Contaminated flexible endoscopes: A hazard

According to Mark Duro (AORN; 2016) we can improve our medical device reprocessing through education and audits. In September 2015 the CDC (Centres for Disease Control) and the FDA in America issued a health advisory urging hospitals to assess their medical device decontamination processes. The focus point of this advisory was to ensure that all staff that are reprocessing medical devices have been adequately trained in reprocessing. According to the CDC and the FDA staff should be trained when they are first employed, when new devices are purchased, when manufactures instruction are changed (as is the case with duodenoscopes) and they should have a refresher course annually. This training should be hands-on as all staff need to physically demonstrate they are able to decontaminate particular devices. Although it is critical that staff have theoretical knowledge (for example knowledge gained from the CSSD Foundation Course sponsored by SafMed) it is equally as important that staff demonstrate physical competencies. Read more

Low Temperature Sterilizer: Do I really need one?

Have you ever heard of NOTES or TAMIS?

NOTES stands for natural orifice tansluminal endoscopic surgery and TAMIS stands for transanal minimally invasive surgery. Surgeon’s used to use flexible scopes to diagnose conditions and perform simple procedures like removing a foreign object, (a fish bone for example). Advances in technology and design of scopes have created a whole new approach to MIS (minimally invasive surgery).

We in CSSD need to be able to clean and sterilize the medical devices used to perform these types of surgery. Read more

Important factors to consider when positioning a patient

1. Is the patient a risk?

When doing a risk assessment with regards to positioning of a patient, the follow factors must considered:

  • How old the patient is
  • How long the surgery will take
  • What the overall condition of the patient is
  • Does the patient smoke
  • How will be patient need to be positioned in order to access the surgical site
  • What positioning devices will be required
  • Does the patient have any underlying conditions that would increase his/her risk, for example diabetes, obesity, malnutrition, vascular disorders
  • Has the patient had previous surgery, if so what surgery was done
  • Has the patient had a joint replacement
  • Is the patient pregnant

Read more

Why do we use BI’s (Biological Indicators?)

Various methods are used to monitor the efficacy of a sterilization process. This would include physical monitoring, chemical indicators (CI) and the use of biological indicators (BI).

In CSSD we should read the sterilization process print out in order to verify that the parameters of the sterilization cycle were met. Chemical indicators will verify that one or more conditions needed for sterilization (for example time, steam and temperature) have been achieved within a specific instrument set. Read more

Surgical Illumination what does the Surgeon need

It is critical that Surgeons have access to good lighting when performing surgical procedures. Most commonly Surgeons ask for adequate illumination of the surgical site (including deep cavities), minimal heating of the surgical site, helpful colour that renders tissue in a familiar way, convenient positioning of the light head and convenient control of the lighting systems features. Read more

Washer Disinfectors what is the next step

In 2006 I had the pleasure of touring a purpose built outsourced CSSD in Manchester, England. It was a fascinating tour, but the most amazing feature that stood out for me at the time, was the bank of automated instrument washers. I watched in amazement as the operator received the dirty sets, scanned the set’s barcode and loaded it into a pass through washer disinfector. Read more

Who has cleaner hands, doctors or nurses?

Research was undertaken to assess compliance to the implementation of the WHO’s (World Health Organisation) Hand Hygiene Programme.
The research was undertaken in 43 hospitals situated in Africa, Costa Rica, Italy, Pakistan and Saudi Arabia.

The study found that nurses were far more compliant with hand hygiene (71%) then doctors who were only 60% compliant.
The implementation of the hand hygiene programme improved overall hand hygiene compliance from 51% to 67%.

ALLEGRANZI, B., GAYET-AGERON, A., DAMANI, N., BENGALY, L., MCLAWS, M.-L., MORO, M.-L., MEMISH, Z., URROZ, O., RICHET, H. & STORR, J. 2013. Global implementation of WHO’s multimodal strategy for improvement of hand hygiene: a quasi-experimental study. The Lancet Infectious Diseases, 13, 843-851.