How can surgical professionals ensure they maximize the use of their surgical instruments with proper care?
1. Stringing instruments in decontam for more effective cleaning. By stringing the instruments with a wide stringer, the instrument, including the hinges, is completely open and exposed to water and cleaning solution in the instrument washer. This makes a huge difference in the effective cleaning of instruments. This will result in the delivery of much safer instruments for patient care. It’s also effective in extending the life of the instruments because a common area of breakdown is where organic soil builds up. Proper cleaning can dramatically extend the life of an instrument and result in reduce repair costs.
2. Effective flushing of lumened instruments. Brushing is important, but research has shown that flushing lumened devices with copious amounts of water and/or cleaning solution is critical to making sure that those devices are clean. Without that, you can have a buildup of organic matter inside the instruments and once sterilized, the soil can become fixed and is almost impossible to thoroughly clean. Whether that is done with a spray-gun or a more elaborate automated device, it’s critical to include thorough flushing of lumens as part of the reprocessing procedure.
3. Have a tray audit program. While every institution must decide what works best for them, having a program where a tray of instruments that’s gone all the way through the process, including sterilization, is pulled off the shelf and opened up. The instruments are inspected, ensuring all the instruments are there, in good working order, are completely clean, all chemical indicators are there, etc. As important is keeping a record of audit results over time, so that the facility can track their performance in delivering clean, ready-to-use, safe-to-use complete surgical sets.
4. Know the standards. Know the industry standards and best-practices, so have on-hand the relevant AAMI (Association for the Advancement of Medical Instrumentation), Joint Commission (JCAHO), Association of periOperative Registered Nurses (AORN) guidelines, SGNA (Society of Gastroenterology Nurse and Associates), etc. guidelines. Have the instructions from the medical device manufacturer. Make sure you have a program not just for auditing but for in-services so that your staff is up-to-date. Also, have a program of remedial education, so not just when a facility has a new employee, but a program where staff members must demonstrate their knowledge over time.