Special Edition on Sterile Processing Imperatives Special Edition- Sterile Processing Imperatives | Page 24

Phase Minimum
Recirculation
Time Water Tempurature Detergent Type and Concentration (If
applicable)
Pre-Wash 15 Seconds Cold Drinking Water 1°C - 16°C
(33°F - 60°F) N/A
Enzyme Wash 1 minute Hot Drinking Water 43°C - 82°C
(110°F - 179°F) Wash 2 minutes Hot Drinking Water 43°C - 82°C
(110°F - 179°F) Rinse 15 seconds Pure Rinse 10 seconds Drying N/A
Hot Drinking Water 43°C - 82°C
(110°F - 179°F)
Treated Water (Hot) 43°C - 82°C
(110°F - 179°F)
N/A
• Detergent: pHneutral/enzymatic
• Concentration: Per the detergent
manufacturer’s recommendations
• Detergent: pH-neutral cleanser
• Concentration: Per the detergent
manufacturer’s recommendations
N/A
N/A
N/A
Expert Casey Czarnowski says that two of the biggest barriers to IFU adherence are format and size. There is no standard format to IFUs; many have too much
information and some have too little. A common example of this is the washer/disinfector cycle grid. While washer/disinfector cycle grids have become common,
end users often have difficulty finding it in a document filled with legal language, warnings and caution statements.
in it, which, as sterilization processes are run and the soil
turns into cement, will block the operation of the instrument,
leading to expensive repair or replacement.
HHM What are the biggest barriers to IFU adherence
and why?
CC: Two of the biggest barriers to IFU adherence are
format and size. There is no standard format to IFUs. Many
have too much information and some have too little. A
common example of this is the washer/disinfector cycle grid.
While washer/disinfector cycle grids have become common,
end users often have difficulty finding it in a document filled
with legal language, warnings and caution statements.
A standardized IFU will have just the information that
technicians require to do their job properly and safely. IFUs
are sometimes printed on onion paper, in a font so small
that magnification is required to find relevant information,
among the numerous languages included in the document.
The IFU must be easily readable to the technician in the
fast-paced world of sterile processing.
MO: Every sterile processing professional is trained to
follow the determined steps in order to render a medical
device decontaminated, disinfected and/or sterilized. We
are groomed from the moment we begin to learn the
cleaning principles that shortcuts and variance in processes
can have major consequences and put patients at risk.
But why then we find that in every hospital adherence
to IFU is a major challenge. There are at least four major
barriers to IFU adherence: competency, equipment, time
and leadership support.
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Competency: Some IFUs are very complex and the
multiple steps makes them difficult to understand
and follow. During the past few years, we have had
many new technicians entering the field who still
require continuous coaching in order to perform the
tasks. The complexity of the IFU’s and lack of training
negatively affects the ability for these technicians to
perform the tasks according to the IFU.
Equipment: It is impressive when an IFU lists the
type of equipment, the cycle, the timing or even
the brush size the technician must use in order to
process the medical device. Sadly, many SPD’s do
not have upgraded equipment that can help them
determine if their equipment runs at the specific
parameters for example; if the ultrasonic is running
at 45-50 kHz or if the washer disinfector is set for
the amount of time on each phase listed on the IFU.
Additionally, the SPD may not have the equipment
that might be listed on the IFU to be used to clean
or sterilize the device.
Time: In a fast-paced environment like sterile
processing time is very critical. The rule of thumb
is to always follow the manufacturer’s instructions
for use and to ensure there is enough time between
cases to do so. This is not always the case resulting
in non-adherence to IFUs and skipping steps in
the process. 
Leadership support: It is important for the govern-
ing body of the organization to understand the steps
in decontamination, disinfection and sterilization
process and the impact failure to adherence to the
Sterile Processing Imperatives 2020 • www.healthcarehygienemagazine.com