Outpatient Surgery Magazine

Did Skin Prep Fuel This Fire? - February 2017 - Subscribe to Outpatient Surgery Magazine

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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Page 85 of 146

limited space, where at any given time you might have 20 trays that need to be sonic-ed before they go into the washer. Too often, people are inclined to simply skip that crucial step. Now you can handle sev- eral trays simultaneously in one machine, provided they all require the same amount of sonication time. A washer can't do everything. The ideal cleaning process typically starts with an enzyme soak, is followed by ultrasonic cleaning, and then by mechanical washing. Virtually every instrument manufacturer's instructions for use (IFU) recommend including ultrasonic cleaning as part of the repro- cessing process. If you don't have an ultrasonic cleaner and bypass that step by placing instruments directly in the washer, you're not complying with the IFUs. You're in effect saying you know more than the manufactur- er, and you think you can get the device clean by doing it your way instead. Mechanical washers and ultrasonic cleaners have different processes and different functions. Ultrasonic cleaners agitate water and create bub- bles that implode and create pockets of suction around instruments. They're good at removing debris out of all the nooks, crannies and serra- tions, but they don't disinfect. Washers, on the other hand, aren't nearly as effective at dislodging debris from hard-to-reach areas, but they do usually raise the temperature at the end of the cycle to a level that reduces microbial count. Some facilities may be able to get by with just an ultrasonic cleaner (as long as that's the instrument manufacturer's recommended proto- col and the people doing the prepping and packaging wear powder- free gloves), but most need multiple pieces of equipment to comply with the manufacturer's IFUs. And you'll need more than one. You should never have just one of any type of equipment, because when it goes down, which it inevitably will, you'll be facing a major problem. This may be one of the reasons that tunnel washers — the car-wash types that let you put instruments 8 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 7

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