Author: Megan Pietura

Studying Your Department: Where to Start and How to Gather Data

Posted on by Megan Pietura

Voice of the Customer

In March, our Voice of the Customer (VOC) Committee gathered to discuss a topic that can play a critical role in sterile processing departments but often gets overshadowed: Data.

Jhmeid Billingslea of Advantage Support Services , and longtime Voice of Custumer member

Jhmeid Billingslea

While it’s easy to acknowledge the benefits of collecting and using data to solve problems in sterile processing, the process can be a bit daunting. Where do you start if you want to start getting insights on your department through data?

We took the conversations from our VOC call and went a step further, collaborating with longtime VOC member, Jhmeid Billingslea of Advantage Support Services, to give readers some direction on beginning to collect and use data in their sterile processing departments.

 

Productivity

The first step towards becoming a data-driven department is honestly assessing exactly how productive your department is. If you’re perpetually behind on cases, there won’t be any time or energy available to begin taking on new initiatives. Struggling productivity can also make it feel like a department is understaffed, further worsening a team’s perceived bandwidth. A productive department is a proactive department, so tackling issues that reduce productivity, or implementing tools that can boost it, is important for departments to consider.

Unfortunately, recognizing productivity issues can be difficult without addressing them. If your department might be under performing, take these two basic stepsSurgical instruments trays laying on a washer cart

  1. Look at the total number of trays completed vs the number of people in your department.
  2. Assess the output of your highest-performing employees against the output of your team.

Determine how many trays your team completes per shift and compare it to the number completed by your high performers. This allows you to start identifying ways to optimize task completion across the department.

 

Quality assurance

The next step towards becoming a data-driven department is implementing quality assurance policies to ensure what your department produces is accurate, correct, and safe to use.

Rating carts coming into your department is a critical component to begin collecting data, and the benefit is two-fold:

  1. If every cart coming from the OR is assessed and rated by a member of your team, you now know when that cart first showed up to the department. This will help you determine how long it takes your department to fully reprocess it.
  2. Identifying and rating carts allows your SPD to clearly identify damages and concerns with point-of-use cleaning before any reprocessing is done. Reporting poor ratings and failures to the OR manager can help improve pre-cleaning practices before SPD receives an instrument, helping to reprocess it more efficiently.

Implementing proactive quality assurance measures before storage is also a big piece of the puzzle. This approach helps you identify deficiencies in your department and reduce the number of failed trays sent to the OR.

A couple of best practices to keep in mind:

  1. Importance of categorizing trays and tray complexity. Not all trays are equal; completing 10 basic trays may take the same amount of time as completing 3 complex ones. Gauging performance requires factoring in complexity, and planning must account for it. You gain a better understanding of how much time is spent on specific types of trays and add qualitative information to your data.
  2. Avoid opting for simple solutions to meet quality requirements. Once you’ve identified the most complex cases that have the highest likelihood for error, increase the required QA quota for them to learn more about how to improve on them.

With your department’s productivity level understood and QA procedures in place, it’s now time to start collecting and using data in your department. What information should you collect, and what hurdles might you encounter in the process?

 

Get your team on board

A significant challenge related to getting good data about your department’s performance is soliciting team involvement in data collection. Many see it as an additional, unnecessary step that only makes their lives more difficult. In reality, this could not be further from the truth.

By demonstrating a few points to your team, you can get on the same page about the usefulness of data in SPD:

  1. Insights from departmental performance can help you justify investments for more staff, new equipment, and training to help your team achieve their goals more easily.A sterile processing manager leading a group huddle with their team.
  2. Individual performance metrics give managers objective information they can point to when looking to give raises or promotions, offering sterile processing professionals more opportunities to grow in the industry.
  3. Proactive quality assurance and cart ratings can help improve communication with the OR and solve problems before they ever get to SPD.

There are many more benefits, but the more objective information a manager has about their department, the better they can advocate for and improve their department.

 

Ease of input and data complexity

Even if your team is on board with following the procedures to gather data about your department, it may not get done. Choose metrics that are easy to collect and analyze. Even though metric A A Person typing on a digital keyboard on a touch screen monitor.might be valuable to have, the complexity of collecting it could make it difficult to reliably obtain. However, with a little creativity, you might be able to collect metrics B and C and get the same insights you would have gotten from A.

Inputting information is another hurdle worth accounting for. Rather than making your team type information into a system, incorporate preset functions and options that can be selected with one click. Better yet, incorporating barcodes and scanners removes many barriers to tracking.

Easy and accurate is better than difficult and perfect.

 

Explore what your tracking system can do

Many of our VOC members indicated they’ve only tapped into the potential features of their integrated tracking systems, and that there were opportunities to improve.

Here are a few tips for getting more out of your tracking system:

  • Train, train, train. Most tracking solutions have training programs. Make sure that your team knows how to use your tracking system.
  • Become friends with the administrator of your tracking system. Every facility administers software differently, and many times the tracking software used by SPD isn’t controlled by SPD at all. If this is the case, learn who manages the software and explore what they’re able to do with it. There may be functions available to you that you are not yet aware of.
  • Use it. While there may be many features that aren’t enabled or configured for use, it’s important to use all of the ones available to you and understand their capabilities. Since you already own it, make the most of its capabilities.

Taking action

You’ve taken all the steps needed to start collecting data, but how long should you wait before you start taking action based on what you learn from it? The short answer: one month.

While you can wait a little longer, maybe 2-3 months, the fact of the matter is that if you start seeing opportunities to improve based on the data, it’s better for the department, the hospital, and most importantly, the patient to start improving as soon as you’re able to identify and solve the problem.

“To the SPD community: Don’t be afraid of data; data can be your best friend. It can be used to really positively impact your team and department.”

– Jhmeid Billingslea

With the tools and knowledge to start collecting data in your sterile processing department, it’s time to take the next step: using data to improve your department.

Check out the next blog in this series: Optimizing Your Department with Data

 

About: Voice of the Customer Committee

The Voice of the Customer Committee is a panel of healthcare and instrument reprocessing professionals who have graciously donated their time to share their expertise and guidance on current challenges faced by the instrument reprocessing community. Through sharing their insights, experiences, and best practices, we have been given the opportunity to share these findings with our readership. We’d like to thank our VOC members for their outstanding input and insights, as well as their time! Thank you for your continued partnership, and all you do.

Behind the Scenes: Partnering with Pure Processing

Posted on by Megan Pietura

Choosing a partner for a project or renovation can be daunting. The products or services a vendor offers are one thing, but as important is aligning in partnership with your vendors. The process of finding that partnership? That’s not something easy to evaluate from pamphlets and brochures.

Below, we highlight our goals and mission as an instrument reprocessing manufacturing partner and vendor, and some experiences you’ll have in partnership with Pure Processing.

 

Get to know each other’s goals

The first step in any good partnership is getting to know and understanding each other’s objectives. Your Pure Processing representative sits down for a virtual consultation to get to know you and your department.

Through this consultation, we learn your:

  • People: Your team, and your relationships within the facility
  • Processes: Your standard operating procedures and workflows
  • Problems: Challenges preventing your departments optimal, operational success
  • Patients: Your goals and objectives in delivering optimal patient care

Through any consultation, we hold ourselves to one Core Value: Passion for Processing. It represents our dedication to our customers in the instrument reprocessing profession, and eagerness to constantly expand our knowledge of the industry. We aim to learn from your experiences and insights, as much as we can provide equipment and services.

 

The right fit

With a thorough understanding of your department and its needs, we can evaluate potential solutions together. We explore options that meet your needs, address your challenges, department layout, budget, and time frame. With these considerations in mind, we identify the right-fit solutions for your department and discuss if they can positively impact your goals.

As a true partner striving towards the best end-result for your department, we may recommend products or solutions from other companies during this stage. We may also recognize that development of modified products or services is required, especially in reprocessing sinks and assembly tables. Exploration of custom solutions may also occur for your given clinical needs!

 

Customization

Upon determining solutions your department will invest in, such as a reprocessing sink or prep & pack table, you’ll work with your Pure Processing representative to zero-in on exactly how that solution will be configured.

Walk-throughs of custom solutions and features may include:

  • Width/depth of your equipment, especially for areas limited in space such as endoscopy
  • Pegboard layout and workflow
  • Basin configurations
  • Accessories and tools
  • Lighting options and configurations
  • Ergonomic options, such as height adjustability and wrist rests
  • And many more!

 

Review

During the review phase, configurations and layouts are presented for discussion. Many departments value seeing common pegboard configurations that other facilities have implemented to incorporate their accessories in an optimal way. It can also be helpful to visualize equipment at this stage, assessing impacts to space, tools and facility’s needs.

With decisions reviewed, we’ll walk through each line item in your proposals to ensure the project meets your intended specifications, and for clarity on each line items’ purpose.

Several pre-meetings can be held before quote approval to ensure internal hospital teams are aligned with installation responsibilities. No effort is spared to make the implementation as seamless as possible.

 

After ordering your new equipment

Once you’ve ordered your new equipment, Pure Processing goes into action to create exactly what your department needs. We do a few things during this time:

  • Verify and confirm your pegboard layout
  • Fabricate your new piece of equipment
  • Dress your equipment with the accessories and tools as specified in your pegboard layout
  • Quality check
  • Ship it to you!

Our internal process goes through multiple teams to ensure the highest quality of equipment and delivery. No item leaves our dock doors without a fine QC’ing eye.

 

Ready to go

Upon receipt of your equipment, our team will work with yours to ensure a seamless implementation. All accessories and electronics will be configured and mounted, and customers can choose to have Pure Processing provide pre-configured plumbing packages. All you’ll need to do is final connections and plug your new sink or table in to be ready for reprocessing!

 

Summary

Through a consultative, department-first approach, Pure Processing goes the extra mile to ensure that your new equipment investments will not only remedy challenges but enhance your department’s ability to achieve its most optimal patient safety outcomes. With Passion for Processing as our guiding philosophy, we give consideration to the smallest details to guarantee right-fit solutions for each partnership, and a seamless implementation, allowing your department to feel the impact on day one.

Looking for a vendor partner on a new project? We’d love to chat!

 

Supporting Surgical Robotics Programs: The Robotics Reprocessing Toolkit

Posted on by Megan Pietura

From journals like The New England Journal of Medicine and The Lancet refusing to publish information about the “seemingly incredible nature of robots assisting with surgery”1 in 1997, to the majority of minimally invasive surgeries being conducted via robotic-assisted surgery in 20202, Intuitive Surgical®’s robotic surgical platforms have been sweeping the healthcare industry in the U.S. over the last 20 years, and that growth is poised to continue at a rapid pace in the coming years.

Unfortunately, the same investments made by healthcare facilities to implement new, or additional robotic surgical volume, doesn’t often extend to sterile processing departments, causing them to take on an influx of sophisticated surgical devices without additional tools or personnel to do it.

How can the addition of appropriate tools and equipment turbo-charge a sterile processing department supporting a surgical robotics program?

 

Automated flushing systems

Flushing requirements of robotic instruments are one of the most laborious aspects of their reprocessing instructions for use (IFU). Not only do they contain time and volume requirements, but there are also two, sometimes three, ports that need to be flushed. Each additional port doubles, or triples, the flushing time required per device compared to single port devices, leading to lengthened reprocessing times and bottlenecks.

Automated flushing systems enable technicians to flush each port simultaneously, significantly reducing time spent flushing. Further, automated flushing systems ensure that the appropriate volume of solution is flushed per device IFUs, meaning compliance comes at a much lower cost in time spent and repetitive motion.

The most guesswork (and human error) often comes from ensuring 30psi is met during robotic lumen flushing. Automated flushing systems ensure that the 30PSI flushing requirement is met consistently for all ports; this is often impossible to meet or validate with syringes.

The benefits of automated flushing systems go beyond ergonomics, productivity, and compliance. With SP robotic devices requiring two-handed manipulation of wrists and joints while simultaneously flushing ports (seemingly impossible to do all at once), an automated flushing system can be securely connected to allow technicians to freely manipulate joints according to IFU.

As the sophistication of robotic arms increases, manual flushing is likely to become a of thing of the past in modern sterile processing departments.

 

Sink, basin, and soaking solutions

Two other significant concerns are the length of robotic arms and their extensive soaking requirements.

The length of robotic devices has been a concern in departments due to inadequate basin size of many older sinks currently in use. Narrow basins lead to an inability to fully submerge the device, causing compliance concerns as well practical cleaning issues.

Soaking requirements also create problems in sterile processing departments that haven’t received the budget to prepare for reprocessing robotics. With long soak times, robotics tie-up sink basins and slow down throughput at the sink.

Transporting robotic instruments can be challenging, but transport containers, such as the InstruSafe XL Transport Container, solves transportation and soaking concerns. An ideal size for soaking and protecting your valuable instruments, it offers a standalone soaking basin solution for larger instruments, with a lockable, dry-erase lid to note the start time. Additionally, it’s cart washer safe and includes water volume indications and bio-hazard labels for a complete soaking system.

Limitations associated with space plague many departments, making the implementation of new, fixed equipment challenging. Mobile solutions bring the benefits of an additional basin capable of fitting a robotic device without giving it a permanent location in the department. With casters, a pegboard to mount tools, and a small footprint, the PureSteel™ Mobile Soaking Station is streamlined for robotics  reprocessing in a package that can be deployed and removed from the department as needed, saving precious space without forfeiting capabilities.

While a sterile processing department may not receive a sink upgrade with the implementation of a robotics program, smaller and more targeted solutions can help tremendously. Small, dedicated sinks, such the PureSteel™ XI Reprocessing Sink, can kill two birds with one stone:

  • The 28” sink basin comfortably submerges da Vinci robotic arms
  • A dedicated standalone sink doesn’t bog down other reprocessing sinks from their workflows

With the addition of a pegboard to organize automated flushing systems, a dosing pump and soaking timer, PureSteel™ Xi Reprocessing Sinks can get a department back to the productivity levels required while fully supporting their facility’s robotics program, at a small cost relative to that program.

Robotic surgery is an exciting, innovative part of the modern surgical landscape and is likely to continue expanding and evolving. It’s vital that sterile processing’s tools, equipment, and capabilities evolve alongside it.

 

Need to get your department prepared for a robotics program implementation? We’d love to help!

 

Works Cited

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261744/

2 https://www.generalsurgerynews.com/Opinion/Article/09-21/The-History-of-Robotic-Assisted-Surgery/64651

Spring VOC Takeaways: Data as a Driver of Decisions

Posted on by Megan Pietura

Our Voice of the Customer (VOC) council convened earlier this spring to discuss a topic on the minds of many sterile processing department managers, but not necessarily at the forefront of current conversations: data.

During our panel discussion, a few bullet points were recognized as important by nearly all committee members:

  • How to gather data
  • Creating processes using that data
  • Solving problems with data
  • Creating departmental scorecards

While new, Reprocessing Report blog posts regarding each of these topics are upcoming, here are some high-level takeaways from the VOC call:

 

How to gather data

The first step towards using data in sterile processing departments is ensuring that there is a means to collect it. Our VOC members each had different ways of collecting quality data in their departments, and identified a few ways to improve data collection:

  • Make a commitment to collecting data at the department level
  • Utilize more features of tracking systems that may already be in place
  • Increase communication between sterile processing department and the operating room

Keep an eye out for our upcoming blog post, “Studying Your Department: How to Gather Data” to learn more.

 

Creating processes using data

A key advantage around data was the ability to use it as a base to create functional, efficient processes. For example, a reduction in output because of a standard or guideline change may require additional headcount or technology investments. In order to maintain compliance and output levels, data can help sell these investments internally.

Data can also be used to remedy processes by offering an objective assessment of performance. Our VOC council noted that in many departments the “workaround becomes the workflow”; what was once a temporary solution to a problem quickly become the standard. Analyzing processes using data can enable sterile processing and gastroenterology managers to identify workarounds that have taken root, and take actions to correct them.

 

Departmental problem solving

Data can be used to identify and solve a myriad of problems in sterile processing departments. Our VOC council explored how data can solve problems in their departments:

  • Use key leading indicators (KLI’s) to identify bottlenecks and productivity concerns to address issues proactively
  • Create audit programs to gauge and address quality issues
  • Tie performance to volume
  • Gain insights into the root cause of problems; data can help give context and identify underlying problems causing surface-level issues

 

Creating departmental scorecards

With all this discussion about data, it was only fitting that the conversation concluded with creating scorecards that departments can use to organize and track critical data. Some important considerations discussed, included:

  • Identifying what information is most important to your department
  • Ensuring the accuracy of the data collected
  • Finding the right solution to build, store and manage your scorecard
  • Determining capabilities, features, and limitations of existing tracking software
  • Identifying the resources and people you may need to ensure ongoing, accurate data collection.

 

These are just some of the high-level takeaways from our Voice of the Customer council meeting. Stay tuned for deep-dives into each of these data discussion points in upcoming Reprocessing Reports, and help your department begin leveraging data to benefit your department!

 

Already using data to identify problems, but need help solving one? We’re here to help!

Solutions for the Top Ergonomic Issues in Reprocessing Departments

Posted on by Megan Pietura

Following our previous blog post, How to Identify Ergonomic Concerns in Your Reprocessing Department, it’s time to discuss how to remedy some of these issues. Poor ergonomics can have a significant impact on employee safety, productivity, and overall job satisfaction. Fortunately, there are many solutions available that can alleviate these concerns and create a safer, more comfortable working environment. In this post, we will list the top five best remedies for ergonomic issues in the reprocessing department.

1. Sink Inserts

Many workplaces, like gastroenterology or sterile processing departments, recommended height-adjustable sinks to accommodate employees of different heights and reduce the risk of workplace injuries. However, the budget of many departments don’t often allow for immediate upgrades to height-adjusted sinks. In those cases, a more affordable and practical solution can be a is a sink insert. A sink insert is a temporary solution that can be easily installed into an existing sink basin to raise the work level, reducing the need for employees to bend over and potentially suffer from back injuries or strain.

Sink inserts may also reduce water usage and are often made of a softer material, reducing impact damage for delicate devices.

2. Anti-Fatigue Mats

Anti-fatigue mats can help reduce the discomfort caused by periods of prolonged standing and working. Anti-fatigue mats are designed to provide a cushioned surface that can reduce foot, leg, and hip fatigue. Additionally, ANSI/AAMI ST91: 2021 4.2.1 suggests the use of anti-fatigue mats in areas where employees stand for extended periods, such as in front of decontamination sinks or sterile processing workstations.

3. Automated Flushing Systems

Repetitive tasks requiring force and pressure, such as manual syringe flushing of lumened devices, can put a significant strain on the hands and wrists of technicians, potentially leading to injuries such as carpal tunnel syndrome and other musculoskeletal disorders. To address this risk, Independent Flushing Systems can be used.

Automated flushing solutions allow for hands-free, ergonomic-friendly lumen flushing, removing the need for repetitive hand movements, and eliminating the risk of hand-related injuries and strain. Additionally, the use of an automated flushing system can help to address ergonomic concerns identified by HPSA and meet the standards set forth by ANSI/AAMI ST79:2017 and instructions for use (IFU) requirements.

4. Task Lights

In reprocessing departments, employees should pay close attention to detailed areas when inspecting and cleaning instruments. This requires optimal lighting that illuminates the working area and provides a clear view of the instruments. Many sterile processing and gastroenterology departments struggle with optimal lighting, which has a direct impact on eye strain.

Task lights can provide the focused lighting necessary to make fine-detail inspection easier for nurses and technicians without added strain. Further, many task lights are equipped with a magnifier, enhancing one’s ability to visually inspect instruments. A magnifying lens can help nurses and technicians spot imperfections and defects that they may have missed with the naked eye, Reducing the likelihood of errors and defects.

5. Height Adjustable Sinks & Inserts

In any workplace, it’s common to have a team of employees of varying heights. This can create difficulties related to finding a work surface that is at the optimal height for each individual. However, with the use of height-adjustable sinks or tables, this problem can be easily solved. Height-adjustable sinks and tables are designed to allow the height of the surface to be adjusted at the push of a button, easily meeting the individual needs of nurses and technicians. This means that nurses and technicians can work at a height that is comfortable for them, ultimately reducing the risk of strenuous postures that can cause back, neck, and shoulder pain.

Height-adjustable equipment is suggested by OSHA as it can help to prevent work-related injuries and promote a safe, healthy working environment. By providing employees with the ability to work at an optimal height, employers can help to reduce the risk of musculoskeletal disorders and promote better overall employee health and well-being.

Conclusion

Addressing ergonomic concerns in reprocessing departments is essential for ensuring employee safety, productivity, and job satisfaction. By implementing solutions such as height-adjustable equipment, automated flushing systems, sink inserts, anti-fatigue mats, and adequate lighting, managers can help create a safer and more comfortable working environment for their team. It is important to regularly assess the ergonomic needs of the reprocessing department to ensure that solutions are effective and continue to meet the needs of the employees.

To see a full list of our ergonomic-focused products and solutions, click here.

 

How to Identify Ergonomic Concerns in Your Reprocessing Department

Posted on by Megan Pietura

If you have worked in a reprocessing department, it is likely that you have experienced discomfort, decreased productivity, or even injury due to poor ergonomics. The Occupational Safety and Health Administration (OSHA) defines ergonomics as “fitting the job to the person” rather than “fitting the person to the job.” Although this definition can be complex, it is essential to understand why ergonomics plays a critical role in reprocessing departments.

The intensity of manual labor required for reprocessing tasks can be serious if not adequately addressed, and it is crucial to ensure employee safety, enhance productivity, or create a better working environment. In this blog post, we will discuss how to identify these ergonomic concerns in your department.

Concern #1. Uncomfortable Postures

Uncomfortable postures are common during the reprocessing of medical instruments, as workers often perform repetitive actions in strained positions. Staff members may be hunched over sinks or prep and pack tables while manually cleaning or reaching too far for tools or materials at a prep & pack table. Performing these types of movements frequently can lead to musculoskeletal disorders if sinks and tables are unable to accommodate the height of the users. Many sinks also have deep basins, which are not conducive to manual cleaning and can cause lower back, shoulder, and neck pain.

Concern #2. Prolonged Standing

Prolonged standing can cause significant discomfort for technicians and nurses, as they are often required to stand in the same position over a sink basin or prep and pack table for extended periods of time. This can lead to foot, leg, knee, or hip fatigue, as well as back pain, which can become chronic if not adequately addressed. Extended standing can also lead to decreased blood flow to the legs, causing swelling and discomfort. In addition, standing in the same spot or area for long hours can lead to poor posture, which can contribute to musculoskeletal disorders over time.

Concern #3: Forceful movements and repetitive motions

Strained or difficult movements and repetitive motions are also common in reprocessing departments. Some tasks require applying substantial force, such as the manual cleaning of heavily soiled or narrow instruments, which can lead to strains and sprains. Repetitive motions, such as scrubbing instruments or using syringes when manually flushing, can lead to muscle fatigue and injuries such as carpal tunnel syndrome, which may result in missed shifts and staffing challenges.

Concern #4. Inadequate Lighting

Inadequate lighting can cause a range of issues for nurses and technicians working in sterile processing or gastroenterology departments. Poor lighting can cause eye strain and headaches, which can result in decreased productivity and reduced accuracy in completing tasks. Additionally, it can make it difficult to see fine details. Debris, and damage to instruments, which can compromise the quality of the work being done. An inability to visually identify these issues can not only lead to extra work in the form of returned trays but can also patients at unnecessary risk.

Conclusion

Although no one sterile processing or gastroenterology is the same, many departments varies, many departments share similar opportunities to enhance ergonomics. A comprehensive ergonomic assessment can help identify your ergonomic pain points and address concerns and give your team the best working conditions to achieve a high quality of work.

 

Downloading our ergonomics assessment checklist for your department can help ensure that your department is on the right track to ergonomic success.

 

The Impact of Changing Compliance Standards

Posted on by Megan Pietura

In professions like sterile processing and gastroenterology reprocessing, change is a way of life and adaptability goes a long way. As industry standards, guidelines, devices, and IFUs change, inflexible reprocessing solutions can cause problems, ranging from struggling to meet IFUs to the need for additional capital investments in equipment that departments likely don’t have the budget to purchase. Here are some examples of industry changes that made equipment inadequate or entirely obsolete.

 

Xi Arms

When Intuitive Surgical® released the da Vinci® Xi Surgical System in 2014, the robotic arms came with many new features and benefits; they also came with additional length and more stringent, sophisticated IFUs for reprocessing departments to learn and accommodate.

Two primary challenges came with these changes:

  • Length: The standard length of the new da Vinci Xi arms was 24”, longer than previous versions. With soaking requirements that call for full submersion of the arms, many departments found that their sink basin width was inadequate, meaning full submersion couldn’t occur.
  • Flushing requirements: With two ports and an IFU that calls for extended flushing times, departments that didn’t have space at their sinks for automated flushing solutions now found themselves spending more time flushing to achieve IFU compliance. This extra flushing can have a direct impact on productivity, and make departments feel as though they’re understaffed.

The impact for sterile processing departments:

  • Difficulty achieving IFU compliance
  • Sapped productivity and feeling short-staffed, even if case load didn’t increase

 

ANSI/AAMI ST91:2021 Updates

ANSI/AAMI ST91:2021 brought about many changes and updates to guidelines and standards. Among them were changes to the requirements of sinks:

“Sinks should be deep enough to allow complete immersion of the endoscope to minimize aerosolization. The size of the sink should be adequate (i.e., a minimum of 16 inches x 30 inches) to ensure that the endoscope can be positioned without tight coiling and 8 to 10 inches (20 to 25 cm) deep, enabling a person of average size to work comfortably without undue strain on the back.”

Section 4.3.2 – Sinks and Accessories; ANSI/AAMIST91:2021This update to ANSI/AAMI ST91:2021 immediately put many departments in a bind, with specific measurements being called out for sink basins in scope reprocessing, as well as directly pointing to ergonomics and the depth of basins. With many sink basins either not wide enough for proper scope coiling, or too deep for adequate ergonomics, departments had to make investments in short-term solutions because their sinks had become obsolete.

The impact:

  • Compliance concerns regarding sink basin size
  • Ergonomic challenges
  • Additional investment of short-term solutions for obsolete sinks

Check out our blog post on other updates in ANSI/AAMI ST91:2021

 

These are just two examples of IFU and guideline changes putting departments in a tough situation due to capital equipment purchases that weren’t built with the future in mind. Partnering with a vendor that can provide solutions capable of evolving alongside your department as changes occur helps to ensure that the money your facility invests goes as far as it possibly can.

Starting a project or renovation in your department? Let us help!

Considerations When Planning A Reprocessing Project or Renovation

Posted on by Megan Pietura

Your department has gotten the greenlight to conduct a large project or renovation; Congratulations! It’s an exciting opportunity and there are probably a ton of ideas bouncing around in not only your head, but the heads of everyone in your department. Projects and renovations don’t happen every day, and this is a chance to make meaningful changes your department has likely wanted (and needed) for years.

You as a leader want to maximize the benefit of this project, so what are some considerations to keep in mind as you begin planning?

 

Equipment

If you’re like many departments throughout the United States, you probably have aging sinks and tables that weren’t originally designed for use in a reprocessing department. Your decontamination sink might be suited for a restaurant!

There are a few things to keep in mind when starting your research on equipment:

  • Height adjustability: With teammates of varying heights, it can be difficult to find the right height for sinks & tables and create a comfortable working environment. The best way to remedy this concern is ensuring that your new equipment is height adjustable, and that the method of lifting and lowering is reliable. No one wants downtime because their sink or table’s lifters need to be repaired! Try seeking out reputable lifters that are electro-mechanical; hydraulic lifters may be cheaper up front but can incur years of service costs.
  • Ergonomic features: Height adjustability is a great start to improving ergonomics for your team, but there are other ergonomic considerations as well. Reducing pinch points with wrist rests, ensuring materials and tools can be easily reached, and that the depth of your basins is adequate for the work being done, but don’t require reaching or hunching, are all important considerations.
  • Quality & longevity: Large investments in reprocessing departments don’t come around very often, so it’s important to implement equipment solutions that will last for the long haul. Fabrication and build quality, as well as component reliability, are two key aspects of longevity that need to be top of mind; you don’t want to be replacing your equipment after 3-5 years!

 

Workflow

Equipment in reprocessing departments serves as an engine for activities and productivity; many aspects of reprocessing revolve around them. For this reason, it’s important that the workflows built around sinks or tables are dynamic and optimized for the needs of your department.

  • Pegboards: Pegboards on sinks and tables should almost be considered mandatory when planning your project or renovation, and with good reason! Pegboards allow you and your team to not only consolidate tools and materials right where they’re needed, reducing time spent away from the sink and table, but also configure them in a way that streamlines workflow and makes it easier for your team to accomplish their tasks. Some hinged pegboard options for reprocessing sinks can allow re-organization of accessories to further tweak workflows.
  • Workflow plates: Mounted on pegboards, workflow plates clearly identify which basins should be used for which activity at a reprocessing sink. This helps teams organize their workflows more clearly, help ensure compliance, and demonstrate the thought put into your processes in the event of a visit from the Joint Commission.

 

Space Limitations

With the opportunities a project or renovation present, you don’t want to miss out on the ability to make necessary changes because of unique spatial constraints in your department. Identifying a

partner that is able to offer you options based on your needs will give you the flexibility to get exactly what your department requires while the window of opportunity is open.

  • Various sizes: A partner that offers a variety of sink and table sizes will help you get the right tool implemented quickly if you’ve got room for a standard-sized sink or table. The more standard sizes available, the higher the likelihood of identifying a good fit quickly.

  • Custom configurations: If your department has limited or unique spatial considerations, a partner that’s able to develop custom-sized tables or sinks to fit your space is exceptionally beneficial. This doesn’t just mean being able to build very big or very small, it’s about the ability to create sinks or tables in the odd, in-between sizes to make sure that the space your department does have available to it is used to its maximum potential. This can also mean custom configurations for basins, shelving, feet, and other equipment features.

 

Conclusion

While this is certainly not an exhaustive list of considerations when planning for your large project or renovation, it does serve as a great starting point and lens to assess your options through. Making sure that you’ve identified your needs and unique departmental circumstances up front will help you move through your project or renovation process more smoothly, as well as maximize the benefit to your department upon completion!

Want to bounce some ideas around or get an outside perspective on your project? We’d love to help!

Making a Case for Automated Endoscope Flushing: The Data Behind the Guidelines

Posted on by Megan Pietura

Endoscopes are critical medical instruments used for various procedures such as colonoscopy, gastroscopy, bronchoscopy, among others. Due to the complexity of the device and the nature of the procedures they are used for, endoscopes are prone to contamination with bacteria and other pathogens. Therefore, it is essential to clean and disinfect endoscopes thoroughly before they can be used on another patient to prevent avoidable infections.

AORN, SGNA, ANSI/AAMI, among others, have issued guidelines for the reprocessing of endoscopes, including pre-cleaning, leak testing, manual cleaning, high-level disinfection, and storage. In this post, we review the data behind automated flushing endoscopes during the manual cleaning step, and how studies within make a compelling case for automated flushing technologies.

Reduction of Human Error Rate

Human error is common in all jobs, including the reprocessing of endoscopes. Reprocessing endoscopes involves many steps, and those who perform this task have limited space, time, and resources. As a result, some steps may be overlooked.

A study revealed that nurses and technicians frequently do not follow all reprocessing steps for endoscopes. The study found that over 47% of personnel did not consider manual cleaning to be a step they enjoyed in the manual cleaning process. Additionally, 98.6% of personnel did not perform all 12 required steps of endoscope reprocessing IFU correctly.1 These findings suggest that failure to adhere to recommended protocols is the primary cause of endoscopy-related infections.

To ensure compliance and reduce human error, the use of automated flushing instead of manual flushing is recommended. Automated flushing can reduce the time spent manually cleaning by nurses and technicians while removing steps which can be subject to interpretation or accidental oversight.

Increasing Efficiency

In the same Ofstead & Associates study, 75% of employees reported feeling pressure to work quickly when reprocessing endoscopes.1 This comes to no surprise, due to high turnover of both staff and scopes. With manual cleaning consuming a large chunk of time, use of automated flushing systems during the manual cleaning stage of endoscope reprocessing can result in more efficient and effective results compared to manual flushing. The devices built for automated flushing are designed to provide consistent flow and pressure during flushing. When two facilities used the Flush Buddy Systems, they found and increase in efficiency and consistent flush times.1

Ergonomic Benefits

Using automatic flushing during the manual cleaning stage of endoscope reprocessing can provide several ergonomic benefits over manual flushing with a syringe. According to Sivek, “There also are manual flushing aids available for staff who perform manual cleaning. Doing that flushing manually is quite onerous—think about flushing a scope with a syringe over and over. It can result in issues with the wrist, hand and thumb, especially for anyone who has arthritis.”

Further reinforcing this statement, one baseline survey revealed that correlation between employee physical pain and number of hours reprocessing each week (p= .041), with 47% of survey participants stating that the discomfort in their hands or arms.1 If automated flushing was included in manual cleaning, the percentage of employees experiencing hands or arm pains could be reduced.

 

Conclusion

Manual cleaning of endoscopes is a critical step in the reprocessing process that requires attention to detail to ensure that the endoscopes are thoroughly cleaned and disinfected before use on another patient. With advances over the years and the launch of diversified flushing pump options, automated flushing is now an effective and efficient way to flush endoscopes beyond syringes, reducing the risk of human error, saving time, and improving effectiveness. As such, their use should be considered as an alternative to manual flushing channels in accordance with IFU, ANSI/AAMI, SGNA, AORN guidelines, among other recommending associations.

Learn more about the FlexiPump’s benefits in increasing efficiency, staff ergonomics, and reducing human error compared to manual flushing and competition.

Curious about the best practices when flushing practices for reprocessing flexible and rigid endoscopes? Read more here!

Citations:

Ofstead, C. L., Wetzler, H. P., Snyder, A. K., & Horton, R. A. (2010). Endoscope reprocessing methods: a prospective study on the impact of human factors and automation. Gastroenterology Nursing, 33(4), 304-311. [IIIA]