Special Edition on Sterile Processing Imperatives Special Edition- Sterile Processing Imperatives | Page 20

I believe it’s imperative to have infection
preventionists, as well as sterile processing
and perioperative managers and directors
spend a day in each other’s shoes.”
properly trained and certified. It’s the same in the sterile
processing department; certified technicians understand
that a single-use instrument or cleaning tool, as dictated
in the instructions for use, can only be used once. They
understand that they need to always wash their hands
after they remove their gloves. They understand these
protocols because they have been professionally trained
and understand the evidence.

HHM What can be done to further break down
barriers to implementation science in the sterile
processing department?

CO: I believe it’s imperative to have infection preven-
tionists, as well as sterile processing and perioperative
managers and directors spend a day in each other’s
shoes. We know people are very busy, but it’s critical to
have an infection preventionist spend time in the sterile
processing department to observe several scopes being
processed to see how difficult and time-consuming it
is. They would understand how challenging it can be to
follow the IFUs to the letter.  I also think that if sterile
processing technicians would watch procedures in the
operating room, it wouldn’t take long for them to realize
how complex surgical services is. They could also imagine
the patient on the table as being their loved one, and
would they want a scope or an instrument used on them if
it weren’t decontaminated, cleaned, disinfected, sterilized
and packaged correctly? Technicians must understand
that a scope could be in the operating room for three
or four hours, and in that time, is it being reused, is it
being wiped down, is it getting pre-cleaned, and is it
getting handled roughly? That’s why you are inspecting
it, because you don’t know what happened behind those
closed doors in the operating room the last time it was
used. So, if they can observe for themselves, they will
understand why it matters, and I think we could take
a giant leap forward in terms of interdepartmental
collaboration and resource allocation. I think the hospital
administrator should spend a day in the surgical services
and sterile processing departments as well. It would
be advantageous to all if there was some shadowing
being conducted. 

Reference:
Geerligs L, Rankin NM, Shepherd HL and Butow P. Hospital-based
interventions: a systematic review of staff-reported barriers and facilitators
to implementation processes. Implementation Science. Vol. 13, No. 36.
Feb. 23, 2018.
20
In COVID-19 Patients,
Contaminated Reusable
Bronchoscopes Could Cause
Secondary Infections and
Higher Mortality Rates
At
a time when the COVID-19 pandemic is compli-
cating care for critically ill patients, researchers
are now calling attention to secondary infections caused
by contaminated reusable bronchoscopes. As Ofstead and
Hopkins, et al. (2020) explain, “During the novel coronavirus
disease (COVID-19) pandemic, critically ill patients may
require therapeutic bronchoscopy or sample collection
via bronchoalveolar lavage (BAL), which involves using a
bronchoscope to flush lungs with saline solution. Results
of BAL assays are used to make clinical decisions that may
impact outcomes. Clinicians have reported that COVID-19
patients had bacterial and fungal pulmonary coinfections
with potential pathogens including Escherichia, Salmonella,
Pseudomonas, and Stenotrophomonas.”
Two years ago, researchers in Wuhan City, China identified
Stenotrophomonas maltophilia in 55.55 percent of BAL
samples. As the researchers explain, the source was the
channel of an improperly reprocessed bronchoscope, and
the pseudo-outbreak involved 25 asymptomatic patients
undergoing treatment for tuberculosis and other infections.
Reprocessing and hand hygiene deficiencies were identified.
In the U.S., epidemiologist Cori Ofstead, MSPH, and her
team of researchers have identified numerous nosocomial
outbreaks and pseudo-outbreaks which have been linked to
inadequately reprocessed bronchoscopes. In their prospective
studies which evaluated effectiveness of bronchoscope
reprocessing in five U.S. hospitals in the United States, they
detected microbial growth on 23 (65.7 percent) of 35 bron-
choscopes. They report, “Ten (28.6 percent) bronchoscopes
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