QUALITY!

Imagine you’re in decontamination, facing several case carts full of dirty instruments.  You think, “I’ve got to get this done as soon as possible or it looks like I’m not doing my job.”  So you start washing as fast as you can…and maybe you’re not soaking the instruments for 5 minutes.  Maybe you’re not flushing and brushing each lumen.  Maybe you’re not scrubbing each instrument.  It looks clean.  They probably  didn’t use it.  It’s no big deal, right?

WRONG!  If you’re trying to rush through cleaning, then you are sacrificing the QUALITY of your work. 

There may be some bioburden left in that suction.  There may be a piece of cement on that impactor.  Always remember that cleaning is the most important step in sterile processing.  Nothing can be sterilized if it is not clean.  So yes, you do have to take those extra few minutes to adequately soak the instruments in enzymatic solution, brush each one to-and-fro, and thoroughly rinse.  Never  assume that because it looks clean, it wasn’t used.  You don’t know that.  Wash every instrument as though it is covered in microbes, because even if you can’t see them, they are there.

Quality reprocessing is not limited to decontamination.  Assembly inspection is equally important.  Inspect each instrument carefully.  Use lighted magnification to see nooks and crannies that may be hard to see with the naked eye.  Use a borescope to see down that lumen.  If you question anything, send it back for recleaning.  It’s better to be safe than sorry.

You’re probably thinking, “But that’s going to slow me down. I won’t be able to get much done.”  Remember sterile processing is quality over quantity.  It might slow you down, but you will be completing a quality tray that is ready for patient use.  It will be ready for the OR to use, the surgery can proceed without delay, and the patient is at a lower risk of infection. 

Let’s not forget sterilization!  We know that sterilization is what we do, but it also factors in the quality of our instruments.  Is the sterilizer functioning properly?  Have all the necessary tests been completed and passed?  Did we include our PCD pack with the load?  When the load is completed, have all required parameters been met?  Have the external indicators changed color?  Do we have a negative biological indicator?  These are more points to think about before skipping steps.

It’s not about how many trays you can get washed, assembled and sterilized in a certain time frame; it’s about each tray being safe for patient use.  Skipping steps or trying to speed through each process because it’s “faster” is not quality sterile processing.  Just remember who the end user is.  It’s not the surgeon, the surgical tech, or the nurse.  It’s always about the safety of the patient.  Remember that the next time you consider skipping ahead to be “faster”.