"Automation plays a significant part in every CSSD, and as it continues to evolve it will allow staff to focus on added value actions including inspecting instruments or assembling sets," said Brodowski. "Conveyor belts are being used today to allow staff to manage peak times most effectively. Here, finished racks can continue the process even when all washer/disinfectors are in use, without delaying staff from completing their tasks."

According to Cole, there is a growing need for automation as more complex instruments come to market:

"Reprocessing these items manually is time-consuming. An automated way of reprocessing these new complex instruments is a benefit for the staff and their department."

Nies feels automation is very useful in the right situation. He has seen more medium to larger facilities transitioning to automation, most often with washers. He states:

"The workload in the decontamination side of the sterile processing department is not steady so an automated washer system, with a queue, allows personnel to pre-clean and load instruments on the wash rack without being slowed down by washers that are full and running."

Ensuring instruments are dried effectively is a significant challenge to the CS/SPD as instruments become more complex, feature hard to access components, and are comprised of various materials that cannot withstand high temperatures. We asked manufacturers to provide their advice on how to facilitate proper drying. Here are their responses:

"Drying is the big challenge," said Nies. "Just like those hard to dry plastic food storage containers in your home dishwasher, medical washers are now seeing more low heat conductive materials, such as plastics, that need to be washed and dried. We often see special longer dry time cycles set up in the washers and advise personnel to sort the instrument sets and try to load those with plastics together so only those loads need the longer cycle. That helps to reduce post washer hand drying, which is inefficient and time consuming, without slowing everything down."

"Process all metallic items together to get the maximum benefit from process temperatures - the hotter the goods, the easier they will dry," said Cain. "Use treated water such as RO or DI water for final rinsing, as this will reduce droplets or clinging water on loads. Utilize very hot water for the final rinse (between 185°F – 190°F) just prior to drying to promote flash drying. Also, make certain HEPA filters are clean and air flow is not obstructed. I also suggest utilizing wash racks that force drying air through the spray arms and injectors."

Cain notes how some washers/disinfectors now feature a drying sensor, which monitors humidity of the chamber air during the drying phase and controls drying time accordingly.

"Traditionally, drying is a preset time duration programmed into the cycle parameters. Depending on the load, the preset time will be too long for partial loads and too short for heavy loads," said Cain. "Drying by chamber/load humidity saves time and energy with partial loads and produces more consistent drying results across all loads."

Cole stresses the importance of ensuring instruments are thoroughly dried both inside and out:

"Many washers out in the market can dry the outside of the instruments, but Medisafe’s Niagara SI PCF has Soft Shot Air Purge to dry the inside of the instruments," said Cole.

According to Brodowski, highly efficient drying systems recycle 90 percent of the air used, which shortens drying phases to five-to-seven minutes with an exhaust of only 10 percent. These features reduce energy usage and impact on the facility’s ventilation system.

"Effective drying starts with a highly efficient drying system," said Brodowski. "Our Reliance Vision and 7053L Single Chamber washer/disinfector’s drying phases reach all instruments and optimize the evaporation of any remaining moisture. Correct loading of the washer/disinfector is also crucial. Double stacking or overloading of trays and the use of plastic inserts should be avoided whenever possible."