Process Monitoring for Terminal Sterilization
By Janet Moran, RN, MBA, CNOR
ASP Senior Clinical Education Consultant

Healthcare-associated infections (HAIs) occur in one out of every 20 hospitalized patients.¹ Healthcare-associated infections are devastating to patients and their families, and they also can be costly to healthcare facilities. In fact, the Centers for Disease Control and Prevention (CDC) estimates the direct costs of HAIs at from $28.4–33.8 billion.²

Surgical site infections (SSIs), which fall under the HAI umbrella, are considered “never events.”³ What this means to healthcare facilities is that the Centers for Medicare and Medicaid Services will no longer pay the extra cost of treating SSIs that occur after specific procedures.⁴ For these reasons, proper care of instrumentation at all points during the process is critical to minimize the risk of an SSI occurring.

Process monitoring—from care of instruments in the surgical suite to patient ready instruments—ensures that devices are safe for use on surgical patients. The points of monitoring include: surgical suite, transportation, decontamination (including manual versus automated cleaning), assembly and packaging, sterilization, and storage (patient ready).

Professional organizations, such as the Association of periOperative Registered Nurses (AORN), provide Standards and Recommended Practices that support proper handling and care of surgical instrumentation. The following is a review of the basics that every care provider within or supporting the operating room should adhere to:

1. Surgical suite: Care of instrumentation in the surgical suite includes using aseptic techniques to present the instrument to the surgical field, keeping the instrument clean during the procedure, checking the integrity of the instrument before and after use, and accounting for all instrumentation used.

   AORN Recommended Practice (RP): Care of Instruments IV: “Instruments should be kept free of gross soil during surgical procedures.”⁵ READ MORE

ASP is working with the leading Instrument Tracking System providers to develop an interface that will allow STERRAD^® NX^® and 100NX^® Systems to connect with a hospital's IT network.

Stay tuned for more information in the next issue of Frontiers.

STERRAD^® System Consumables Now Available Through Distributors

STERRAD^® System consumable products now are available through major U.S. distributors. This change, which is in response to requests from customers, is designed to improve access to supplies and help users better manage inventory levels. Consumable products affected include cassettes, chemical indicators, pouches and rolls, instrument trays, and containers. Click here for more information.

Worker Safety Though Automation
By Cathy Rocco, RN, MSN, CNOR
ASP Senior Clinical Education Consultant

The safety and health of sterile processing personnel, including staff members who handle flexible endoscopes, can be challenged by exposure to numerous chemicals and the physical demands of reprocessing scopes. As a result, technologies that automate the reprocessing of endoscopes can play a role in helping to reduce these safety risks and help protect healthcare workers.

Chemical Exposure
Reprocessing employees are routinely exposed to disinfectants and detergents, such as glutaraldehydes, ortho-phthalaldehydes, peractic acids, alcohols, and enzymatic solutions. In most instances, a given product is designed for a specific purpose and is to be used in a certain manner. Users should read labels carefully to ensure the correct product is selected for the intended use and applied according to the manufacturer's instructions for use. Occupational diseases among healthcare processing personnel have been associated with use of disinfectants, such as formaldehyde, glutaraldehyde, and chlorine.¹ As a result, precautions should be taken to minimize exposure, such as gloves and proper ventilation.¹ READ MORE

EVOTECH^® ECR More Cost Effective than Manual Cleaning Followed by AER Disinfection

A recent study published in BMC Gastroenterology found that the EVOTECH^® Endoscope Cleaner and Reprocessor (ECR) from ASP is more efficient and cost effective for reprocessing flexible endoscopes compared with manual cleaning followed by automatic endoscope reprocessor (AER) disinfection.¹

Conducted in a Canadian hospital, the study compared the cycle costs and annual utilization costs (labor and consumable supplies) involved in using each reprocessor (EVOTECH^® ECR and Medivators DSD-201*). READ MORE

Helpful Hint: Tips for Working with Ortho-phthalaldehyde High-Level Disinfectant
By Patti Fritz, RN, BS, CNOR, ASP Senior Clinical Education Consultant

Ortho-phthalaldehyde provides rapid, reliable high-level disinfection. As with all high-level disinfectants, proper procedures must be followed to ensure safety and efficacy. READ MORE

Interactive Technology Comparison Tool

A new online comparison tool is available to help instrument processing professionals evaluate automated endoscope reprocessing options. This tool provides information on multiple automated endoscope reprocessors for high-level disinfection. Select at least one model to view a side-by-side comparison of the EVOTECH^® ECR with other endoscope reprocessors.

There is a growing scientific consensus that the patient environment is a key source in the transmission of healthcare-associated infections (HAIs), as routine cleaning in healthcare facilities does not always eliminate pathogens.¹ As a result, reducing the pathogen load on environmental surfaces is an important step in eliminating HAIs, and many facilities are currently evaluating tools such as area decontamination systems to augment manual cleaning.

As part of its commitment to providing healthcare practitioners with information about best practices in infection prevention, ASP recently hosted a satellite symposium titled “Current Trends in Automated Area Decontamination: Effective Use of Guidelines, Evidence, and Newer Technologies—Are We There Yet?”

The symposium, held at the 2012 APIC Annual Conference in San Antonio, Texas, was attended by more than 150 participants and covered key topics in environmental decontamination, including current decontamination practices, the microbiology of the hospital and role for new technologies, and implementing new technologies in the healthcare setting. Highlights from the symposium follow below.

Current Decontamination Practices
Allan J. Morrison, MD, MSc, FACP, FIDSA, FSHEA, hospital epidemiologist at Inova Fairfax Hospital in Fairfax, Va., talked about environmental decontamination and its role in reducing resistant infections in hospitals. Morrison said that depopulating the patient environment is one of the “four pillars” of infection prevention. READ MORE

ASP University offers workshops with the opportunity to earn continuing education credits. Several courses have been presented, including 30-minute workshops at ASP's booth at the 2012 AORN and IAHCSMM conferences covering:

• Elevating the standard of care through operational excellence
• Updates about reprocessing semi-critical and critical devices.

A workshop at APIC addressed the role of the environment related to healthcare-associated infections.

Stay tuned for more information about other professional education workshops and initiatives offered as part of ASP University.

Staying current with helpful industry updates and resources is just a mouse-click away. Visit the Calendar of Events page on ASPjj.com often to access up-to-date information about conferences, Webinars, CE courses, and other educational opportunities on a wide variety of infection prevention topics.

Many healthcare facilities have questions about what information to follow to determine approved cleaning and sterilization instructions for medical devices. Click here to watch a Webisode offering recommendations based on the latest guidance and standards. View and share this quick video segment today!