HEALTHCARE SELF-STUDY SERIES N


PURCHASING EWS


June 2016 The self-study lesson on this central service topic was developed by 3M Health Care. 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 May 6, 2019. The approval number for this lesson is HPN 160605. For more information, direct any questions to


Healthcare Purchasing News (941) 927-9345, ext. 202.


LEARNING OBJECTIVES


1. Discuss instrument reprocessing in the ambulatory surgery setting.


2. Review the processing environment for instrument reprocessing.


3. Examine verifi cation monitoring of decontamination equipment.


4. Discuss quality monitors used for sterilizers.


5. Review immediate use steam sterilization (IUSS) practices.


Sponsored by:


Sponsored by


Reprocessing in the ambulatory surgery center setting


by Susan Klacik CRCST, CHL, FCS, ACE


hen a patient has surgery in an ambulatory surgery center their expectations are that the care they get will be the same as the care they would get if they were in a traditional hospital setting. To meet the patient’s expectations, the instrumentation needs to be processed following the same standards used in a hospital setting. This is confi rmed in the ANSI/AAMI ST79 Comprehensive guide to steam sterilization and sterility assurance in health care facilities introduction overview, which states “This recommended practice encompasses steam sterilization in all health care facilities, including ambulatory-care and offi ce-based facilities.”


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Processing environment The processing environment is an important part of infection prevention. The processing environment needs to be clean to prevent contamination of the instrumentation, pro- vide employee safety and maintain sterility. It must also prevent confusion as to whether or not an item has been cleaned. For this reason, there are best practices for this area. According to AAMI ST79, the sterile pro- cessing area should have a one-way direc- tional fl ow to prevent cross-contamination. Physical separation by walls is the best practice, however, in offi ce-based facilities physical separation may not be possible. In that case, spatial separation could be ac- ceptable, but it must be supplemented with a one-way directional workfl ow pattern, appropriate airflow characteristics, and good work practices.


The directional flow should begin in the area where contaminated items are received. The workfl ow should ensure that contaminants are contained. Work area de- sign also should allow adequate space for all functions and should promote effi ciency by minimizing distances between related areas. Containing contaminated instrumen- tation helps ensure employee safety. Processing personnel need training and education to perform the critical task of


26 June 2016 • HEALTHCARE PURCHASING NEWS • hpnonline.com


instrument processing. Hiring a certifi ed CSS Tech provides a distinct advantage as they have the foundation of medical device processing knowledge. As staff are on-boarded it is important that they are shown how to operate all of the process- ing equipment, perform all of the quality monitoring tasks, and perform packaging duties. They should also be informed of safety practices, be taught how to do in- strument decontamination, preparation, inspection, packaging, and sterilization and be informed of facility storage policies and procedures. Processing staff should receive training for all new instrumentation and processing equipment. Annual competen- cies should be performed especially for the high-risk tasks such as processing fl exible endoscopes, instrument decontamination and sterilization. The training should be documented and the records maintained. There should be policies and procedures based on best practices developed and available for staff.


Point of use Processing instrumentation is a team effort. It begins at the point of use to prevent the formation of biofi lm. It is at the point of use that debris can begin to dry. Techniques used to keep debris moist are to place a towel moistened with water over the instru- ment, placing the instrument inside a pack- age designed to maintain humid conditions, or using a pretreatment instrument spray. After the instrumentation has been treated, they need to be safely transported to the decontam room.


Transport Before being transported, the contaminated instrumentation needs to be contained and marked as being biohazardous. This is true even if the instrumentation is being trans- ported across the hallway. The method of transport is not determined upon distance, it is determined by the contamination. Ac- cording to the OSHA Bloodborne Pathogens


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