Sterilization and reprocessing remains a topic of intense discussion at many ASC's. This is for good reason. Patient safety starts and ends with properly reprocessed, maintained and sterilized equipment. Surveyors are consistently looking for lapses which can lead to unfavorable citations.

The problem? Many facilities have staff reprocessing equipment without the proper training. It's not the staff's fault. Most have been placed into the reprocessing role with the understanding they will learn as they go. But the question remains, how will staff learn as they go without proper training? The old adage of "we don't know what we don't know" applies.

There are so many advantages to training. Not only will it enhance reprocessing and sterilization activities, but it will enhance staff understanding of principles. Staff will be able to recognize discrepancies and subtle signs of instrument deterioration. They can apply knowledge to assess effective decontamination processes during the inspection phase.

Those in the reprocessing department are no longer there to wrap instrument trays like Christmas presents. Their role is crucial to positive patient outcomes. They deserve the proper training and recognition to achieve expected task performance. Infection preventionist and leadership have a responsibility to take proactive roles to contribute to the educational needs.

Take the test. If you discover even one question in which the answer escapes your knowledge base, you may want to participate in the upcoming "WISH: Wash, IUSS, Sterilize and High Level Disinfection" webinar. WEBINAR LINK. As a healthcare provider, you ARE responsible for meeting established guidelines.

1)  How is a piece of aluminum foil used in the decontamination room?

2)  What does a purple-black discoloration on an instrument mean?

3)  Why must a peel pack seal be sealed 50% on the paper and 50% on the plastic?

4)  What is the significance of a sharpie marker?

5)  Inspection after cleaning is a vital step in the reprocessing protocol. What should staff be looking for?

6) This process is not intended to replace insufficient instrumentation

7)  Rigid containers must be validated for this process before use. What is the process?

8)  Some of these chemicals require periodic monitoring for employee safety.

Guess what time of year it is? It is influenza season. That is right, from October 1, 2016-March 31, 2017 facilities should be tracking influenza vaccination for all staff, physicians, licensed independent practitioners, students, and volunteers. This requirement is for any of the disciplines that are in your facility for 1 day. Reporting to CMS will be due by May 2017.

Why all of the hubba-baloo about influenza vaccinations? Influenza virus circulates throughout the United States usually late fall to early spring. Most that become infected will recover without incident. However, significant illness and even death is common in older adults, young children, pregnant women, and those with chronic medical conditions.

There are two (2) types of influenza virus, A and B which cause human disease. The influenza A virus can cause a pandemic more readily than influenza B. However, both have the capacity to cause pandemic disease. Although the exact timing of onset, peak and end of influenza season varies, seasonal influenza is typically during the late fall to early spring.

Each year, I hear someone mention they have had the flu. But come to find out, they are confused as to the symptoms of influenza. Influenza is a contagious respiratory illness. Therefore, you can understand how the elderly and very young children with compromised respiratory systems can quickly deteriorate and end up hospitalized or even in death. Key symptoms of influenza are:

True influenza is spread person to person. It can travel up to six (6) feet away through droplets as people with flu cough, sneeze, and even talk. Sometimes, the influenza virus can transferred from the environment to a host person when they touch their own mouth or nose.

What can we, as healthcare providers do to protect ourselves, our families and our patients?
1) Avoid sick people and if you are sick, STAY HOME!
2) Wash your hands often preferably with soap and water, but when not available alcohol based hand rub will suffice.
3) Do not share linens, eating utensils, and dishes with those that are sick without thoroughly washing first.
4) Frequently touched surfaces in the environment should be cleaned and disinfected at home, work, and school, especially if someone is sick. Finally,
5) get vaccinated!

As I mentioned, the flu is contagious. Therefore, it is concerning that a healthy adult can infect another person beginning one (1) day before they develop symptoms and up to 5-7 days after becoming sick. Children can pass the virus for 7 days. This means you can pass the flu virus to someone before you know you are sick.

For the 2016-2017 season, the CDC is recommending the use of the inactivated influenza vaccine or the recombinant influenza vaccine. The nasal spray flu vaccine should not be used. The vaccine is recommended for everyone 6 months and older. Once vaccinated, it will take approximately two (2) weeks for the protection to set in.

Are you interested in more information? Check out the CDC here: https://www.cdc.gov/flu/index.htm

Endoscopy centers across the United States have been questioning a practice which has been ongoing for numerous years. That is the use of simethicone administered via the endoscope lumen. A recent evidence-based article published in the AJIC journal, November 2016, finds residual simethicone in the lumens of an endoscope after reprocessing.

 

As an infection preventionist, I would recommend facilities cease the use of simethicone. Any residual product that is left in a lumen after reprocessing can lead to biofilm and increased microorganisms. These biofilms and micro-organisms can potentially be readily transferred to the next patient. As you know, cross-contamination is always high on the list of prevention activities.

Want to read the article? Check it out here: http://www.ajicjournal.org/article/S0196-6553(16)30581-8/abstract