says Ms. Staubitz. "Empower them to speak up and rely on them as a
resource. There are thousands of surgical instruments, so there could
always be issues down the road that they can help you identify."
Have each sterile tech trained at least twice a year. Refreshers may
help to prevent "little pieces of information from getting lost," she
adds, be it knowing which brush by diameter and bristle type to use
on a particular instrument, or any limitations on heat-sensitive scopes
processed in a low-temperature sterilization system.
4. Automate. Automated endoscope reprocessors may help to
enhance critical steps in the manual cleaning process, or even elimi-
nate them altogether, while automated irrigation systems flush biobur-
den from narrow channels at the push of a button. They also remove
the human temptation to skip vital steps — say, manually pushing
only 1 syringe of water through the channel when the manufacturer's
instructions for use clearly call for 3.
"Some sites just use a syringe full of fluid from the sink, but it's hard
to effectively do this with some lumened instruments," says Ms.
Ofstead. "If you're not using the right mix of water and enzymatic
detergent, rinsing may not be effective enough to remove all of the
detergent, which is bad because it contains protein that can foster the
growth of bacteria."
5. Consider every "touch" during the cleaning process.
Carefully audit the cleanliness of the area where your techs are clean-
ing instruments, including the area used to verify the effectiveness of
cleaning, by using adenosine triphosphate (ATP) testing to indicate the
presence of living cells. Is the workflow designed so sterile techs start
in one place and don't have to backtrack? Are the brushes and other
cleaning tools being stored where they can't be contaminated? Is this
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