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were linked to improperly cleaned duodenoscopes). That's why even the most ded-
icated techs in central sterile need regular reminders about proper manual cleaning
protocols. Here are some key points to emphasize.
1. Start at the bedside
Cleaning at the point-of-use helps remove gross debris and flushes lumens
before instruments arrive at central sterile. Keeping instruments moist immedi-
ately after use basically ensures that blood, tissue and other bodily fluid doesn't
dry on surfaces and in channels to make manual cleaning even more difficult. It
can also help keep instruments in better shape by reducing the amount of corro-
sion and pitting that bodily fluid can cause. Cleaning at the bedside is a step
that's often overlooked, because facilities place an emphasis on turning over
rooms quickly instead of making pre-cleaning a priority.
Here's how to do it correctly: After instruments are used in the OR or proce-
dure room, wipe them down with a moistened towel or sponge to remove gross
soil. Lumens should be flushed using a syringe and an enzymatic detergent,
which starts breaking down bioburden. Enzymatic solutions are considered best
practice, although flushing with water is also acceptable. The instruments
should be kept either under a moist towel or soaked in a neutral pH enzyme
detergent until they're brought to sterile processing.
New gel and foaming enzymatic detergents are specifically designed to make
pre-cleaning even simpler by keeping instruments moist without having to fill a
basin for soaking. These options form protective barriers that keep instruments
wet for longer periods of time. Special transport sacks are also available to keep
instruments moist after use and are especially helpful in busy sterile processing
departments where techs might not be able to clean lumened devices as soon as
they arrive.
2. Follow the instructions for use
It's something you hear over and over again: Follow the instrument manufactur-
