moisture invasion or other contamination. These devices are "reject-
ed" and must go back to the very beginning of the reprocessing work-
flow. The same is true for sterilized surgical trays that don't contain an
internal chemical sterilization indicator to confirm the contents were
exposed to the appropriate sterilant.
Contaminated trays
One of the most significant and highly publicized quality metrics
to benchmark is the incidence of bioburden and other contamination
you identify in your sterilized trays. Evaluate any event that involves
retained bioburden on a surgical instrument from all aspects of the
instrument use and reprocessing workflow. This should be a shared
metric between the OR and SPD teams. Remember, removing biobur-
den begins during and immediately after surgery in the precleaning
process that takes place in the OR.
Surgical case delays
Case delays is another collaborative metric between periopera-
tive teams. The reprocessing department should document specific
reasons for a sterile processing-related case delay — such as "tray not
available," "incorrect preference card pulled" or "missing critical
instrument" — to enable appropriate root-cause analysis and follow-up
by department leadership. You'll find that you can track many of these
types of case delays back to dirty data as often as a broken process.
Employee injuries
Track employee injuries in the decontamination area, particular-
ly sharps exposures. Because of the substantial risk associated with
exposure in this area of the workflow, you should document, report
and track all events in a transparent fashion across perioperative
9
8
7
2 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 9
Infection Prevention
IP