sterile processing
sterile processing
By David Taylor III , MSN , RN , CNOR
Instrument Maintenance : Inspected , Tested and Repaired
Having a welleducated staff that knows how to properly manage instruments and identify issues before they become bigger problems is key to a successful instrument maintenance program — and to healthcare organizations ’ broader quality , infection prevention and safety initiatives .”
With shrinking healthcare budgets and the ongoing quest for infection prevention and the delivery of safe , high-quality patient care , the need to effectively maintain ( and sustain ) a robust and proactive instrument maintenance and repair program has become even more critical . More specifically , it is imperative that all sterile processing ( SP ) professionals recognize the importance of proper device care and handling , cleaning , inspection and testing of all items they manage and process .
Having a well-educated staff that knows how to properly manage instruments and identify issues before they become bigger problems is key to a successful instrument maintenance program — and to healthcare organizations ’ broader quality , infection prevention and safety initiatives . The delicate nature of surgical instruments and devices and the high cost associated with preventable damage and subsequent repairs and replacement warrants focused training and attention by SP technicians as well as the surgeons , nurses and other staff members in procedural areas .
Aligning resources
Having adequate instrumentation inventories , time and other resources to meet procedural volume — and ensuring that devices are processed and managed according to instructions for use ( IFU ), standards , guidelines and internal policies and procedures — is critical ; however , in my consulting experience , I have seen many facilities fail to invest in adequate instrumentation to support their surgical programs , which results in device overuse and reduced life expectancy for instrumentation .
Every device being reprocessed should undergo thorough inspection before being packaged for reuse or storage . The importance of thoroughly inspecting each instrument cannot be overemphasized . Instruments are subjected to a great deal of abuse over their life cycle , and repeated use and rough handling can damage instruments over time , increasing the risk for device failure during the procedure and , potentially , device contamination that may cause patient infections .
The following steps should be performed routinely by SP technicians :
● Hinged instruments ( single or double ) should be checked for cleanliness and stiffness ( they should move smoothly and easily ). Ensure that jaws and teeth are in proper alignment .
● Box locks , serrations , and crevices should be inspected for proper function and cleanliness . Bioburden and other debris can significantly impact the proper function of the box lock function .
● Instruments with cutting edges , such as scissors , rongeurs , chisels , curettes , and the like , should be checked for sharpness . Cutting surfaces should be straight and aligned and absent of nicks , chips or dents .
● Ratcheted instruments should open and close easily . When closed , they should hold firmly .
● Instruments with pins or screws should be carefully inspected to ensure they are intact and functioning as intended .
● Plated instruments should be inspected for chips , worn spots or sharp edges . Defects in the plating can harbor debris and bioburden ( and rust over time ).
In-house or outsourced ?
There are two options when establishing an instrument maintenance and repair program . The first is to create an in-house program , employing a skilled instrument repair technician ( or technicians ) to work for the SPD / organization . This option may not be financially feasible for a small- or medium-sized facility ; however , it may be better suited to large hospitals and health systems .
The second option is to outsource the program . Many third-party companies provide instrument repair and maintenance programs ( and , of course , original equipment manufacturers also service their own equipment *). It is essential to investigate the quality and depth of the services provided and ensure that their technicians are skilled and well educated — and then take time to compare the various options and service providers . Remember that the least expensive option is not always best . Also , before choosing a maintenance and repair provider , it is prudent to understand the current state of existing instrumentation by completing a thorough assessment of all devices and equipment in inventory . This process will ideally include :
● Assessing current instrument inventory and comparing it to the number of specialties each instrument set supports . Do you have enough instruments ( loose or in sets ) to support your surgical program ?
● Asking how many times an instrument set has been reprocessed in a day to meet the needs of the operating room ( OR ). Does current inventory support the workload ? www . healthcarehygienemagazine . com • november 2023
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