1. Follow instruments from dirty to clean.
The 4 main com-
ponents of a sterile processing department are decontamination,
inspection/assembly, sterilization and storage. But the inspection
neither starts nor ends in those areas. Using what's called the
Tracer Method, surveyors will follow instruments from dirty to
clean. They'll observe them from the OR post-use until they're
returned to the OR for the next procedure. Here's what the sur-
veyors will expect to see from your OR and reprocessing staffs:
• Point-of-use cleaning. Surveyors want to know that you're
cleaning instruments as much as possible during procedures.
They're checking that gross debris is removed and lumens are ade-
quately flushed so the decontamination process that follows is
more efficient and effective.
• Transport. Instruments should be transported in a closed con-
tainer to prevent spills. They should also be pre-treated with an
approved enzymatic foam and kept moist. They must be labeled
with a biohazard label. There shouldn't be any holes in packs and
wraps, and no missing or damaged container filters.
2. Decontamination documentation.
Surveyors will ask to
see instrument manufacturers' instructions for use (IFU). They'll
want to know that you're following those detailed guidelines on
disinfection, cleaning and inspection, and ask you to describe and
demonstrate how you're reprocessing in accordance with those
written instructions.
You should have a 3-basin sink — one for soaking, one for washing
and one for rinsing. Remember that the third basin should incorporate
either deionized or reverse osmosis treated water. Adding a treatment
to the rinse helps to ensure that you are compliant. It will also help
your instruments have a longer life.
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