Sterilization and Decontamination
Case study 1: Decontamination Principles
Decontamination entails a blend of processes which includes cleaning, enhanced cleaning, and disinfection that are used to ensure that re-usable medical instruments are safe for re-use (Panta et al., 2019). With respect to the case study, it is evident that an issue of lack of proper decontamination has occurred. The cause of the error might include the lack of clear management control measures, in-experienced technicians, and the absence of guidelines to follow for the decontamination. Decontamination is a public health problem since when it is not effectively done it increases the risks of Hospital-acquired infections (HAI) (Panta et al., 2019). In this context, enhanced cleaning was omitted resulting in dirty surgical instruments, which poses a major health threat. Cleaning during the decontamination process can either be done manually or using automated machines. The efficiency of the cleaning process with regard to minimizing microbial contaminations usually depends on various factors such as the amount of dirt present and cleaning thoroughness (Forrester et al., 2018). Enhanced cleaning has proven to be successful in increasing the safety of medical instruments while also minimizing infections.
The sterile processing department can resolve the issue by setting new measures and management control for cleaning, sterilizing, and storing medical devices such as surgical instruments to ensure patient safety (Forrester et al., 2018). The department should not only be responsible for ensuring that the instruments are properly cleaned, processed, and stored but also creating awareness and familiarity among technicians. The best practice in the decontamination process should incorporate the equipment cleaning phase, enhanced cleaning, disinfection as the use of specialized automated machines (Panta et al., 2019). The four-way technique is the most successful in cleaning and decontaminating medical equipment hence protecting patients as well as healthcare professionals from infections spread. Setting clear guidelines and training technicians on proper decontamination can help in ensuring that clean medical instruments are delivered to the surgical suite.
Case Study 2: Sterilization Methods
Sterilized loads are normally considered as a wet load in the case that moisture comprising of droplets, dampness, or water puddles is present on the package even after the cooling period (Basu, 2017). Moisture on sterilized loads is caused by non-condensable gases (NCG) including nitrogen, oxygen, and carbon dioxide as they create wet packs (Basu, 2017). The issue might result from having an extensive duration between the cycles of sterilization and cooling or a defective vacuum pump which leads to air pockets building in the sterilizer compartment (Mohapatra, 2017). Also, it is worth noting that the presence of ineffective steam traps affects the ability to capture NCGs moving within the steam pipe.
Wet packs on sterilized loads can be prevented by the application of several methods such as the use of good steam quality, period maintenance and assessment of the autoclaves, avoid overloading the sterilizer, permitting substantial after sterilization period for the devices to cool down within room temperature, using high-quality wrapping supplies, proper temperature maintenance as well as humidity of the storage setting (Mohapatra, 2017). In this case, the problem can best be eliminated by ensuring that the equipment is of the highest quality equipment for sterilization to avoid steam from building up.
The wet load issue tends to result creates inefficiency issues for the sterile department while it threatens the safety of patients and healthcare staff in the operating room (Basu, 2017). The ability of the surgical team to provide quality and safe services to the patients is adversely affected, which intensifies the risks for spreading infections (Mohapatra, 2017). In ensuring quality control, Kristen should identify the loads and return them to be processed further by documenting them as unsterile devices.
References
Basu, D. (2017). Reason behind wet pack after steam sterilization and its consequences: An overview from Central Sterile Supply Department of a cancer center in eastern India. J Infect Public Health, 10(2), 235-239. https://doi.org/10.1016/j.jiph.2016.06.009
Forrester, J. A., Powell, B. L., Forrester, J. D., Fast, C., & Weiser, T. G. (2018). Surgical instrument reprocessing in resource-constrained countries: a scoping review of existing methods, policies, and barriers. Surgical Infections, 19(6), 593-602. DOI: 10.1089/sur.2018.078
Mohapatra S. (2017). Sterilization and Disinfection. Essentials of Neuroanesthesia, 929–944. https://doi.org/10.1016/B978-0-12-805299-0.00059-2
Panta, G., Richardson, A. K., Shaw, I. C., Chambers, S., & Coope, P. A. (2019). Effectiveness of steam sterilization of reusable medical devices in primary and secondary care public hospitals in Nepal and factors associated with ineffective sterilization: A nation-wide cross-sectional study. PloS one, 14(11), e0225595. https://doi.org/10.1371/journal.pone.0225595
