systems ( delivery and pick up ). Note : It only takes a few vendors to claim instruments and implants are missing from their trays to understand that the investment in such a dedicated space will pay big dividends .
Decontamination area
The decontamination area is used for unloading case carts , containers , etc . and cleaning , preparing and inspecting instruments . This area ’ s size should be based on the expected production requirements and range from small ( approximately 600 square feet ) to large ( over 900 square feet ). For example , SPDs that process fewer than 150 instrument trays daily may require a smaller footprint , while those that process 150 to 400 trays or more will need additional space . Keep in mind , surgical programs are expected to grow exponentially as the U . S . population ages , and there will be a growing need for more equipment to meet the demands and keep up with technological advancements . If an SPD is responsible for endoscope processing , additional square footage will likely be needed . Equipment needs ( including automated cart washers ) will help dictate the proper size of a space ; it is important to consider the manufacturer , type and quantity of the equipment ( currently in use and what may be needed in the future ). The decontamination area should include :
● A handwashing sink with emergency eyewash fixture
● Counter space or storage racks to prepare instruments and equipment for their first phases of cleaning
● At least one pass-through window large enough to accommodate all instrumentation and equipment
● A pass-through door for durable medical equipment
● Dedicated space if endoscope reprocessing will occur
Assembly area
SPD leaders should understand the various aspects the assembly area will accommodate . Like in decontamination areas , space needs will depend on the number of sets processed in a 24-hour period . Consider space needed for an instrument washer and pass-through window , an instrument unloading and preparation station , an instrument set assembly area , a workstation for inspection and quality assurance validation , a workstation for containerizing and wrapping sets , a dedicated space for telecommunication , computers , bar code readers / trackers and printers , and storage for supplies , instrument containers , wrappers , pouches , clean linen , etc .
Sterilization area
When considering space needs in this area it is important to know the type of equipment that will be processed , and which sterilization modalities will be used . Additionally , space should be allocated for biological monitoring and proper documentation . Again , space needs in this area will depend on the number of sets processed over 24 hours .
All-inclusive approach
Healthcare organizations must understand the SPD ’ s needs and workflow demands before determining renovation needs and next steps . When considering a renovation project , relocating the department , or building a new facility , healthcare leaders should first consider creating new-and-improved processes and workflows to help immediately resolve inefficiencies ( this should always be done before beginning a construction project ). When
Expanding the department ’ s capacity ( square footage ) and improving the infrastructure to support modifications in the SPD will improve efficiencies within the department ( and downstream ) and help improve processes in the OR and other procedural areas , thereby creating greater revenue streams .”
a renovation , expansion or new build is in order , a collaborative approach is vital and should include strong SP representation and other stakeholders ( e . g ., nurses , doctors , leadership , facilities and maintenance department , and construction personnel ).
Collectively , the team must determine whether the project can be completed without disrupting services . It will also be necessary to update preference cards ; determine instrumentation inventory for each surgeon and specialty ( based on current and projected volumes per specialty ); reassign , rebuild or decommission instrument sets from surgeons no longer working at the facility ; evaluate instrument sets with each surgeon and determine changes in their practice that could impact instrumentation and equipment needs ; standardize trays ( adding new instrumentation as needed , removing excess instrumentation to speed production , and meeting set weight limits ); evaluate containerization versus wrapping of instrument sets ; review vendor tray opportunities ( ensuring appropriate space for instrument arrival / check-in and pick-up / check-out and removing excessive vendor tray storage .
When determining equipment needs and proper layout , it is also vital to identify instrument workflow and equipment paths , standardize workstation location and layout , and determine supply and equipment needs for inspection and assembly .
Determining the SPD ’ s mission and fully understanding the customers they will serve — all while anticipating future space and resource needs — is also essential , as is a thorough evaluation of storage needs and options ( e . g ., vertical versus horizontal and automated versus manual ).
Facilities will also need to consider how the SPD will transport clean and dirty instruments ( e . g ., use of dedicated elevators or ensuring adequate staffing to facilitate transport to and from user areas ), how many FTEs are needed to perform effectively in the new space , and whether the new SPD will require automated processes and perhaps even robotic assistance .
In conclusion , many factors come into play when considering SPD renovations or new construction . A team approach with representation from SP professionals and other stakeholders is critical to ensure that the SPD ’ s current and future needs are understood and supported . When organizations take time to carefully examine current processes , equipment and spaces and future requirements , they will experience a far greater return on investment .
David Taylor III , MSN , RN , CNOR , is an independent hospital and ambulatory surgery center consultant and the principal of Resolute Advisory Group LLC , in San Antonio , Texas . He has served as an HSPA contributing author since 2019 .
www . healthcarehygienemagazine . com • april 2022
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