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Hi Kerrin,
Air guns post-washer are found in most facilities in SA. Even where new washers are installed and the product is more reliably dried, many facilities still operate with a policy of blowing out lumens onto a low-linting cloth within a covered enclosure directly adjacent the washer unload.
It has been protocol at the CSSDs I have managed to blow out lumens and items with complex crevices inside an enclosure such as that depicted in the other post. For items where one can’t look down a lumen, this provides extra certainty that water (and, as is occasionally discovered) contaminants are not present.
Regards,
Andrew Ellis
Sterilising and Reusable Medical Device Reprocessing State Coordinator (Part Time: Monday/Friday)
Infection Control Service | Communicable Disease Control Branch
Health Regulation & Protection
Department for Health and Wellbeing | Government of South Australia
Level 3 | Citi Centre | 11 Hindmarsh Square | Adelaide SA 5000
HCW infection prevention: http://www.sahealth.sa.gov.au/infectionprevention
General public: http://www.sahealth.sa.gov.au/hospitalinfectionsThis email may contain confidential information, which also may be legally privileged. Only the intended recipient(s) may access, use, distribute or copy this email. If this email is received in error, please inform the sender by return email and delete the original. If there are doubts about the validity of this message, please contact the sender by telephone. It is the recipient’s responsibility to check the email and any attached files for viruses.
Good morning,
I don’t understand how they are using the air gun post washer/disinfector. I have never seen an air gun in the packing area. Our washers do not totally dry some cannulated instruments however they are placed in the dryer in an upright position for 15 mins then retested to see if they are dry.
We have decided that for any cases with confirmed Covid-19 the instrument trays will go through the washer/disinfector for thermal disinfection, prior to any other cleaning. The cycle will be manually aborted at the drying stage to enable them to be taken back out in the receive area. Then any brushing, flushing, ultrasonic etc as per manufacturers instructions will be carried out prior to them being put back through an entire cycle.Regards Kerrin
Kerrin Maher RN BN
Nurse Unit Manager | Central Sterilising Department
QEll Jubilee Hospital | Metro South Health
Kessels Road QLD 4108
t. 07 31826151
e. kerrin.maher@health.qld.gov.auHI there
I was asked by CSSD this morning regarding the use of our air dryer gun on cannulated instruments. Staff are still using this to dry cannulated instruments as the new washers drying cycle does not completely dry these instruments.
I’m just wondering whether there is any advice on the use of this with covid19. They stated they had read one paper that did mention this but now find it.
Any advice would be appreciated.
Cate Coffey
Clinical Nurse ManagerCentral Australia Health Service
Department of Health
Northern Territory GovernmentInfection Prevention and Control Unit
Alice Springs Hospital
PO Box 2234, Alice Springs, NT 0871t. 08 8951 7737
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Hi Michelle,
Apologies if it sounds obvious, but prior to procurement, do check any proposed carts/trolleys for design elements which may be prone to water retention. It’s also good to consider the thermal load incurred by the design and material. This applies especially to bespoke designs and modifications, which should be accompanied by a full engineering risk assessment before being altered further.
I have had some experiences with a bespoke case cart design an subsequent modifications which retained rinse water in an internal structure and therefore risked re-contaminating sterile packs during transport. This caused rework and expensive interim controls until it was resolved. Also the very heavy, closed design means that washer cycle time and energy are increased in order to reach the required surface temperatures.
Regards,
Andrew Ellis
Senior Project Officer, CSSD
Central Adelaide Local Health Network
L5, Royal Adelaide HospitalWe are here to provide a quality Sterile Supply service that is patient-focused, reliable and personally accountable.
Hi All, just hoping for a little advice on the plans for our new CSSD. Of course we do not have enough space for a clear dirty to clean flow round trip so we are trying to prioritise so we as compliant with AS4187. One member of our team does not like the plan of the trolley washer in the decon zone going in and out in the same zone before going back down the corridor to the packing zone (not ideal!) as the wheels will be contaminated. The other option is to have a flow through cart washer that flows through from decon to the packing zone but this poses the risk of excess water as the carts are wheeled past the packing benches. We have tried all possible different spaces for the cart washer but we are really limited with the design! Any advice would be greatly appreciated.
Thank you
Michelle Kennedy
CNC | Infection Prevention Service
Maitland/Kurri Kurri Hospitals
550-560 High Street
Maitland NSW 2320
Tel 02 4939 2467 or 0437919767 |
michelle.kennedy@health.nsw.gov.au[cid:image001.png@01D3B0A1.DB49DAB0]
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Hi Louise,
I am involved with two hospitals which also use low temperature sterilisation in CSSD for these probes. These can be packed by any CSSD staff member there. One site has electronic tracking and there are pictures and instructions which come up at packing. The other site has a manual with photos. Both use a long, thin case suitable for low temperature sterilisation.
A sterile cover is not a suitable solution for reprocessing of the probe itself. Note AS/NZS4187 requires that “Cleaning, disinfection or sterilization, as appropriate, of RMDs shall be performed between uses even if a single use sheath/sleeve/protective barrier is used”.
Like you, we change the battery at each instance of packing on the request of the theatres, as the probes are motion activated and are able to be drained through general vibration, handling or the trip down to theatres on the robot. The problem was first noticed when the probes were stored on a compactus which rocked back and forth all day as people stocked the shelves, completely depleting the battery by the time it was due to be used.
Many containers for low temperature sterilisation come with silicone pads with a cut-out or slit into which you can rest a rigid scope, probe or other delicate item. As longs as the pack is handled gently, not tipped or dropped, there should be no internal movement with these in place. I would suggest them over a piece of finger matting in the base of the container. We don’t generally get many repairs of these probes except from intraoperative damage or faults.
Regards,
Andrew Ellis
Sterilising and Reusable Medical Device Reprocessing State Coordinator (Part Time: Monday/Friday)
Infection Control Service | Communicable Disease Control Branch
Health Regulation & Protection
Department for Health and Wellbeing | Government of South Australia
Level 3 | Citi Centre | 11 Hindmarsh Square | Adelaide SA 5000
HCW infection prevention: http://www.sahealth.sa.gov.au/infectionprevention
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Dear all,
I would like to hear how other hospitals are reprocessing the probe used for sentinel node biopsies.
We have been reprocessing ours in Low Temperature Plasma steriliser after we had our probe upgraded. We’ve been placing the probe in a long thin tray and silicon fingered mat underneath it. It just fits in this arrangement and can not roll around too much. We replace the battery after every use to ensure there is enough battery life still in the probe when its used next. We then place the tray into a clear pouch for the sterilising packaging so we can see that the battery still works. Since we’ve been sterilising it in this way we have had many problems and the probe has needed to be repaired 3 times this year. (Previously it had been repaired once a year).
I appreciate that as the manufacturer recommends it can be sterilised in Low Temperature Plasma sterilisers, we have to sterilise it in this way. Unfortunately, our surgeons do not see it that way and I blamed everytime the probe goes off for repair!
Is anyone not sterilising the probe and just placing it in a sterile plastic cover instead?
I am wondering what methods or systems other hospitals are using with their probes. Do you have a select number of staff that reprocess the probe? What are you using to hold and package the probe?
I look forward to hearing from you.Regards
Louise Grant PhD Cand, MCl Sc(Periop)
Project Consultant Reprocessing Compliance
Top End Health Service | Northern Territory Government
Room 221, Building 4, Royal Darwin Hospital,
Rocklands Drive, Tiwi NT 0810 | PO Box 41326 Casuarina NT 0811
t 08 8944 8005 | m 0404 491 183 | e Louise.Grant@nt.gov.au | http://www.health.nt.gov.auTEHS Vision: Building Better Care | Better Health | Better Communities Together
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Afternoon Joe,
When I first came on to manage a CSSD in SA government hospital around 2010, I made similar enquiries to our State Records department. This was in part due to a towering pile of physical records in the sub-sub-basement of the building, going back many years and of dubious completion. The requirement in AS4187:2003 at the time was that sterilisation records should be “controlled and retrievable” and I had come upon a situation which was neither.
The General Disposal Schedule for government health records made no reference to sterilisation and reprocessing, so I worked with a couple of officers in State Records to add something into the next version. AS4187 had already specified the list of documents which shall be kept in the running of a reprocessing facility, so we decided that the entry should read “…as required by Standards” or similar. That way, regulatory changes to the required documentation would just carry over.
As for the retention period, the advice of State Records was that of a 15 year period.
Section 3.8.2 of the GDS28 was the final product.
We then had a wonderful time cataloguing, re-boxing and sending all of the records off for storage. Luckily the hospital where I am involved now has a fully electronic tracking system, so the volume of physical records is not only greatly reduced but we can make more of them electronic themselves.
Regards,
Andrew Ellis
Sterilising and Reusable Medical Device Reprocessing State Coordinator (Part Time: Monday/Friday)
Infection Control Service | Communicable Disease Control Branch
Health Regulation & Protection
Department for Health and Wellbeing | Government of South Australia
Level 3 | Citi Centre | 11 Hindmarsh Square | Adelaide SA 5000
HCW infection prevention: http://www.sahealth.sa.gov.au/infectionprevention
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Good morning everyone
I have discussed the retention of records in sterilising departments with several people and I get different answers!
I have checked NSW Records and their retention rules but they are not specific for sterilisation departments. They make blanket statements eg Quality Assurance (7 years), Accreditation (10years), Significant Investigations (State Archive).
Does anyone have any more definitive information? Will it be different in each State/Territory?
Thank you
JoeINFECTION CONTROL REVIEW PTY LTD
Joe-Anne Bendall Consulting
ABN 98630512284Joe.bendall@bigpond.com
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Hi Michelle,
My answer to the question posed would be simply that they simply are not “perfectly good sinks” as described to you, in that they do not meet the ergonomic requirements of the task. Corporate services would expect this of their own workstations and furniture. RMD cleaning workstations facilitate specific tasks critical to effective instrument reprocessing, and the inability to perform it at a safe and comfortable height with easy view of the task, may lead to staff taking less time to clean and check an instrument, unwillingness to work at the manual cleaning station leading to instruments being left for a longer time and therefore impede thorough decontamination.
Both of the CSSDs I have managed in my network have at one stage had only fixed sinks. We used “sink raisers” to alleviate some of the risk in each case, but this is a poor risk treatment. The Royal Adelaide was lucky enough to move entirely and be fitted out with adjustable height workstations, and The Queen Elizabeth will be redeveloping soon with a stipulation of the same.
At TQEH, we came to an interim measure by obtaining funding for one double-bowl, adjustable height sink station with suitable fixtures. This was then dedicated to the stream of RMDs which are designated manual-only and for leak testing scopes, both of which are the known activities which most warrant ergonomic protection.
Regards,
Andrew Ellis
Senior Project Officer, CSSD
Central Adelaide Local Health Network
L5, Royal Adelaide HospitalWe are here to provide a quality Sterile Supply service that is patient-focused, reliable and personally accountable.
Good Morning,
Can anyone please help clarify the following question regarding the sink workstations.
In our facility, the decontamination sink is fixed system that is used by staff of varying height i.e. 5 feet to 6 foot 7. The staff who currently use the sink have issues with pain every day due to the sink. Our current fixed sink also only have one bowl to wash and rinse equipment.
The Perioperative NUM and myself have been trying to have the sink workstation changed to an ergonomically designed double bowl sink which is height adjustable, for the past 7months. We have taken the AS/NZS 4187:2014 standards to both Infection Control Co-coordinator and Corporate Services Director who believe they don’t have to replace the current fixed sink with an ergonomically designed double bowl sink that is height adjustable.
Have I read and interpreted the AS/NZS wrong?
Statement posed to me this am “Why would people ripe out perfectly good sinks; sure other hospital’s wouldn’t be replacing their sink”.Cheers
Michelle Punton | Infection Control CNC
Infection Control
Portland District Health
Bentinck Street, Portland VIC 3305[PDH logo with tagline 2016_EMAIL]
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