A Few Ideas To Help Reduce Surgical Infections In 2020

The primary responsibility of everyone involved in reusable medical device reprocessing is to minimize the risk of a surgical infection caused by a device that remains contaminated with organic debris after reprocessing. This responsibility begins with pre-cleaning the device at point of use and it continues through all of the reprocessing steps prior to its eventual use with a patient. The responsibility to minimize patient risk of contracting a surgical infection from a contaminated device is especially critical when it comes to reprocessing surgical instruments.

The Association of periOperative Registered Nurses (AORN) publication “Guidelines for Perioperative Practice” provides healthcare facilities with guidelines and directions for improving patient care and reducing patients’ risk of contracting a surgical infection. Along with improving patient outcomes, the publication also provides guidelines that are intended to help improve workplace safety for all OR personnel.

“These evidence-based guidelines are intended for use by perioperative professionals to promote safety and optimal outcomes for patients. The Guidelines are available for individuals or teams within facilities and multi-site health care systems. The best practices for evidence-based perioperative care should be your only practices.”1

A quick review of the Guidelines shows a significant number of new, evidence-based practices that reflect the latest research and input from healthcare professionals and healthcare facilities from around the country.

Far too many headlines and news reports over the past several years have high-lighted the patient harm caused by reusable medical devices that remain contaminated with organic debris after reprocessing. In an on-going effort to help combat this problem, AORN's Guidelines for Sterilization and Disinfection cover five key topics: Flexible Endoscopes, High-Level Disinfection, Instrument Cleaning, Packaging Systems, and Sterilization.

During the past year there has been a lot of increased emphasis and attention placed on pre-cleaning surgical instruments in the O.R. prior to transport to sterile reprocessing. This new, increased emphasis is coming from many sources and organizations, including the Joint Commission (TJC) who is now citing facilities for failure to pre-clean instruments at point of use.

 

Recommendation III in the AORN Guideline states that instruments should be cleaned and decontaminated as soon as possible after use. The goal of cleaning at the point of use is the removal of all gross bioburden. Then instruments are to remain moist (either from a water-soaked towel, enzymatic treatment, spray foam or other method to maintain humid conditions) to prevent them from drying.2

 

These new recommendations and guidelines for point of use instrument pre-cleaning will mean a process change in the O.R. at many facilities in order to comply with these new requirements. More importantly, the risk of an instrument contaminated with organic debris getting through the entire reprocessing cycle will be reduced as well.

 

The AORN Guidelines can be a great tool to increase communication and cooperation between CS/SPD staff and O.R. staff. Schedule a meeting with your counterpart in the O.R. and review the sections on High-Level Disinfection, Instrument Cleaning, Packaging Systems, and Sterilization. During the meeting be sure and point out to the O.R. member that the Guidelines state that instrument reprocessing begins with pre-cleaning at the point of use. Getting the OR staff to pre-clean all instruments in the OR prior to transport will significantly help to reduce the risk of a contaminated instrument being returned to the OR after reprocessing.

The AORN Guidelines contain a number of significant, evidence-based, major changes that will potentially impact you, your staff and your facility. A quick review of the more significant changes will help you and your staff to prepare for these new policies and practices in 2020:

  1. Cover the sterile field.
  2. Identify how traffic is limited in your OR.
  3. Assess your air handling system..3

Order a copy today of AORN’s Guidelines for Perioperative Practice to help your facility reduce surgical infections in 2020 (4). Your patients are counting on you!

 

1 AORN website: https://www.aorn.org/

2 AORN’s “Guideline for Cleaning and Care of Surgical Instruments” Section III(a)

3 Op. Cite.

4 AORN website  https://www.aorn.org/guidelines/purchase-guidelines