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Instruments can be designed to facilitate sterile processing .
• We are seeing things like ERCP scopes with disposable tips and robotic instrumentation with simpler easy to follow cleaning protocols – and surgical drills that can be processed through automated washers .
• Manufacturers are learning to build and design instrumentation with sterile processing in mind as well as the clinical end user perspective .
( such as the walls and ceilings , pneumatic tubes and carriers , and sterilizer service access areas ). While visual inspection provides a check of cleanliness , it is a subjective inspection . Quantitative measurements such as the use of ATP monitoring provides a measurement of the cleaning effectiveness , which can be used to document the cleaning thoroughness and provide feedback to personnel performing the cleaning . To assure terminal cleaning and scheduled cleaning procedures are performed , a checklist or log should be used for documentation . Checklists are a method to standardize cleaning procedures and assure all areas are cleaned ( and no areas are missed ). Maintaining a clean SP environment is so important that the AAMI working group 40 ( WG40 ) for hospital practices of steam sterilization has met and has added a new amendment to ANSI / AAMI ST79:2017 Comprehensive guide to steam sterilization and sterility assurance in healthccare facilities for environmental services / fans / food and drink . This new amendment provides recommendations for environmental cleaning of the SP areas . This amendment should soon be released .
MW : One of the big lessons we saw in the SP field ( outside of COVID-19 ) is that we can solve long-term problems with novel solutions . Instruments can be designed to facilitate sterile processing . We are seeing things like ERCP scopes with disposable tips and robotic instrumentation with simpler easy to follow cleaning protocols – and surgical drills that can be processed through automated washers . Manufacturers are learning to build and design instrumentation with sterile processing in mind as well as the clinical end user perspective . This partnership between manufacturing and sterile processing will lead to more effective cleaning and processing . Ultimately , this will result in fewer instrument malfunctions and eliminate the possibility of injuring a patient through bloodborne exposure . This partnership still needs to grow and develop further . As an industry , we have made headway with key vendor partners ; however , the larger scale of the medical device industry is still not fully integrated . There are many device manufacturers who continue to design and release instruments that are impossible or near impossible to clean and sterilize safely and effectively . Until this is solved , we will continue to have the systemic processing failures that have been plaguing our industry .
HHM What are the ongoing clinician knowledge / implementation gaps that persist and do you think they can be addressed in the coming year ?
KM : During the summer of 2020 , ANA conducted a series of listening sessions with nurses from a variety of healthcare settings to address this exact question . We learned nurses desire to better understand how to navigate implementing best practices with limited resources . There was a stated need for broader accountability for resource tracking and allocation , the need for “ just-in-time ” IP & C training for all staff , not just for nurses along with a desire to have a unit-based designated IP & C expert for “ just-in time ” education , along with the need for a “ living guide ” to IP & C best practices that evolves as the landscape changes . A team-based approach to IP & C was emphasized while the need to standardized education in all healthcare settings was acknowledged . This is one of the reasons ANA , in collaboration with American Academy of Pediatrics and the CDC , has entered the Project Firstline collaborative to provide IP & C education and training to all healthcare teams .
AMP : One of the challenges is the shifting expert recommendations . Every time you think you have it nailed down in terms of educating staff , you have to redo it . For example , CDC just came out with changes to quarantine recommendations . With the constant changing of expert opinion you feel like you are never done . Another thing is that it is difficult to learn something when you are afraid . That fear among healthcare personnel is a challenging environment in which to educate people .
LG : Lack of a coordinated plan and communication from the federal agencies to the healthcare community . Lack of a coordinated plan to educate public on vaccination acceptance and compliance .
DB : One of the true challenges / gaps clinicians have in regard to sterile processing is understanding what the SPD really does and the pinch points , obstacles , tools and training needed to do this complex job . We have come a long way and SPDs joining in the clinical conversations is a must , as is having IC and our clinical counterparts round and spend time in the department . That can really go a long way . That is one of my goals for the upcoming year -- to share knowledge and experiences . This also needs to work both ways .
PT : We have reached out to other small facilities like our own and helped with sharing knowledge that has been learned with supplies for infection control . I believe that reaching out and sharing information is what we need to do more .
SK : I believe the greatest gaps relate to proper inspection of medical devices . The newer technologies of borescopes and other cleaning verification methods can fill some of the quality gaps . The implementation of these technologies requires planning , training , and policies and procedures based on best practices and the instructions for use .
MW : The industry needs more technical experts and leaders . We need a voice . Nationally , SPDs continue to be staffed with surgical technicians and sterile processing technicians without certification . These team members are hard-working employees , but they need the technical training . SP used to be a field where on the job training was enough . Today ’ s