Author: Megan Pietura

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!

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.

 

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]

 

 

Uniquely GI: Challenges Facing Endoscopy Managers in Endoscope Reprocessing

Posted on by Megan Pietura

Endoscopy managers have a big job. Between staffing, training, and ensuring the needs of their department are met, there’s no shortage of challenges.

Endoscope reprocessing, too, has been under a microscope by infection control practitioners, directors, and surveyors for years, and with good reason. The number of endoscope adverse events in quarter 4 of 2022 reported by the Food and Drug Administration (FDA) in the MAUDE database is shown to be more than 10 times the number of adverse events in the same quarter in 2018 (6,161 versus 373). These adverse events have increased every quarter since quarter 2 of 2021. Search the MAUDE database, here.

But often the resources allotted to endoscopy managers do not match the rising complexity in devices and their IFU.  Gastroenterology departments differ in notable ways from their instrument reprocessing counterparts in sterile processing. It’s important to evaluate these unique challenges to ensure they’re addressed with the finest accuracy possible in a gastroenterology setting.

Reprocessing Rooms

Gastroenterology departments often suffer from small, cramped reprocessing rooms. Nearly every regulatory body or accrediting organization seeks to establish “one-way” directional flow separating clean workspaces from dirty. Limited space makes compliance incredibly challenging for endoscope reprocessors and managers to accommodate. Space is often a major issue for endoscopy managers, and there’s no easy way to remedy it.

General lack of space also means staging space is severely limited, which can lead to other problems, such as stacking scopes. Stacking scopes creates hazards for both infection control and the device itself. Many gastroenterology managers resort to vertical staging as their only compact solution.

When reprocessing spaces are too small for the demands of a facility, equipment needs also suffer. Many reprocessing sinks are not only too small, but often too deep to properly coil endoscopes, and feature few of the necessary tools needed. Lighting plays a critical role in cleaning verification, and yet most sinks do not have the room or space to add overhead lighting or task lights for focused inspection.

ANSI/AAMI ST91:2021 provides great guidance regarding lighting recommendations:

“Generally, all functions performed within a processing area require detailed and accurate inspection. Ancillary lighting should be considered for areas where instruments are manually cleaned and inspected. Lighting fixtures should be selected and mounted in positions that focus the light in front of the employee so that they are not working in their own shadows.” 4.3.8 Lighting

Space is such a pervasive challenge in gastroenterology, it creates challenges for handwashing sink compliance, emergency eye wash stations, worker mobility, and more. For guidance on making the most out of your space, check out our Study Guide of Space blog post for ideas.

High-Level Disinfection

Most endoscopy departments rely on high-level disinfection as the final cleaning treatment before storage. The recent change in ANSI/AAMI ST91:2021 has spurred significant discussion around sterilizing high-risk endoscopes. Both ethylene oxide and hydrogen peroxide methods are available, however, drawbacks follow, including incompatibility with scope models, longer processing times, and potential for carcinogenicity.

While ANSI/AAMI ST91:2021 doesn’t yet mandate sterilization for high-risk endoscopes, the change is likely inevitable, and will create challenges regarding the integration of sterilization technologies into departments, and ultimately increase the cost to process scopes. Space will continue to be a struggle, and entire department workflows may need to be evaluated. Training will need to be added and increased, as well. Departments may also find themselves re-evaluating their scope inventories, and investing money into new endoscope models, such as those with disposable components.

 

Gastroenterology departments have many challenges to consider tackling in order to achieve excellence in endoscope reprocessing compliance. It is also important to evaluate gastroenterology sinks in a separate lens than that of sterile processing to ensure they’re implementing the most impactful solutions in their departments.

Looking for guidance on a potential endoscope reprocessing sink project? Download our free Endoscope Reprocessing Sink Checklist, with 16 key considerations for selecting the right solution, including workflow compliance, space considerations, and more.

Have another problem you’d like help solving? Let us know!

The Joint Commission – The Silver Lining of a TJC Visit

Posted on by Megan Pietura

A sterile processing department group huddled together to take a team photo.Many sterile processing department managers know how it feels to learn that your facility is about to undergo a Joint Commission (JC) survey; even for the most prepared departments, it can be anxiety-inducing.

Many SPD managers also know another feeling: the frustration of knowing that your department requires investments in new equipment and tools, but cannot get the approval to get impactful projects completed.

Earlier this year, we gathered our Voice of the Customer committee to discuss TJC surveys, their experiences with them, and the direction they’re headed. One interesting piece of advice we discussed was that a TJC visit can serve as a great way to get a long-overdue project underway. How can a TJC visit support the completion of your projects?

Start with awareness of what needs improvement

Don’t let a visit from TJC be the first time you learn that something needs to be resolved or improved in your department. Auditing your department for areas of deficiency and opportunities for improvement can help you stay on top of what TJC may be looking for during a visit, as well as keep your department operating at peak efficiency.

One strategy to help with identifying potential areas for improvement is regularly communicating with your team and opening the floor to get input from them. Another is to participate in local industry communities to share thoughts and ideas with other reprocessing professionals.

Have solutions identified and pre-sourced

When TJC determines that something needs to be resolved, departments aren’t generally given a long time to do so. Our VOC members indicated that 60 days is typically the amount of time allotted to resolve findings from a survey.

This means that not just being aware of a problem ahead of time is enough, it’s also important to have solutions identified to remedy the problem. For instance, if you don’t have a dedicated sink basin for ocular reprocessing, pre-sourcing solutions like a single soaking station or a dedicated sink insert can resolve that problem quickly.

Have game plans ready

Knowing what options are available to you is one thing; understanding how to implement the right one is another. Laying out game plans for each solution to the problems you’ve identified will not only help your department resolve TJC findings as quickly as possible but give your facility enough time to adequately weigh the pros and cons and make the right call for your department.

The Silver Lining

Sterile processing professionals know what it takes to make their department great, and do everything they can to achieve that level of greatness. Unfortunately, sterile processing doesn’t always get the budget approvals they know they need. A visit from TJC can be the catalyst for change in departments that know they need it, and planning ahead is the best way to take advantage of that opportunity when it presents itself.

 

Looking to get your department prepared for a Joint Commission Visit? Check out: All About: The Joint Commission – How to Ace a Visit from TJC

The Joint Commission – How to Ace a Visit from TJC

Posted on by Megan Pietura

We recently convened our Voice of the Customer council to discuss a dynamic topic that every department deals with at some point: TJC surveys.

The logo for The Joint Commission. A Gold circular logo.

Department managers shared their unique experiences with their most recent TJC visit, both the positives and negatives. We’ve assembled some of the key takeaways and suggestions from our VOC council to help your department ace a TJC visit.

Train your team

A chain is only as strong as its weakest link, and your department is only as effective as your least-trained teammate, at least in the eyes of the TJC. Making sure your team is aware of your department’s policies, processes, and procedures helps ensure that everyone is on the same page when a TJC survey inevitably happens. A few strategies our VOC council suggested include:

  • Make processes and procedures easy to follow and understand.
  • Regularly conduct team huddles to ask and answer questions.
  • Perform ‘pop quizzes’ of your team to help them improve and stay sharp.
  • Show your team the ‘why’ behind the way things are done to help them understand how everything fits into the bigger picture.
  • Make standard operating procedures (SOPS) part of their everyday environment by integrating into their operations. You can achieve this in various ways, including posting it throughout the department, integrating it into your tracking systems, and discussing it in formal huddles and staff meetings.

Anticipate the questions, prepare the answers

This seems like a straightforward, and maybe even assumed, piece of advice, but our VOC panel says this simple idea is one of the best ways to ace a TJC visit. A surveyor has a lot of ground to cover and many considerations to make, so when they ask a question it’s best for everyone to get down to brass tax on answering it.

Meandering in your answer, or deviating from the original question, can give the impression that you’re not confident of the answer, or don’t have command of the processes in your department. Confident, to-the-point answers let the surveyor know that you know your policies & procedures and how they are performed in your department.

Be ready to present policies

Policies and procedures are often the name of the game when addressing TJC concerns. Being well-versed in your policies and procedures, as A sterile processing technician taking notes in a binder.well knowing how to readily access, retrieve, and present them, demonstrates that your department is well organized, and has done the work to ensure policies and procedures are established and accessible.

It’s also important to know what standards you follow and were to retrieve them at your facility. Consider these questions when preparing for your TJC Survey:

  • How frequently are you referring to them and using them to create and update your policies?
  • Can you speak about the updates and how your department is positioned to address the necessary changes to maintain compliance?

Be able to provide information

Dependent on the software and tools available at your department, being able to provide data related to your processes can help a TJC surveyor get a better understanding of the inner workings of your department and how effective those processes are.

Departments with modern tracking software for various processes and systems are in a better position to demonstrate this kind of data, but the software alone doesn’t make it possible. Having a good data hygiene plan in place allows you to provide meaningful data readily, as opposed to sifting through unorganized data that is hard to discern.

Data is a broad term and can include but is not limited to  some of the following information:

  • Staff competency
  • Sterilization load records
  • Equipment maintenance history
  • Policies & Procedures
  • Manufacture IFU library

In addition to frequently reviewing your data and following a data hygiene plan, routinely quizzing yourself and your team on how to access, read and narrate that data is an exercise that not only keeps it in the forefront of your mind, but can also build your confidence in how your present the data as well.

Demonstrate knowledge

As a sterile processing professional, you’ve got a ton of information about the industry and profession in your head. Don’t be afraid to ‘talk shop’ and get into specifics when it’s appropriate. Letting your surveyor know that you’ve done the work to be an expert helps instill confidence in your ability to run a tight ship and do things the right way.

Speaking to the rationale or “why” behind the process is a terrific way to highlight your knowledge and expertise. When you can demonstrate how the language translates into application it it speaks to your competency and engagement with the end goad: staff and patient safety.

Be enthusiastic and collaborative

At the end of the day, a TJC survey aims to do two things: improve your department and help keep patients safe—both of which are important to you as well! Our VOC committee stressed that setting those thoughts and feelings aside and instead embracing the visit as a positive one, is one of the best things you can do.

Taking an enthusiastic, collaborative approach to a TJC visit can help you identify how and where to improve your department, and be better for it.

Get to it!A sterile processing manager doing a group huddle with their team

Joint Commission surveys can seem intimidating, but they don’t have to. Take some of the strategies and suggestions our VOC council highlighted and start putting them to use now, so your department is ready to make the most out of (and ace) your next visit from TJC.

To get a few more tips on preparing for your department for a TJC survey, check out our blog: Joint Commission Preparedness: Starting Steps to Ace a TJC Visit

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.

Common Problems at Sinks in Reprocessing Departments

Posted on by Megan Pietura

Healthcare reprocessing sinks play a central role in the reprocessing of medical devices. Technicians and nurses spend hours using these important pieces of equipment. The critical nature of the work and devices in decontamination, coupled with the long periods of time spent using them, means that when there’s a problem or shortcoming related to a sink, it’s noticeable.

Here are some of the most common problems found with sterile processing and endoscope reprocessing sinks.

Overflows

With no shortage of tasks to be completed in any reprocessing department, there’s little time to waste. That’s especially true when it comes to filling sink basins. Often, technicians will turn on the water and step away to keep working on other tasks (as opposed to watching the basin fill).

Unfortunately, with so much to do and so little time to do it, that sink basin can easily be forgotten, leading to overflows, equipment damage, and slippery floors, as well as time being spent mopping up the overflowed water. Thoughtful sink design will consider this (often too common) occurrence, and account for it in its features.

Basin Volume

Speaking of filling up sink basins, many instructions for use (IFU) call for specific volumes of water to properly rinse and soak devices in a sink basin, mixed with detergents and chemistries. Many departments have gone to either etching their sink basins permanently, or using fill line stickers. Both bring their unique challenges, as permanent etchings are nearly impossible to terminally clean, and stickers can encourage bioburden with their sticky, exposed adhesives or need constant replacement. But without some kind of indicator, it’s easy for cleaning chemistries to improperly diluted, and be less effective.

Soaking Time

Soaking is a part of many device’s IFU, and an important step towards ensuring patient safety. With many departments now soaking devices with longer soak times, but without adding the basin capacity to accommodate it, departments have to juggle their basins more than ever.

The best way to handle this balancing act is using quality timers. Without permanent, dedicated timers on sinks, many departments turn to small, handheld timers. With low visibility of these handheld timers, and alarm volumes that can’t overcome the noise of a bustling reprocessing department, they go unnoticed when soaking time is complete, leading to excess time spend soaking. Excessive soaking can also cause damage in certain situations, furthering the issue.

Alternatively, a lack of any dedicated timers leads to departments approximating the time spent soaking. This can lead to lack of compliance with device IFUs, and potentially impact patient safety at the facility.

Ergonomic Concerns

The considerable amount of time technicians and nurses spend using reprocessing sinks means that any ergonomic challenges or concerns will be greatly amplified. It’s one thing to hunch over a sink for a few minutes, it’s something else entirely to do it for an entire shift.

A major ergonomic challenge regarding sinks is the depth of their basins. Because many sinks being used in SPDs and GI were not originally designed for use in the reprocessing space (or managers being unable to be involved in selecting their sinks in the first place), their basins are often significantly deeper than needed. This results in technicians and nurses hunching and stooping over the sink for long periods of time, leading to musculoskeletal issues and general fatigue.

Beyond the depth of a sinks’ basins, the height of the sink is another major concern related to ergonomics. Fixed height sinks mean that a technician’s height needs to land in a ‘goldilocks’ zone to work comfortably. Anyone above or below that height will have to squat or stretch in order to do their job effectively.

 

Organizational Challenges

Technicians and nurses require various materials, tools, and equipment to do their job effectively. Without a dedicated space around the sink for these necessities, disorganization can quickly become standard practice, leading to poor processes, reduced productivity, and even compliance concerns that can impact patient safety.

While many departments implement shelving to help facilitate organization and standardize their workflows, changes to guidelines & standards can cause the rigidity of these configurations to lead to the “workaround to becoming the workflow,” resulting in a loss of organization and potentially hindering the adoption of needed changes.

 

These areas are just the tip of the iceberg when it comes to challenges surrounding reprocessing sinks. The opportunities to improve the quality of life (and work) of the technicians and nurses that use them are countless. Ultimately, the right tool leads to the right outcomes, and a higher standard of patient care.

Pure Processing has seen it all when it comes to healthcare reprocessing sinks. Our designs were built by listening to the challenges of our many customers, and designing solutions around guidelines, department limitations, and IFU requirements. Have a challenge or are interested in exploring ways to enhance your sink situation? Let us know, we’d love to let you know everything available to you and your department!

The Recent Evolution of Surgical Devices

Posted on by Megan Pietura

As long as humans have been around to get ill or hurt, surgery has existed in one form or another. From the inventions of x-rays, anesthesia, antibiotics, and importantly, sterilization practices, surgery has also evolved with us. To some, surgery is the oldest form of art and innovation.

These surgical advancements come with unintended consequences for those meant to keep up with them, however. Sterile processing and gastroenterology departments, for example, struggle to advance their processes alongside the rapidly evolving techniques in surgery and the devices that enable them.

Three recent examples of surgical evolutions demonstrate this struggle:

Robotic surgery

Robotic-assisted surgery (RAS) is the definition of the modern-day operating theater. Software and computer programs allow minimally invasive surgical (MIS) procedures with less exposure for operating room staff, and typically fewer complications for patients.

Robotic devices, however, can prove difficult for some sterile processing departments to accommodate. With many fine surfaces on the disc face, adequately brushing can be challenging. The newest robotic technology features instrument shafts with multiple elbows and wrists, further complicating brushing and visual inspection. Certain devices may have up to three ports or require specific pressures when flushing. Robotic devices are typically long, meaning reprocessing sinks and assembly tables feel and function smaller, if the devices fit at all.

While impressive technologies, robotic devices introduce unique challenges for many reprocessing departments.

Flexible endoscopes

Flexible endoscopes have long been both brilliant and complicated in their design. Extra-long, with built-in cameras, wire cables, multiple channels, and video imaging systems, they are incredibly intricate and delicate. Some of the newest flexible endoscope models include permanently integrated balloons at bending sections, or removable distal end caps to better enable access behind mechanical elevators.

Scopes are easily damaged through simple reprocessing mistakes or oversights. Too much enzymatic detergent, over-coiling, using the wrong brushes, leaving the soaking cap off… it’s easy to make honest mistakes, especially under time constraints.

Gastroenterology and sterile processing staff should be careful to avoid scope damage, but also bear in mind the lengthy nature of scope reprocessing. Some scope manufacturers have cleaning IFUs with over 100 steps. Time is money when reprocessing these scopes, both in preventing damages and ensuring patient safety for a highly turned over device.

 

Powered devices

Powered devices look straightforward to clean. Their deceiving appearance hides many challenges:  batteries, cables, pneumatic devices with hoses for compressed gas, and components that disassemble require careful attention to detail during cleaning. Being cautious to avoid fluid invasion in powered surgical devices, as well as remembering that the attachments and subcomponents are complex devices themselves, are just some considerations as advancements in orthopedic surgery evolve.

U.S. Service members with the Joint Task Force (JTF)-Bravo mobile surgical team perform a surgical procedure during a medical readiness training exercise in Puerto Cortes, Honduras, Feb. 25, 2014.

Bringing innovation into instrument reprocessing

Surgery must advance just as diseases do, and these advancements have saved countless lives. For sterile processing and gastroenterology professionals, asking questions and continuous evaluation of processes and procedures will help keep instrument reprocessing advancing too.

Innovation is a muscle best kept in shape: involve others to contribute new ideas, problem solve, and evaluate current practices to continue fueling innovation in your department. Test new concepts, incentivize innovation when possible and give technicians and nurses support from leadership when new ideas come the front line.

These considerations, among others, can help sterile processing and gastroenterology staff stay ahead of the surgical evolution curve and continue keeping patients safe

 

As surgical devices evolve, so do sterile processing tools and practices, but some fundamentals never change. Learn about the three pillars to effective lumened instrument cleaning, and how these three timeless practices ensure proper reprocessing outcomes.