Jackson, MI (Vocus) October 26, 2010
The reprocessing of reusable medical instruments is an increasingly important task in the daily operation of medical facilities. As more and more instruments are designed to be reusable in order to cut costs, the risk of patients contracting healthcare acquired infections due to improperly cleaned tools increases.
In an effort to ensure that patients and staff are protected from HAIs, regulations require manufacturers to provide customers with detailed instructions describing how to correctly reprocess their reusable instruments. Manufacturers test different cleaning processes and develop a method that they believe should adequately clean the tool. These regulations have had an unfortunate influence on reprocessing practices in medical facilities. By concentrating on the process of instrument cleaning, the focus is taken away from the actual results of the cleaning. Because they are following the manufacturer provided instructions, facility staff assumes that they have adequately cleaned the instruments.
The main problem with this process tested method of cleaning is that the manufacturer instructions are often difficult to follow in practice. For example, the long, narrow passages of canulated and orthopedic tools are a common problem area. The manufacturer often suggests cleaning these areas with a long brush. In this situation the use of a brush that is not coarse enough, not flexible enough, or otherwise unsuitable can lead to unclean tools. Without knowing exactly what type of brush the manufacturer used when developing the process, it is impossible to adequately follow their instructions. Even if a suitable brush is used, not every tool will reach the same level of cleanliness due to human induced variations in the process.
Because of this human induced variation, it is impossible to fully follow the manufacturer guidelines as they were originally performed. The manufacturer may have gotten the tools clean during the development of their process, but there is no guarantee that facility staff will get them clean by attempting to follow their guidelines. While the differences in the process might be small, the influence on the result can be large. This can lead to unclean instruments. Combine this with the difficulty of determining the cleanliness of some hard to clean tools and there is an increased risk of patient infection due to contaminated instruments.
Another problem with process testing is that it provides the device manufacturers with the opportunity to easily avoid responsibility for infections caused by contaminated instruments. If hospitals determine that an infection outbreak was caused by unclean tools it is easy for the manufacturer to claim that the staff did not correctly follow the cleaning procedure, even though that procedure might be nearly impossible to actually follow. This puts healthcare facilities in a position where they are unable to hold manufacturers responsible in the event of an infection.
One way to avoid the problems associated with process tested cleaning methods is to automate the cleaning process. With this in mind, Midbrook Medical, the Jackson, MI, based manufacturer of medical decontamination systems develops item specific automated cleaning processes for all reusable devices. For example, Midbrook Medical’s Tempest automates the process necessary to ultrasonically clean the outside of canulated instruments while also power flushing the interior lumen. This provides a series of actions that will not vary from cycle to cycle, ensuring that the cleaning process is consistent and repeatable. The Tempest cleans the problem areas of instruments that cause difficulty when manually washed with brushes. This removal of the human variables in the cleaning process means that the process performed at the facility is the same as the procedure developed and tested by Midbrook and can be expected to produce consistent and repeatable results.
As reusable medical instruments become more and more prevalent in medical facilities, the use of automated washing processes such as those developed by Midbrook Medical is increasingly important to protect patients and staff from healthcare acquired infections. Following the process tested cleaning methods provided by manufacturers can put patients at risk due to the inherent problems with manually cleaning tools. Using an automated washer is an effective way to ensure consistently clean instruments and combat the threat of HAIs.