5 Ways to Identify The Best Reprocessing Sink for Your Department

Sterile processing departments, endoscopy/GI labs, and surgical departments rely on specialty sinks for medical instrument reprocessing after instrument use. They are a critical element for the removal of all bioburden hazards to ensure a device’s safe return to use for the next patient. They must also provide efficient workflow and support technicians with ergonomic considerations to prevent injury.

Choosing a sink for the department when you’re ready to upgrade or renovate may seem a simple task at first. But there are many factors to the right sink. Use the following guidelines to inform your decision when identifying a sink to serve your department needs for the long term.

1. Facility requirements

A large reprocessing sink can demand more than just a large chunk of floorspace. It has plumbing and drain requirements as well as potential electrical connections. It’s important to anticipate facility systems operations and future, scalable growth considerations. Keep these facility needs in mind as you consider sink options for your department:

  • Space availability and potential for renovation
  • Plumbing and drain location considerations
  • Electrical connections: Current and future needs

Ideally your sink supplier will work with you from beginning to end to facilitate a smooth transition. They should provide planning documents that will help your department prepare for the new equipment and its requirements. That would also include how it will be delivered and what you will need to transport it from the loading dock and through the facility to your department. Planning ahead helps to avoid the unpleasant surprise of your new reprocessing sink being too large to fit in the elevator!

2. Workflow efficiency

Efficiency is something every department strives for. It’s a powerful tool to mitigate potential backlogs and impacts everything from employee satisfaction to maintained standard compliance. It is critical to consider when adding new equipment. You’ll want to look at your caseload, your specialties, and how many technicians you have.

Before you begin looking for sinks, consider the following to add to your decision process and future planning:

  • Are you going to use the same workflow? Or will it change?
  • Are you upgrading water quality?
  • Will you be adding new surgical specialties?
  • What tools do you currently use?
  • What tools will you add to improve efficiencies or accommodate new instrument IFU?
  • What is your average caseload? Will that change?
  • How do instruments get to the department?
  • What steps do technicians take first?
  • Where do my biggest backlogs take place?

 

All of these should be included in your planning and decision process and be part of your purchase process as well. The ideal sink provider will help you work through all of these to ensure you have the right sink for your departmental needs.

3. Reprocessing sink customization

Every department has different space, specialty, and workflow requirements. It can be difficult to use a one-size-fits-all sink that only offers a specific number of bays, lengths, or basin sizes. Be aware of all the options when planning to add new sink equipment, such as custom modifications.

Choosing a standard size sink may be tempting because it seems easier and possibly cheaper. But the wrong sink can disrupt an entire department if it cannot meet its needs, and ultimately leads to expenses down the road with backlogs and inefficiencies. Choose a sink provider who can work with your specific departmental needs, whether you need a standard sink or customization to improve its effectiveness, while also following recommended guidelines.

Pure Processing’s PureSteel Healthcare Reprocessing Sinks are available in multiple standard sizes, and also in customizable by size, basin or features, to fit specific needs for each unique department.

4. Sink accessories

Most reprocessing sinks come with accessories designed to make work easier. Certain accessories can make sinks more effective and efficient for your technicians. Those would include:

  • A back wall that adjusts with sink height, but that can also organize accessories at the optimal worker height
  • New reprocessing tools to help meet changing IFU requirements
  • Lights for inspection
  • Features which add ergonomic benefit to staff, on top of height-adjustment

 

flexipump independent flushing system laparoscopicAutomated flushing systems can help meet complex IFU requirements task light

Tasks lights come in many varieties, not all suitable for reprocessing sinks.

workflow plate rinse

Ensuring workflow compliance is critical for new staff, or new department layouts

 

Many accessories are a nice to have, but they can also become a burden if they are not properly chosen. Pieces and parts can go down, which can impact the usability of the sink itself. Mechanical accessories are especially at risk for this. “Bells and whistles” can be tempting, and ultimately effective for your department’s needs. But consider all implications when adding certain accessories. If they cannot bring real, day-to-day efficiencies and value for staff or compliance, they may be nice, but impractical.

Instructions for use (IFUs) should also be part of your accessories decision. They may seem like a great addition, but you’ll want to evaluate their effectiveness to meet IFUs. Added spray guns can make a sink look good, but they may fall short of meeting critical flushing requirements.

5. Sink ergonomics

Technicians spend many hours at sinks performing repetitive tasks that can have a painful impact on hands and wrists, not to mention pain from bending over for periods of time. Choose a sink with ergonomic considerations to minimize such risk for injury:

  • Electronic push button height adjustment
  • Ergonomic wrist rests
  • Back wall panel auto adjust with sink height
  • Height adjustable storage shelves

Some sinks will include features beyond height-adjustment to improve worker ergonomics

Evaluate the mechanisms your sink uses to adjust its height

 

The right sink can keep your technicians comfortable, satisfied with their working environment, and pain-free while performing their work.

Each department wants to achieve reprocessing effectiveness, efficient workflows, and quality outcomes. And every piece of equipment your department uses contributes to success in all those areas. A reprocessing sink is no different.

A sink is more than a sink. It’s a vital piece of equipment that can have a huge impact to your department, your technicians, and your work. You can identify the best sink for your unique department by planning ahead, considering facility requirements, workflows, customization, accessories, and ergonomic impacts to your team. The right vendor can work with you through the entire process to identify what you need and how to achieve it.

 

Pure Processing’s PureSteel Healthcare Reprocessing Sinks are the industry gold standard for flexibility, function, and quality in both sterile processing and endoscopy departments.

Contact our sales team for a free consultation and quote and see why so many customers switch to a new vendor option.

Sterile Processing’s Role in Preventing Healthcare Associated Infections

Imagine requiring a surgical procedure on your hip. It’s a standard surgery performed hundreds of thousands of times every year in the US. You don’t spend much time considering that something could go wrong. Now imagine a couple weeks have passed since your surgery. You feel great and have a follow-up appointment with your surgeon. The surgeon confirms you’re healing well, and you are very thankful to the surgeon for a successful procedure and your ongoing recovery.

Unfortunately, some people are not so lucky. Some patients do experience unforeseen and unnecessary consequences from routine procedures, leaving them with a surgical site infection (SSI) or other healthcare-associated infection (HAI). While you were right to thank your surgeon for doing an excellent job, you also should have thanked the Sterile Processing Department (SPD) for properly cleaning, disinfecting, inspecting, and sterilizing the instruments before they were used during your procedure. The risk of an SSI would have increased if the sterile processing department had not properly cleaned the instruments used.

Two types of healthcare-related infections

What are healthcare-associated infections and surgical site infections?

  • An SSI is an infection that occurs after surgery in the part of the body where the surgery took place. While they are both infections resulting from medical treatment, SSIs refer specifically to an infection acquired in surgery.2
  • HAI’s are infections acquired while receiving any treatment, not only in surgery.

According to the CDC, “each day, approximately one in 31 U.S. patients contracts at least one infection in association with his or her hospital care”.1 That number might seem high, but it would certainly be higher if the central sterile department wasn’t doing its job properly.

How sterile processing prevents infection

What role does SPD play in preventing these infections? When instruments are used between patients, residual human bio-burden on surgical instruments (blood, feces, mucous, bone, etc.) can potentially contaminate another patient. Sterile processing follows strict, technical instructions for use (IFU) to ensure every crevice, corner, hinge, bend, and channel of medical instruments are thoroughly cleaned. Instruments must also be fully functional. Surgeons can potentially make unnecessary mistakes during the procedure if scissors get stuck, if blades don’t cut, and graspers can’t grasp.

 

Sterile processing departments need highly technical and efficient devices to perform their job correctly. For example, even a department’s reprocessing sink should be considered. If a sink can’t fit the large, heavy instruments used during a hip surgery, how can they be properly cleaned? These sinks are not just sinks you would find in your house or a restaurant, nor are the brushes, sponges, detergents, washers, and other pieces of specialized equipment. Because SSIs, HAI’s, and patient safety are such serious concerns, they need to be treated as such with the proper equipment.

The sterile processing department in your hospital is crucial to patient safety and is needed to run a safe, efficient, and effective surgical department. So next time, if ever, you need to go in for a surgery, make sure to not only thank the doctors, surgeons, and nurses, but also the people working behind the scenes to keep you safe: the sterile processing department.

 

Looking for more information on improving cleaning outcomes to prevent surgical site infections and HAI’s? Watch our free, 1 CE program, A Royal Flush: Your Winning Hand for Pre-Cleaning Protocol, to learn how the reprocessing sink is at the heart of every successful patient procedure.

 

References

  1. “Current HAI Progress Report.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 26 Oct. 2021, https://www.cdc.gov/hai/data/portal/progress-report.html
  2. “Surgical Site Infection (SSI).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 24 Nov. 2010, https://www.cdc.gov/hai/ssi/ssi.html

Visual Inspection of Surgical Instrumentation: “We Cannot Clean What we Cannot See”

Instrument reprocessing departments are at the heart of their facilities. Without their crucial work inspecting, cleaning and sterilizing instrumentation, operating rooms and physicians would not be able to provide life-saving procedures to their patients. One of sterile processing’s core functions, visual inspection, is critical in assuring that the instruments delivered are safe for patient use.

“We cannot clean what we cannot see” is unmistakably clear. Instrument reprocessing professionals must be able to visualize theirGuidance for Internal Inspection instrumentation fully to deliver high quality cleaning outcomes. External inspection is good for 50% of the device, but what about the other half of your instruments? The internal channels and components of devices are as important and yet more dangerous to leave unchecked.

 

Regulatory guidelines and industry recommendations are urging for more internal visual inspection of lumens for this reason. For example, ANSI/AAMI ST79 and ST91 both list guidance on internal inspection:

 

“The internal channels of a flexible endoscope that are accessible can be inspected by a borescope or other appropriate inspection method. Those conducting the inspection should be trained to identify damage and retained contaminants. Refer to the endoscope manufacturer’s written IFU, maintenance bulletins, and other labeling for direction on what is considered a defective or damaged medical device that cannot be used and must be sent to the service provider for further inspection and potential service activities.”

ANSI/AAMI ST79:2021 7.8.3

“Visual inspection is greatly enhanced with the use of magnification and illumination. Visual inspection can include the use of borescopes to inspect the inner channels/lumens present in many flexible endoscopes.”

ANSI/AAMI ST91 13.5.1

 

Facilities will also find updated guidance when inspecting complex devices, such as flexible endoscopes or shavers:

“Complex devices such as flexible endoscopes may require the use of lighted magnification or additional methods to assist with the inspection process..”

https://www.cdc.gov/hicpac/pdf/core-practices.pdf

 

“The internal channels of reusable arthroscopic shavers should be inspected using an endoscopic camera or borescope.”

2017 AORN Guidelines. www.aorn.org

 

Departments reprocessing any of these complex devices or who are adhering to ANSI/AAMI guidelines should consider enhancing their internal visual inspection procedures with borescope technologies. Borescopes remove the guesswork of internal inspection; they provider the users to the ability to inspect internal channels, capture images, and assist in confirming if a device is patient ready.

When implementing borescope technologies, departments may need to ask themselves the following:

  • What am I looking for?
  • What does clean look like inside a channel?
  • What instruments should I inspect, if not all of them?
  • What do I do when I find something inside my channels?

With these questions in mind, department managers can create implementation plans. These plans extend beyond the answers to these initial questions. For example, your technicians may find the following in your instrument channels:

  • Debris
  • Damage, such as kinks, grooves, and scratches
  • Discoloration and staining
  • Residual moisture, notably in flexible scope channels

While it can be intimidating to uncover hidden issues, we also “cannot clean what we cannot see”. Internal visual inspection directly impacts patient safety outcomes when these issues are uncovered. Enhancing cleaning outcomes is at the heart of any instrument reprocessing department.

 

Visual inspection is more than external inspection. While important, it can be further enhanced by also inspecting the other 50% of your instruments through borescope technologies. These technologies uncover many avenues for process and quality improvement, and ultimately, improve the outcomes your department delivers.

 

Do you have questions on implementing a borescope program into your department, or would like to discuss the potential with an implementation professional? We can help start the conversation. Contact our sales and education team at (877) 718-6868, or by emailing info@pure-processing.com to start the conversation.

When to Use Extended Instrument Soaking During Manual Scope Reprocessing

It’s impossible to ignore. Instrument reprocessing time has increased. A major factor? Extended instrument soaking.

Reprocessing time will continue to increase due to additional instrument technology and safety measures. In fact, the current estimate is an average of 76 minutes for full reprocessing time by staff. But that’s when everything is performed as planned and no added steps are needed to clean properly.

The reality is recommended cleaning at the point of use does not always occur within a specific time frame in the procedure room. Missing the time frame pushes added work to reprocessing professionals and contributes to their backlog. The technicians and nurses must then take on the step of extended soaking to overcome repercussions associated with such a delay.

Pre-cleaning requirements for flexible and rigid scopes

Pre-cleaning must occur immediately after device use to prevent organic material from drying and hardening on instruments. Contaminants left behind on instruments can contribute to less effective high-level disinfection and sterilization procedures. Immediate cleaning practices within 60 minutes after use can prevent disease outbreaks and reduce infection risk.

Keeping track of time can be tricky. We all know manual records can be subject to human error. The Association for the Advancement of Medical Instrumentation (AAMI) recommends electronic record keeping over manual methods for accuracy to ensure cleaning is performed within the first 60 minutes. Even so, delays can occur.

Sometimes it’s more than human error that causes a cleaning delay. Emergency situations may contribute to endoscopes being left out overnight or even over a weekend. Leaving devices out for such time has been likened to a plate of sticky food left to harden that becomes more difficult to clean later. Then the instrument requires extra steps to remove bioburden and prevent infection risk.

Extended reprocessing soaking time

Most manufacturers recommend an endoscope be cleaned within 60 minutes of use to prevent biofilm formation and bioburden hardening. If less than 60 minutes passes between use and manual cleaning, then sterile processing technicians or GI nurses can follow standard leak testing and manual cleaning best practices to continue to remove contaminants.

Extended reprocessing soaking time is recommended if there is a cleaning delay of more than 60 minutes. It loosens hardened debris and bioburden from the instrument. If not performed, biofilms may form which can lead to infection control risk. While extended soaking times vary, they should not exceed 10 hours.1

It is still important to review IFUs for specific instrument cleaning despite common recommended steps for extended soaking. Not all IFUs will include extended soaking directives, however.

The right equipment can also make instrument extended soaking much easier and successful. Many sterile processing or endoscopy departments lack enough sink basins to accommodate extended soaking areas. Review your department’s existing inventory and make an assessment for added basins, transport carts with basins, or mobile soaking stations as needed based on volume of instruments coming through from the OR or procedure rooms.

Steps to include extended soaking look much the same:

Pre-cleaning

Pre-clean instruments as usual

Leak testing

Perform leak testing before extended soaking to prevent moisture damage

Extended (prolonged) soaking

Read IFUs and industry recommendations for extended soaking in detergent solution

Manual cleaning

Follow manual cleaning IFUs and best practices

 

It takes teamwork

Coordinating with the procedure team will help both departments better understand each other’s needs. If the OR or practicing nurses can complete point-of-care instrument cleaning, it reduces the backlog and enables departments to turn instruments around much faster. Not to mention properly pre-cleaning instruments helps to reduce infection risk in the long run.

It is inevitable for reprocessing professionals to reprocess instruments left out too long post-use. And when the time comes, you’ll want your team to be aware of how and when to use an extended soak while having access to enough basins to get the job done.

 

Pure Processing offers many solutions for sterile processing and endoscopy department extended soaking needs, including mobile carts with multiple basins and transport carts.

 

References

  1. Choi, et al (2015). Endoscope reprocessing: Update on controversial issues. Clinical Endoscopy, 2015 Sep; 48(5): 356–360.

 

Have a unique challenge you would like to get input on? We’d be happy to help!