Monthly Archives: September 2013

5 Ways To Save Time In Sterile Processing

fridays
One of the complaints we hear most often from Central Sterile Processing Departments is that there are too many instruments to clean and not enough time. Surgeries are delayed, instruments pass through unclean and SPD workers get frustrated. Too much responsibility falls on this department to have them feeling this way. This is what it looks like when technicians don’t have proper time and tools to properly clean each instrument.

Dirty Surgical Tools

Interior Lumen AFTER Sterilization

1.) Flush and Brush Station

The daVinci instruments used in robotic surgeries do phenomenal things but they also create a lot of hassle for technicians. Instruments get lost, they are hard to clean and difficult to keep altogether. This station from Midbrook Medical sits in the base of the sink and helps technicians keep track of what has been scrubbed already and prevents instruments from contaminating each other. Read More flush and brush 1

2.) Recipe Baskets

These recipe baskets were designed to help central sterile processing techinican’s ability to efficiently follow the Instructions for Use to reprocess full recipe sets of da Vinci Robotic Surgery. Instruments can be transferred from the Flush and Brush Station to the recipe baskets for the Midbrook Ultrasonic Bath. Like the Flush and Brush Station, the baskets are designed to keep surgical sets together during reprocessing allowing CSPD Technicians to reprocess recipe sets for each surgical procedure in a more efficient manner.

OLYMPUS DIGITAL CAMERA3.) The Tempest Surgical Instrument Washer

One of the reasons the Tempest is on the list is because of its automation. With the push of a button the lid comes down and runs a programmable cycle to bring repeatable results.  This instrument washer uses a combination of high-powered, tested, and proven washing actions: ultrasonics, enzymatic soaks, agitation, exterior and interior sprays, and air injection bubble cavitation stream. The instruments are cleaned effectively far surpassing AAMI standards. Just think of what you could accomplish in SPD during this automated 30 minute cleaning cycle.tempestbanner400x289

4,) The UV Flash

Sometimes accidents happen, even in hospitals. What happens when instruments get dropped? Well the good news is that problem can be solved. In 60 seconds. The UV Flash uses UVC light to disinfect objects. All bacteria on the surface of an object will be eliminated by using this station.

UVFlash

5.) Less Repeat (O.K. I know this isnt a product but it’s true!)

Since you’re using the Tempest surgical instrument washer, instruments are being cleaned more effectivly. Since more clean instruments are making their way into the hands of surgeons, less unclean instruments are making the trip back to sterile processing. Sometimes instruments come out of SPD with bio-burden on them so visable that surgeons send them back before even using them. This creates more work for technicians that is really unnecessary. If you do things right the first time, you won’t have to do it again. At least until after the surgery….

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Filed under Gimme Five Friday, Surgical Instrument Cleaning, Ultraviolet light to fight bacteria, Uncategorized

Should You Care What Your Doctor Looks Like?

Infection Prevention

Infection Prevention

Have you ever gone into a business meeting wearing a suit and noticed the guy on the other end of the table is wearing a polo shirt? Or have you seen someone at the pool on a beautiful 90 degree day in long sleeves black pants?  I sure have and it makes me wonder about the difference between expectations and common sense.

It has been engrained in our heads that certain situations call for a certain type of apparel.  We expect in a business environment everyone will dress for a business meeting. We expect that at the pool, you wear your beach apparel. Yet other times its just plain common sense to dress a certain way.  Why dress in all black when the sun is so hot and its such a beautiful day?

Medical facilities are going through these questions as well. Traditionally doctors have donned the long white coat and tie. So that’s what we’ve grown to expect of them. A nice clean look makes the doctor appear professional and therefore respected as an an athority on your health. But does this coat and tie approach follow common sense?

When we stop to think about it, that coat and tie goes from room to room, seeing sick patient after sick patient. Yet it isn’t disinfected between seeing each patient. It probably isn’t even disinfected between each day either. If you really want to get the heebie-jeebies, think about the last time you’ve washed your tie. Some would even admit to, “never.”

There have been nation-wide hospital policies surrounding this issue. Should we ditch the professional physician attire? It should help decrease the spread of harmful infections, but would you take your doctor as serious if he was in kahki’s and a button up? Some resident students have even started attending clinicals wearing jeans! Yet just because you ditch the coat and tie for something else doesn’t mean you’re transmitting less germs. It might however, be more likely to be washed.

Which way would you vote? The professional attire that you expect that comandeers respect or the attire that might be disinfected more regularly and spread less bacteria? I think that is a tough question. Either way we vote, it’s an indication that therein lies some responsibility on the physician to take a pro-active approach to work attire. Dressing professionally should not only encompass the look of their attire but the level of cleanliness as well.

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Filed under Healthcare Acquired Infections, Thursday Thought of the Day, Uncategorized

Influenza: You have options

Wednesday
Flu season is swiftly approaching. While the flu and the flu shot are not nice, this flu season sounds better than ever. The 2013-14 flu shot is already available and it’s said to be better than ever. This year the flu shot and nasal spray covers all four strains of the virus instead of the three it covered previously.

This is good news to me because I hear cases about people getting their flu shot but they still end up infected with the flu. I think to myself, how can it be? Why get the flu shot if you’re still going to get the flu? Well, I guess for some, they had that unlucky “strain #4.” But 3 out of 4 was so last year.

If you thought that news was exciting enough, there are even more reasons why this year will be better than ever. Here are some other new influenza vaccine options:

Are you elderly?
High-dose vaccine for the elderly to boost immune response and protection

Are you allergic to eggs?
Those with egg allergies have the option of two new vaccines without egg protiens

Are you afraid of needles?
A new vaccine can be delivered by a tiny micro-needle into the skin.

Watch the video below from ICT News Desk regarding new the new personalized approach to vaccine options according to Mayo Clinic vaccine expert Dr. Gregory Polland.

ICT

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by | 09/25/2013 · 1:00 am

First Comes Antibiotics, Then Comes Resistance.

drug resistance
The Centers for Disease Control and Prevention (CDC) released the first-ever glimpse of how antibiotic-resistance bacteria is endangering the United States population in a Drug Resistance Threat Report. The CDC broke them down into three grades of urgent, serious, and concerning and classified them as “immediate public health threats.”

Here are the top 3 on the Urgent list:

1.) Clostridium Difficile (C.diff)

2.) Neisseria gonorrhoeae

3.) Carbapenem-resistant Enterobacteriaceae (CRE)

In the report, Federal health officials reported that, “at least two million Americans fall ill from antibiotic-resistant bacteria every year and that at least 23,000 die from those infections.”

Carbapenem-resistant Enterobacteriaceae (CRE)

Where’s the problem coming from?

Antibiotic overuse has led patients to grow resistance to bacteria which renders them insusceptible to future medications. It is said that about half of antibiotic use in people is inappropriate. That says to me that the doctors have a lot of control over who gets these antibiotics and how many. Yet, I’m sure there are also a lot of patients that go into their doctor and request an antibiotic for various ailments when they may not really need it.

On the other hand, many would say industrial-scale animal farming contributes to the problem of antibiotic resistant infections in humans. We’ve known for a while that large amounts of antibiotics are injected into animals to keep them healthy and to help them grow. But did you know just how much? A report from 2011 states: a whopping 70% of antibiotics used in the United States are given to animals.

JAMA Internal Medicine did a study that indicated patients who lived near farms and areas where manure was dumped were 28% more likely to develop a MRSA infection. So maybe that has something to do with the numbers.

I also read an article that suggested hospital janitors have a lot to do with the rate of infection. Some hospitals have reached a realization that hospitals rely on the staff members who know every nook and cranny in each room, to also know which cleaning products contain which chemical compound to use to clean and disinfect. They also may not wash their hands how we think they do.

So with all that said, let’s think back to last week’s survey. I asked, “Who do you think has the most control over hospital infection prevention?” It listed: CSPD, Janitors, Infection Control Specialists, Patients, and Doctors and Nurses. Knowing what you do now, should the survey last week have included Animal Farmers as well? Would you answer the survey differently and say Janitors or patients? Let’s take this survey again with one more category and a little more background on the subject and see what you think now.

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Admit it, You’re Dirty

fridays

On the Yahoo homepage this week was an article about a U.K. study which revealed that about a third of those surveyed admitted they NEVER clean their purses, briefcases, or gym bags! It also stated that a whopping 100% of bags swabbed and tested were contaminated with bacteria like, e.coli and strep. Yuck. Yuck. Yuck.

Not only can germs linger on the outside of your bags, the items on the inside are likely just as bad. Just think for a minute about your cell phones, tissues, money, keys, etc.

With the help of this Yahoo article, here are 5 ways to keep your bags clean and avoid getting and spreading dangerous germs:

1.) When purchasing a new bag, pick a material that can be easily cleaned.
2.) Clean your bag regularly inside and out with a disinfecting wipe, or if your lucky, a UV Flash.
3.) Don’t forget to wipe off the contents of your bag too. Cell phones, keys, wallets and more with disinfecting wipes. Especially during cold and flu season.
4.) Wash your hands regularly and avoid touching your eyes, nose and mouth.
5.) If you carry food in your bag, keep it in a zip-top bag to keep it from contamination. Items like shoes should be bagged as well so they don’t bring in more bacteria to your bag and its contents.

This short list may seem like common sense but they are simple things even medical facilities need to keep in mind as well. At times it can be a crossroads of a domino effect meeting a forest-through-the-trees situation where a large group of people are so focused on the science of healing, forget the basics and it carries throughout the entire facility.

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by | 09/20/2013 · 10:00 am

The Problem with TEE (and The Solution TOO)

Recently Fox News and NBC Nightly News and its investigators, (including renown physician Pritish Tosh, M.D., and representatives of the CDC) featured an outbreak of e-coli infections happening after surgeries that used this TEE probe.

What is “TEE”? Transesophageal echocardiography — or, TEE — is a diagnostic procedure that uses a specialized device to display sonographic images of the heart, known as echocardiograms (which are distinguished from “ECGs,” or electrocardiograms).

In these examples, a “physical defect” in the TEE probe may have caused the TEE probe to remain contaminated after reprocessing. The complex designs of arthroscopic shaver hand-pieces and inflow/outflow cannulae retained infectious bioburden after cleaning.

TEE is a risk factor for healthcare-associated infections of gram-negative bacteria including Legionella spp., Pseudomonas aeruginosa, and E. coli. Therefore, its proper reprocessing is required to prevent bacterial outbreaks. – Lawrence F Muscarella PhD

So how do we ensure proper reprocessing required to prevent bacterial outbreaks?

You may recall a somewhat similar situation of an outbreak of Pseudomonas aeruginosa featured on the Today Show back in 2009 in Houston, Texas.

Watch the Today Show segment here

Jahan Azizi is the head of infection control at the University of Michigan. Over the past few years here at Midbrook Medical, we have had the pleasure of working with him. Azizi, who was featured in this segment, has worked with Midbrook in order to deliver hospitals with the most effective surgical instrument washer.

One of the things Azizi talks about frequently that we’ve adapted ourselves is, “If it isn’t clean, it can’t be sterilized.” That’s what is happening with these instruments. When the instrument is still dirty and it goes into the sterilizer, the bio-burden is essentially getting baked on.

The Tempest process that uses ultrasonic, enzymatic soak, agitation, exterior fluid spray and interior lumen flush system. See for yourself why Jahan made sure to have the Tempest in his Central Sterile Processing Department.

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Filed under Healthcare Acquired Infections, Surgical Instrument Cleaning, Thursday Thought of the Day, Uncategorized

How To Kill The Norovirus

Wednesday

norovirus

New research carried out in the South could help wipe out the winter vomiting bug norovirus, saving hundreds of lives. Scientists from the University of Southampton have discovered that copper kills the bug almost instantly.

Experts say if the surfaces we touch constantly like door handles, taps and stair rails are made with the metal, it would drastically reduce the spread of infections. Christine Alsford spoke to Professor Bill Keevil from the University of Southampton and a norovirus patient Serena Spencer-Jones.

More about Antimicrobial Copper

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by | 09/18/2013 · 10:00 am