1. Instrument complexity
Surgical instruments are becoming more functional and complex and,
not surprisingly, more difficult to clean. The data bears this out. Ms.
Horvath's research found that complex and cannulated or lumened
instruments were identified in 75% of the reported dirty instrument
events. She views this problem as the top contributing factor, espe-
cially in outpatient settings where orthopedic surgeries have signifi-
cantly increased in volume and instruments get soiled by difficult-to-
remove bone, debris and bioburden.
Many newer surgical instruments have more parts, more pieces and
more complex instructions for use (IFUs), points out Ms. Horvath.
"When the instruments are under development by a device manufac-
turer, they're developed very well for their intended use and function,"
she says. "But often there's not significant recognition of how difficult
they are to clean."
There's a big difference between cleaning instruments in a lab,
where you're not dealing with large volumes and multiple other
instruments at the same time, and actually doing it under the time and
productivity pressures of a working facility. Ms. Horvath believes that
in addition to bringing in physicians as advisors when developing new
products, instrument manufacturers should consult sterile processing
personnel to make sure instruments can be properly cleaned and ster-
ilized.
In the meantime, your staff needs immediate access to reprocessing
resources when questions arise about how to care for specific
devices. "It's unrealistic to expect them to be experts on every device
they encounter," says Mark Voigt, CRCST, CHL, director of sterile pro-
cessing at CentraCare Health-St. Cloud (Minn.) Hospital. "Make sure
appropriate educational materials are readily available to them."
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