in one end and have them come out the other end having gone through
all the essential cycles — seem to be falling out of favor with both
manufacturers and users. In addition to providing less control — for
example, you can't change the length of time instruments spend in the
sonic cycle, which is an important consideration in orthopedics —
they take up a lot of space and are extremely expensive. For the price
of one tunnel washer, you can get several mechanical washers.
Test your cleaners every day
A lot of surgical centers that were set up to do small procedures and
have since gone way beyond that still have small processing rooms
and a small tabletop ultrasonic cleaner that's not powerful enough to
do the job. So the staff doesn't use it.
We live in a litigious world. Surgeons have the right, legally speak-
ing, to assume that everything brought into the OR is safe to use. If an
instrument turns out to be unsafe, the person running the facility is
the one who's liable.
Make sure you have mechanical cleaners that comply with IFUs,
and test them continually to make sure they're doing the job. One
test uses actual blood and fibrinogen, and not just chemicals. That's
my preference — the most stringent test available. The Association
for the Advancement of Medical Instrumentation (AAMI) recom-
mends testing at least once a week. But if possible, you should test
every day. After all, if you test on one Monday, and the next Monday
you find out the machine has failed, you'll have no idea when it went
bad. And you'll be looking at a whole week's worth of instruments
that might not have been adequately cleaned.
OSM
J A N U A R Y 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 8 7
Ms. Chobin (nancy@spdceus.com) is the president and CEO of Chobin and
Associates Consulting and Sterile Processing University in Lebanon, N.J., and the
author or co-author of 3 sterile processing textbooks.
