sterile processing
By Susan Klacik , BS , CRCST , CIS , CHL , ACE , FCS
AAMI Updates ANSI / AAMI ST79 ; ASGE and Others Revise Multisociety Guideline for Flexible Endoscope Reprocessing
Last month , the Association for the Advancement of Medical
Instrumentation ( AAMI ) released an updated version of standard ANSI / AAMI ST79 Comprehensive guide to steam sterilization and sterility assurance in healthcare facilities . The revised document includes the following four amendments :
Amendment 1 : Environmental Services / Fans / Food and Drink
A new section was added in section 3.2.1.1 Design considerations that specifically states that food and drink should not be permitted in any area where medical devices are processed , as they can contaminate prepared and sterilized items , and attract insects .
This new section also requires that the sterile processing department ( SPD ) or other areas that perform sterile processing functions should follow the same housekeeping procedures as those used to clean operating rooms and delivery rooms . It is recommended that floors and horizontal work surfaces be cleaned at least daily . Other surfaces in an SPD , such as walls , storage shelves and air intake and return ducts , should be cleaned on a regularly scheduled basis and more often , if needed . Stained ceiling tiles should be replaced . High-level environmental cleaning should also be routinely performed and include ceiling vents , tops of equipment and workstation lights . Low-level environmental cleaning should occur on surfaces such as base boards , sterilizer base and cart bottoms . Lighting fixtures or covers should be cleaned at least once every six months .
It is recommended that a cleaning schedule be implemented and followed . A cleaning checklist may be used to demonstrate appropriate cleaning is being performed . A sample of an environmental checklist has also been added to the revised standard .
Cleaning verification tools should be used to measure the adequacy of environmental cleaning on work surfaces . These tools include ultraviolet visible markers and ATP bioluminescence . The metrics from the cleaning effectiveness should be provided as feedback to personnel performing the cleaning task as providing this measurement can improve the quality of cleaning .
Additions were also made to section 3.3.5.5 Heating , ventilation , and air conditioning ( HVAC ) operating parameters . The ventilation recommendation was changed to direct the healthcare facility to identify which version of ANSI / ASHRAE / ASHE 170 will be used , based on when the HVAC system was initially installed or last upgraded . The healthcare facility should establish and implement systematic processes for monitoring
• This article has provided some highlights of the updated Multisociety guideline on reprocessing flexible GI endoscopes and accessories . The complete guideline is available on the ASGE website at
www . asge . org ( under the “ ASGE guidelines ” and the “ Newly Published ” tab ).
HVAC performance parameters and a mechanism for identifying and resolving variances within the rooms throughout the facility where SP functions occur .
This amendment includes additional recommendations regarding the ventilation systems , including those pertaining to the use of fans and the effects of doors and windows . The environment used to process and store medical devices has an impact on the safety of the devices processed ; for that reason , it is important to have control of bioburden and environmental contaminants . The use of down-draft-type air circulation systems limits contamination by carrying contaminants toward the floor and away from work surfaces . Fans are not permitted in any sterile processing area because they create highly turbulent airflow , which recirculates dust and microorganisms from the floor and work surfaces — this , interfering with designed airflow characteristics . Windows and doors that affect the ventilation and airflow should be kept closed to further limit the risk for environment contamination .
Amendment 2 : Inspection of Insulated Instruments Two new sections have been added to Section 8 Preparation and assembly of instruments .
Section 8.2 addresses the inspection process to emphasize the fact that damaged instruments or incomplete instrument sets / trays may cause a delay or cancellation of a surgical procedure , and / or increase risk of patient harm related to instrument malfunction . Several steps can be taken to prevent such incidents . It is recommended that every time a medical device is processed , it should be visually inspected for cleanliness and integrity . Enhanced inspection with magnification , borescopes or other inspection methods to verify cleanliness and integrity may be
www . healthcarehygienemagazine . com • february 2021
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