Delving Beneath the Tip of the Iceberg: Instrument Processing by Personnel Outside of Supply, Processing, and Distribution

Delving Beneath the Tip of the Iceberg: Instrument Processing by Personnel Outside of Supply, Processing, and Distribution Page E23 K. Hartless*, B. Gray, D. Kenebrew, P. Batiste, J. Landrith, N. Saage Close Close preview | Purchase PDF (50 K) | Related articles | Related reference work articles AbstractAbstract Abstract ISSUE: Disease transmission related to inadequate instrument processing has been documented; however, preventing infections in patients undergoing procedures with instruments processed in the ambulatory-care setting is a unique challenge. Innovative and collaborative methods between Infection Control (IC) and Supply, Processing, and Distribution (SPD) to identify patient procedures, educate non-SPD individuals to perform proper instrument processing, and improve compliance over 3 years are described. PROJECT: Spearheaded by IC and SPD in 2000, aggressive surveillance of instrument processing in ambulatory-care areas was initiated. A multidisciplinary team of six members, including nursing, surgical, and medical services, focused on procedures, instruments, processing techniques, staff training, and policies. Site visits covered a radius of 80 miles. RESULTS: Nonstandardized and inappropriate methods for instrument processing, reuse of disposables, and insufficient staff education were identified. Memoranda through the Chair, Infection Control Committee, requested corrective measures. Formal education was presented in addition to distributing the program on a compact disc. Based on experience and findings, the survey tool was revised and the number of surveyed clinics increased. LESSONS LEARNED: Initial surveys identified only the “tip of the iceberg” of instrument-processing problems. Surveying prompted further investigation into supply storage, appropriate utilization and mixture of disinfectants, and verification of training by documentation. Passive feedback cannot replace continuous proactive investigation into instrument-processing procedures and training requirements. IC and SPD collaboration is essential for standardization of processing procedures and training. Unequivocal definitions, measurable and objective tools, and surveyor training facilitate the survey process and evaluation of compliance.