There are many reasons why issues with sterilization or high-level disinfection of reusable medical devices are in the news headlines, as well as, a large focus in an accreditation survey. There have been numerous reports of inadequate knowledge or competency, poor documentation, lack of following specific instructions for use (IFU) and not complying with current evidence based standards.
Technicians responsible for reprocessing really want to do the right thing. They do not come to work and intentionally want to put patients at risk. However, they frequently do not even know they are being non-compliant with recommended reprocessing procedures. In my humble opinion, I believe the real issue is a lack of knowledge and resources to be able to follow the current standards and guidelines for best practices.
Over the years, things have changed and so have the devices, equipment, and chemicals used to reprocess. We can no longer rely on what we learned five, ten or even twenty years ago. As we learn more, and more studies relating to reprocessing are completed, the published standards and guidelines are being updated to help ensure safe patient care by using best practices. All healthcare facilities (hospitals, ambulatory surgery centers, clinics, and doctor’s offices) that reprocess reusable devices should have a subject matter expert (SME). This person(s) should be held accountable for staying abreast of current published standards and guidelines such as the Association of periOperative Registered Nurses (AORN) Guidelines and Tools for Sterile Processing and the Association for the Advancement of Medical Instrumentation (AAMI) ST79 Comprehensive guide to steam sterilization and sterility assurance in health care facilities, ST58 Chemical sterilization and high-level disinfection in health care facilities; and ST91, Flexible and semi-rigid endoscope processing in health care facilities.
In order for the SME to stay current on the standards and guidelines they need to have the necessary resources (e.g., time, budget, etc.) available to them. The SME should have access to the most current publications and be able to attend local and national professional association meetings which is necessary to stay current, and make contacts by networking with peers. The SME should be held accountable for ensuring polices are up to date, standardized, and that the reprocessing staff know and understand the procedures. So who is the SME in your organization?