Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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9 1 A P R I L 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E step in decontamination. Instruments must be completely disassem- bled and thoroughly scrubbed with the right size and type of brush before they're run through the washer-decontaminator. You can only sterilize instruments that are clean, and any dried-on debris of blood, body fluid or fatty deposits can become baked-on permanent stains in the autoclave. A helpful hint: When our reprocessing techs are working at the sinks, they scrub the instruments beneath the surface of the water, so as to avoid aerosolizing any contaminants. Following manufacturers' instructions — both instrument manufac- turers' instructions with regard to their specified cleaning agent, and cleaning agent manufacturers' instructions with regard to the amounts and concentrations to be used — is imperative. To maintain instru- ments' quality, do not deviate from the manufacturer-specified prod- uct, typically a neutral pH soap. Overly acidic or alkaline solutions can damage instruments. I recall the sterile processing tech who poured bleach (a chlorine compound) into a sink full of instruments with the intent of disinfecting them while they were cleaned. You're killing the bacteria, all right, I told the tech, and you're killing the instruments, too. When manually cleaning, keep the "Goldilocks effect" in mind. Using too much cleaner, like using too little, won't deliver optimal results. Human error can play a part — your 1 oz. might not be my 1 oz. — and since the cleaning agents we use are low-sudsing, it's easy to overdo it. We've installed a dosimeter that siphons the correct amount of cleaner from its jug into the sink, enabling precise propor- tions of cleaner to water every time. A closer look Even the most carefully reprocessed instruments may occasionally show spotting, discoloration or corrosion. After the washer-decontam- S T E R I L E P R O C E S S I N G OSE_1404_part2_Layout 1 4/4/14 2:40 PM Page 91