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Instrument Cleaning For Today's OR

Tue, 12/16/2008 - 10:28am
The cleanliness and sterility of the surgical instruments used in any procedure play a direct and critical role in positive patient outcome. Even the most gifted surgeon can experience devastating results if bacteria or other contaminants from unclean or improperly sterilized instruments find their way into the sterile field when the patient is at his or her most vulnerable. Of course, the importance of high-level cleaning and sterilization of surgical instruments has been well known for over a century; and over that time major technological advancement have been made in both the processes and equipment used to ensure optimal sterility.

Today there is a wide variety of devices and systems available to hospitals and healthcare facilities designed to reprocess surgical instruments, devices and scopes to the highest levels of disinfection and sterilization. There are washers and disinfectors to remove initial contaminants and bioburden and steam, gas and chemical sterilizers to ensure that any infectious materials and organisms are destroyed or killed off. In addition, there are now a number of biological and chemical tests available that can help facilities monitor the performance of their instrument cleaners and sterilizers to assure that they are functioning at peak performance. Here is a look at some of the latest offerings from among the top infection control companies to help healthcare facilities keep their sterile processing departments effective and up to date.

The Getinge 633HC Steam Sterilizer is available in 3 size and features a power vertical door and optimal integral boiler.
Getinge USA, Inc. is a global leader in the manufacturing and distribution of advanced infection control products. Worldwide, Getinge Infection Control ranks among the leading providers of disinfectors and sterilizers within the healthcare and life sciences segments; and has stood for innovation and technological progress in the field of disinfection and sterilization for over 100 years. Getinge Sterilization Systems are designed to provide a complete combination of sterility assurance, cycle flexibility, real-time information access and advanced operator control.

The Getinge 400/500HC Series Steam Sterilizers are optimized for OR/Point-of-use Central Sterile Processing applications. Getinge 700HC Series Steam Sterilizers feature a large rectangular chamber that offers great loading capacity and better space utilization. Getinge 800HC Series Steam Sterilizers incorporate advanced, user-friendly display screens and best-in-class control system in a floor-loading unit.

A more recent addition to the Getinge Sterilizer line is the Getinge 633HC Steam Sterilizer, which can hold up to twice as many standard instrument trays than similar-sized competitive units. This mid-size steam sterilizer represents the ideal replacement sterilizer for OR renovation projects and is also ideally suited to accommodate the growing number of orthopedic surgeries performed in ambulatory surgical centers and the larger instrument sets associated with these surgeries. The Getinge 633HC is available in three chamber sizes (10.5 cu. ft., 15.5 cu. ft., and 20.7 cu. ft.) and features a power vertical door and optimal integral boiler.

CS Medical, LLC manufactures the TD-100 automated disinfector, a system designed to provide high-level disinfection of transesophageal (TEE) ultrasound probes. This system is far faster and easier than the time and labor required for the manual processing, disinfection and rinsing of probes. After inserting the TEE probe into the TD-100, the sterile processing professional simply follows the prompts on the display. This takes less than one minute. Just 17 minutes later, with no further input from the operator, the cycle is complete.

The TD-100 Automated Disinfector from CS Medical, LLC provides high-level disinfection of transesophageal (TEE) ultrasound probes.
The TD-100 generates significant savings both in labor time and cycle time. In addition, the system utilizes a gentle process that dramatically reduces the amount of stress and the potential for damage to TEE probes. And, because the TD-100 can be placed near the area where the scopes are used, the need to transport the delicate probes back and forth for reprocessing is eliminated.

CS Medical's TD-100 automated disinfector also helps facilities to protect their staff by containing the disinfecting solution. TD-5 is a glutaraldehyde-based, high-level disinfectant made specifically for the TD-100. The single-use, one-pint container, in which the TD-5 is provided, is pierced inside the machine, so splashes, spills and vapors are contained. Fresh disinfectant is used for each cycle eliminating the need for MEC testing. An advanced vapor management system adsorbs vapors during the process.

As an added bonus, the TD-100 performs continuous self-diagnostic tests that confirm the result in a printed report after each cycle. The date, time and identity of both operator and probe are recorded. If needed, additional copies can be printed directly from the machine.

Skytron recently introduced their innovative I Series Washer-Disinfectors, which provide high capacity cleaning flexibility and efficiency for every clinical need. The I Series Washer-Disinfector product line includes the I-5 Pass Thru and Stand Alone models, as well as the I-3 under-counter system for lower volume needs. Each I Series Washer-Disinfector features easy to use and quiet operation, standard volumetric flow meters for chemical pumps and greater processing options that include up to 16 programmable cycles, which are easily customizable to meet specific clinical needs. The I Series Washer-Disinfectors also offer enhanced drying through the unique use of water channels and rotating spray arms during the drying process.

The I Series Washer-Disinfector product line from SKYTRON includes the I-5 Stand Alone model, The I-5 Pass-Thru model and the smaller I-3 Under-Counter model for lower volume needs.
Another addition to Skytron's extensive product line for instrument care is the patented, wireless and completely sterilizable asset management tracking tags for Central Supply and Surgical Reprocessing Departments, powered by Awarepoint. These sterilizable tags can be attached to instrument trays or any other critical asset and tracked throughout surgical reprocessing and sterilization with one to three meter accuracy. The tags allow users throughout the facility to know exactly where critical assets are at every moment. And, as the tags can stay with the instruments and instrument sets throughout the entire reprocessing process, it allows facilities to monitor, measure and improve their sterile processing work flow.

Another world leader in infection control in the healthcare industry is STERIS Corporation. The name STERIS is synonymous with sterilization and the company's extensive product line includes the widely used Amsco® Sterilization Systems, the System1 Sterile Processing System and the V-PRO™ 1 Low Temperature Sterilization System, as well as a number of other steam, gas and chemical sterilizers.

STERIS also offers a complete line of sterility assurance products including barrier and packaging products, biological indicators and chemical indicators. In fact, just last month, STERIS was awarded a sole-source Amerinet Choice contract for a full range of their sterility assurance products. Amerinet Choice is the private-label and sourcing company of Amerinet, Inc, a leading national group purchasing organization. The family of products for steam, ethylene oxide and peracetic acid (SYSTEM 1®) processes that will now be offered to Amerinet's more than 29,000 members includes biological indicators, chemical indicators and integrators, daily air removal tests, sterilization tape and record-keeping labels and sheets. Most importantly, the family of STERIS products in this Amerinet Choice contract also includes the first Class 6 emulating indicators cleared for use in the United States for steam sterilization load monitoring.

An example of the new indicators is STERIS's Verify® SixCess™ cycle-specific Class 6 emulating indicators. A precise thermochromic ink visibly reacts to all the critical parameters of steam sterilization to demonstrate that the desired exposure to steam in a specific cycle has occurred within the pack, container, pouch or wrapped item that was sterilized. When used in every steam sterilization load, the indicators allow the immediate release of all loads and all items in the loads. Sterility assurance products that allow immediate release of loads can significantly reduce the turnaround time for reusable surgical instruments. Immediate results allow documentation to be completed and all items in the load to be made available. Since there is no need to quarantine loads, blind releases don't happen when these types of monitoring products are used. Furthermore, the reduction of quarantine time also reduces the need for flash sterilization of limited inventories or loaned instrument sets. Sets can be processed using standard reprocessing procedures without the worry of device availability delays.

Healthmark Industries Company, Inc. has been a provider of quality instrument care products for nearly 40 years. In addition to a complete line of surgical instrument care, cleaning and storage products, Healthmark also offers a number of sterility assurance products to ensure that instrument cleaners and sterilizers are performing at the highest levels.

One such product is the TOSI® device, which provides sterile processing professionals with a consistent, repeatable and reliable method for evaluating the cleaning effectiveness of automated instrument washers. This is possible because the test blood soil on the device is manufactured to exacting specifications each and every time. When coated on to the stainless steel plate, the TOSI is analogous to the dried blood residue found on dirty instruments. The device is a major enhancement to this "visual standard" because each TOSI is identical, providing an objective measure of cleaning effectiveness.

Healthmark also offers the ProFormance™ Washer Test Kits to help facilities comply with AORN Guidelines for Comprehensive Weekly Testing and the affordable and easy to use TempaChek™-DL device that is capable of independently capturing, logging and recording the complete temperature profile of an Automated Instrument Washer, including thermal disinfection.

There are a number of innovative products and systems available for the cleaning, disinfection and sterilization of surgical instrument, as well as an extensive array of devices to assure these systems are working properly. Nonetheless, a majority of the responsibility for ensuring that instrument cleaning equipment and sterilization processes are reaching their highest potential lies with the hospitals and healthcare facilities themselves. The time and money saving potential of even the most state of the art equipment can be rendered moot if the facility using them has not properly integrated their interdepartmental work flow.

For more information on this important topic, please take a look at Surgical Products' educational webcast, "Bridging the Gap Between the Operating Room and the Sterile Processing Department," now available on demand at www.surgicalproductsmag.com.
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