from inadvertently disengaging. In some lines,
secure reassembly after cleaning can be assured
with the addition of visual markings and audible
clicks to minimize the possibility of human error.
Take-apart instruments should be designed
with reprocessing in mind. Prior to the advent of
take-apart instruments, the interior of an instrument shaft would typically be inspected using a
digital scope. Following protocols, discovery of
any bio-burden would have triggered a repeat of
the series of earlier cleaning steps recommended
by the instrument manufacturer. The best quality
outcomes for Central Sterile Technicians in reprocessing the equipment properly the first time will
come with clearly stated validated reprocessing
instructions for use (IFU). Proper understanding
of the IFU can be gained through partnering with
the company’s product consultants and securing
all the necessary training.
Take-apart instruments should provide flexibility for Central Sterile Processing to process
assembled or unassembled. This versatility of
sterilization validation has multiple advantages
in preparing sterile containers for the OR. When
Let there be
assembled, the equipment trays can be arranged
with instrumentation according to surgeon
preference in advance, saving valuable time in
the OR and ensuring surgeon and nursing focus
on the patient, versus assembling instruments.
However, some hospital protocols stipulate using
one handle for multiple instruments, so sterilization in a disassembled configuration is sometimes preferred. Having the flexibility to sterilize
in assembled or disassembled configurations is
ultimately the most valuable, as most hospitals or
surgical centers will need to use both approaches
in a typical day.
Take-apart instruments should be ergonomi-
cally sound. Cleaning attributes are paramount,
but take-apart instruments should not sacrifice
ergonomic comfort and functional versatility.
Properly designed ergonomic instruments can
reduce instances of intra-operative hand fatigue
and temporary digital nerve compression by
cushioning and evenly distributing thumb pres-
sure in the contour of the ring handle. They
may also be insulated to reduce direct exposure
to conductive metal surfaces. Furthermore, they
should be versatile in providing connectors for
clamps, dissectors, and graspers, allowing for
adjustments in the OR.
What Does The Future Hold?
The industry is working hard to address
patient safety and improve patient outcomes.
The Food and Drug Administration, which
oversees medical devices, and organizations
like the Association for the Advancement of
Medical Instrumentation (AAMI) are working
diligently to issue and promote guidance on
visual inspection, which may ultimately lead to
For now, healthcare facilities need to build
in all of the safeguards they can and work with
device manufacturers to ensure that validated
reprocessing IFU are clarified and well understood. The best way to stay on track is to select
instruments that are easy and intuitive to use
and assemble from a partner who will provide
all of the service you require in working effectively with the latest advances in instrument
design and functionality.
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