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Questions can be sent
to
jakridge@hpnonline.com
called in to Jeannie Akridge at HPN:(941) 927-9345 ext.202
or mailed to:
HPN CS Questions, 2477 Stickney Point Road, Suite 315B,
Sarasota, FL 34231
Names and hospital identification will be withheld upon
request. |
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Processing orthopedic instruments
Q
I have a question regarding the processing and cleaning of orthopedic
instruments through an automatic washer disinfector. We occasionally
find blood, bone fragments and other organic soil remaining on our
instruments after processing them. Should these items be processed
through our washer in the same manner as we do other instrument sets
or is there some special handling that we should follow?
A
In short, you should follow the detailed instructions provided by the
manufacturer of your instruments for proper care and handling which
will include cleaning instructions. Further, you want to also follow
the instructions provided by the manufacturer of your washer
disinfector. Many automated washers do have a special program setting
for processing orthopedic instruments or they allow you to set up a
special cycle for these instruments which allow you to adjust soak,
prewash and wash setting times to allow for extended exposures
accordingly. When a load solely contains implants and orthopedic
instruments with non moveable components the lubricating phase can be
eliminated from the cycle.
Orthopedic instrumentation due to their complex design
often presents a greater challenge to the cleaning process. Further,
orthopedic procedures are highly invasive and often quite bloody; bone
fragments, tissue and other organic matter often becomes lodged in or
between the intricate parts of the instrumentation. If the soil is
allowed to dry on these devices the cleaning process becomes even more
challenging. For that reason soiled instruments should be kept moist
and the cleaning process should begin as soon as possible following
the surgical procedure. It is advisable to either soak or moisten the
instruments with enzymatic foam or spray immediately following the
case breakdown for transport to CPD for reprocessing.
During sorting in the CPD decontamination area a
visible inspection will identify instrumentation that may require
special handling e.g. manual cleaning, processing through the ultra
sonic, etc. Many orthopedic sets consist of multiple layers of
instrument trays within the instrument case. It is imperative that
these cases not be run through the automated washer with the lids on.
Each tray and/or layer of instruments must be removed from the
instrument set case and positioned in the washer basket in a manner
that facilitates thorough exposure to the spray action of the washer.
Some of the molded plastic or metal trays may also inhibit adequate
exposure to the mechanical spray action and obstruct drainage and
removal of soil during automated washing. If this is the case then the
devices should be removed from the trays and positioned in mesh
baskets for cleaning. To be certain that your automated washers are
performing efficiently and effectively you should be conducting
routine QA testing of the cleaning process. AORN recommendations state
that such testing/monitoring be done at least weekly. Validated QA
testing devices and tools are readily available on the market.
Ray Taurasi is Eastern Regional Director of Clinical Sales and
Services for Healthmark Industries. His healthcare career spans over
three decades as an Administrator, Educator, Technologist and
Consultant. He is a member of AORN, AHA, SGNA, AAMI and a past
president of IAHCSMM and has served on and contributed to many
national committees with a myriad of professional organizations,
manufacturers, corporations and prestigious healthcare networks.
Taurasi has been a faculty member of numerous colleges teaching in the
divisions of business administration and health sciences. In addition
to this column he has authored several articles and has been a
featured speaker on the international scene. |
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