The SPD of the future will integrate artificial intelligence and human interaction , working in concert with greater patient benefit .” and challenging to follow . Instrument sets may include several types of surgical tools requiring different instructions for processing . How can a technician easily navigate several IFUs within an instrument set ? Today there is technology available which integrates the different IFUs within an instrument tray and then follow a process with built-in timers ensuring the appropriate timing for each step is adhered . A computer monitor with visual indicators highlights each step of the process and alerts the technician the time to proceed to the next step .
• Accuracy – Today ’ s SPD can integrate manufacturing concepts of just-in-time delivery , integrating OR scheduling platforms into tracking systems enabling SPD to accurately prepare case carts and trays based on what is needed for the surgery . Also , artificial intelligence has been integrated into sterile processing with robotic assistance assembling tray sets , wrap packages , and vision technology capable of generating a list of instruments included in the set . Instrument tracking systems with technology to scan individual instruments utilizing bar codes enable the technician to build the instrument tray precisely . Technicians can prepare instrument sets even if they are not very familiar with the names of the instruments as the dot bar code contains the description , picture , and which set the instrument should be included . This technology can help an SPD achieve zero errors in the assembling process .
• Reliability – Advancements in reprocessing equipment such as automatic endoscope reprocessors , washers , and sterilizers containing technology that functions faster and low utility consumption have revolutionized sterile processing . This equipment can detect if the appropriate parameters have not been met , thus automatically aborting the cycle .
Radio Frequency Identification ( RFID ) tags are another technology widely used in supply chain and manufacturing processes and are now finding their way into the world of sterile processing . The integration of RFID tags and instrument tracking systems alerts technicians the location of trays by entering information into a keyboard or scanning a bar code . This technology is being integrated into vendor tray management systems to improve accountability and delivery of loaner tray sets . Other uses of RFID technology in SPD are systems that alert the technicians if the set is delivered to the OR has not gone through the sterilization process .
• Efficiency – The success of an operating room procedure depends on the speed of instrument reprocessing utilizing the available resources . Recruiting and retaining experienced sterile processing department technicians has become a challenge in most states . Integrating machines as resources in addition to technicians can increase the department ’ s throughput of instrument sets . The task associated with the trays ’ movement can easily be transferred to robotic assistance equipment while experienced technicians perform complex tasks . Robots are programmed to know when a washer-disinfector is available for loading in the decontamination area and in the preparation area to unload and distribute instruments to available workstations . Robots can also deliver materials and instrument sets to the OR and user locations , freeing up a technician to complete essential tasks .
There has been the introduction of other new robotic assistance technology that can assemble sets and even wrap packages . This technology is not substituting technicians but supplementing labor hours and expediting surgical trays ’ throughput . An experienced technician can concentrate on technical tasks like assembling trays and quality audits using their time more efficiently .
• Safety – The goal is to implement systems and processes to promote patient safety . A study by Wubben , et al . revealed that 46 percent of OR delays are attributed to surgical instrument availability . These delays can potentially cause patient injury when the instruments needed to perform the specific procedure are not available , are found to be defective , or there is bioburden present . Investment in tools , equipment , and system that can help prevent these incidents requires minimal thought . We cannot sterilize or do high-level disinfection if residual bioburden is present on surgical instruments . Inspection of lumen and surfaces cannot be done without the appropriate devices needed . A borescope is one of the latest tools to help the SPD team adhere to manufacturers ’ IFUs to visually inspect the lumen of instruments like flexible endoscopes . A borescope is a narrow scope-like device introduced inside a surgical instrument allowing a technician to inspect areas that aren ’ t visible to the naked eye . As technicians introduce the borescope through the channel , they can see potentially harmful residual soil or damage in the flexible scope is present . Residual soil testers are another tool to help detect soil on the surface and channels of the instruments . There are many types of systems available for this purpose utilizing swabs or strips to detect the presence of protein on devices by changing the strip ’ s color or displaying a pass / fail numerical value . These monitoring systems can be used as well to test water and process quality .
We have come a long way from sharpening needles on a diamond sharpening stone and manufacturing essential efficacy tests in SPD . Today , the sterile processing department has evolved from an area in the basement to a vital surgical team member . The bar has been raised , and an SPD technician ’ s expectations are much greater than before . Smooth surgical operations only happen when the SPD is functioning like a well-oiled machine requiring an investment in high-quality equipment , materials , and staffing . To ensure the rapid return of surgical instrument trays to the OR , we must find innovative solutions for the challenges we face . Implementing technology can help supplement some of the labor and performing non-critical tasks can increase efficiencies , reduce the potential for errors , standardize processes , and promote patient safety . The SPD of the future will integrate artificial intelligence and human interaction , working in concert with greater patient benefit .
Mary Olivera , MHA , CRCST , CHL , FCS , has actively participated in the monitoring , surveying and training interdepartmental staff in the proper cleaning , decontamination and sterilization practices and has been highly committed to the standardization of interdepartmental processes . Currently , she is the president and CEO for OSPECS Consulting , LLC , a company dedicated to facilitating process re-engineering in healthcare organizations .
Reference :
Wubben I , van Manen JG , Van den Akker BJ , Vaartjes SR , and van Harten WH . 2010 . Equipment-Related Incidents in the Operating Room : An Analysis of Occurrence , Underlying Causes , and Consequences for the Clinical Process . Quality and Safety in Health Care 19 ( 6 ): e64 – e64 .
www . healthcarehygienemagazine . com • april 2022
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