While sitting in a hospital bed before a procedure, the last questions on your mind should be "Has my nurse washed her hands recently?" or, "Have these medical devices about to be used on me been properly disinfected and sterilized after their last use?" I don’t know about you, but I find it extremely alarming that the answers to these questions could be “No”.Coming from the world of medical equipment, I too often have seen hospitals having a great deal of difficulty guaranteeing that their equipment is clean and patient ready. One of the top concerns that has been voiced to me by healthcare professionals is: “I never really know if the equipment used on my patients is truly clean”. That being said, how do we eliminate the transmittance of unnecessary infection from improper reprocessing of reusable medical devices? It’s time to regain CONTROL.
Just Because You Can’t See Bugs, Doesn’t Mean They Aren't There
Fortunately, we have made strides from the old days when a device was considered ‘clean’ if no foreign material was visible. All of the narrow crevices, hinges, and coils in the equipment used in hospitals today are breeding grounds for bacteria that, in years past, would have passed inspection. But does that mean we are in the clear? Not even close. There are three general types of risk associated with the reuse of medical devices:
1. Disease transmission from one patient to another
2. Inadequate device performance following equipment reprocessing
3. Occupational exposure to infectious materials
To avoid these risks, all medical equipment must be properly cleaned, tested for device performance, disinfected, and sterilized.
Time for Hospitals to Get Aggressive
It has been my experience working directly with healthcare professionals that the concern for hand hygiene in hospitals and proper decontamination of mobile medical equipment has made itself to the top of the priority list. The Joint Commission of Accreditation put out the 2014 National Patient Safety Goals and under the Hospital category, you can see that Infection Prevention NPSG.07.01.01 made it to the list. It is stated that hospitals are to use the cleaning guidelines from the Centers for Disease Control and Prevention of the World Health Organization.
Hospitals are performing infection control rounds; swabbing equipment for bacteria before and after it has been cleaned and reporting these results to the Infection Control and Central Sterile departments. Based off of a percentage of the medical equipment population, results are calculated and measured against the benchmarks set by the hospital. Hand washing is also monitored daily and reported to the CNO to ensure the hospital is within safety compliance. After each patient use, equipment is required to be wiped down with Sani Wipes and then moved to a designated soiled utility holding room. Sounds great! Except…wait…
Where is my Infusion Pump!?
What happens when nurses are experiencing difficulties receiving the right equipment when they need it? Two words: equipment hoarding. An enormous contribution to hospitals failing to remain in equipment cleaning compliance is whether or not the clinical staff has issues getting specified equipment from the management teams. If there seems to be a shortage of infusion pumps, all of a sudden equipment starts being hoarded; clinical staff will wipe it down and reuse the equipment without placing it in the soiled utility rooms. Gross! If there isn’t a centralized process and/or a proper operational workflow in place for the management of medical equipment, hoarding takes place and equipment is no longer managed or cleaned properly through the recommended decontamination process. Simply wiping down the equipment is not nearly as effective as using the recommended cleaning products and procedures that remove the risk of the spread of bacteria and disease.
Let's Get Squeaky Clean
I think the important thing to remember is that there are some really great cleaning solutions out within the market, but the process needs to be managed before organizations start seeing an impact. A few years from now, the situation will remain static if healthcare does not fix their internal operations. Hospitals need to have automated solutions in place to ensure centralized control for improved availability, which ultimately takes the clinical staff out of the “pump business”. The overall management of equipment is highly impacted by the processes set in place over the equipment’s total life cycle.