEWS •
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on water quality for rinsing of medical de- vices? Most of us perform the rinse phase with little thought to rinsing being a critical phase in the reprocessing cycle. Let us take a look at the rinse phase and its importance in the reprocessing of medical devices. In device reprocessing, water can impact patient outcomes and the life of medical in- strumentation. We no longer have to just be concerned with improper cleaning causing adverse patient outcomes, but we also need to understand the impact of how improper water quality affects rinsing.
Some examples of how rinsing can impact outcomes are: instrument malfunctions during a patient procedure, due to water deposits causing instrument damage, impacting the correct functioning of the instrument; toxic effects and tissue irritation occurring from residuals left on devices due to inadequate rinsing; and patient infections, occurring from using contaminated devices, due to cross contamination from rinsing in the decontamination sink and/or area. There are two categories of water quality
that are important for medical device repro- cessing and the level of water quality that may be needed: 1.) utility water (tap water) which may require further treatment to achieve recommended specifi cation, utility water is mainly used for fl ushing, washing and rinsing. 2.) Critical water (extensively
Automated endoscope reprocessor
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