What To Do When Someone Asks About Your CSP Job

“So, what do you do?”

No matter what job you hold, it happens to all of us at some point. The age old question about where you spend  8+ hours, 5 days a week. It’s a talking point at social gatherings and it’s a question that some dread and others wait for. For those that work in Sterile Processing, you probably know what it is like to work in a field area where the average person may not understand what it is you really do all day. I imagine that sometimes when CSP professionals try describing what they do, they are likely to either sell themselves short or make the listener squirm.

So you probably won’t go into details about how you clean off all of the blood and guts that end up on instruments after a surgery.  You certainly won’t mention the smell that you’ve gotten used to or the flattering full body suit you wear every day. That just doesn’t emanate a cool factor. You could tell them that you make sure the surgeons have the instruments they need for each surgery, but you don’t. Because that could come across as a little boring when you’re first meeting somebody.

However, what you should mention is something about how you are a patient advocate. You ensure each and every item that comes out of that room is cleaned, sterilized and disinfected. You make sure that when a patient enters the hospital for an ailment that he isn’t going to wind up with other deadly infections because there was bioburden left on the instrument giving him MRSA or C. diff. You are the one that ensures his safety from infection so he can worry about things like how many days he has to eat that hospital food and how to get the nurses to stop waking you up for testing so you can get some sleep.

Show him this video so he knows just how important your job is, because the more people that realize the value of what you do, the more attention will spread towards the importance of infection prevention.

Is “Looking Clean” Enough?

How do you know your hospital is clean? How do you know something is free of bioburden? Don’t make assumptions because it “looks clean”. The MediCount ATP Testing Device allows you to objectively measure the cleanliness level of a surface or an instrument based on what YOU define as “clean”. Clean should be a result, not a process.

The MediCount ATP Testing Device Provides a Way to Quantify “Clean”. The device provides a numerical reading in less than 30 seconds and provides a quantitative measurement representing the amount of organic material present on a surface. Read More

5 Ways To Save Time In Sterile Processing

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.

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 

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.

3.) 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.

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.

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….

Related articles

• Midbrook Medical Designs First Ever Method to Help Sterile Processing Technicians Improve Efficiency in Cleaning Robotic Surgical Instrumentation (virtual-strategy.com)

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.

July 24, 2013

In Their Own Words- Sterile Processing Department Technicians

Take a look at this clip from the Today Show segment on dirty surgical instruments in healthcare facilities. As this technician explains, Sterile Processing Department (SPD) Technicians in the United States are not required to be certified (with the exception of New Jersey SPD workers).

June 12, 2013

Take a look at this segment of the Today Show reporting on the shortcomings of infection prevention practices and regulations today:

June 11, 2013

That’s crazy!!

In a recent U.S. study, 3 out of 20 endoscopes tested were found to be improperly cleaned. In other words, 15% of those endoscopes were capable of passing on potentially life-threatening HAIs.

Read it for yourself on the Medical Daily website: http://www.medicaldaily.com/articles/16347/20130609/colonoscopy-endoscopy-contamination-medical-devices-endoscope-gi-scope.htm

The Story Behind The Tempest – A Call for Action

Word is finally getting out in the media that there is a real problem with dirty surgical instruments. Google the keywords – “surgical tools”, “dirty” and “infections”.  Take a few minutes, or hours and click on the links to read the heartbreaking stories within the postings and personal comments of hundreds of people who have been affected as patients, loved ones and workers within the healthcare industry. It is disturbing enough to give rise to strong emotions and a ‘Call for Action’.

While the industry at large is beginning to grapple with the need for updated standards of clean and the processes necessary to achieve these goals, Midbrook Medical has been at the forefront and deeply involved in the creation of an effective, cost-saving and reliable system that is a revolutionary advancement in our ability to thoroughly clean these surgical instruments.

The Tempest is the solution to cleaning dirty surgical instruments.

In fact, the recent media blitz generated by the report on NBC’s Today Show by Nancy Snyderman was inspired in part by Jahan Azizi, Clinical Engineer for Risk Management at the University of Michigan Health System. The Centers for Disease Control and Prevention (CDC) has been concerned about hospital acquired infections from cannulated instruments and suction tips. Jahan Azizi performed a study to find out if any of the current washers were actually cleaning the cannulated instruments and suction tips well enough for sterilization.

The answer was an astounding NO!

Midbrook Medical created a fully automated system that would consistently clean these instruments to a new standard of clean and developed the solution – The Tempest.

The Tempest cleans the following:

• Cannulated Instruments
• Suction Tubes
• DaVinci Tools
• Endoscopy Devices
• Orthopedic Devices
• General Surgical Devices

Instruments that have been processed by the Tempest are sterilizer ready, effectively eliminating the need for:

• Ultrasonic washing
• Manual scrubbing or brushing
• Washer cycle before sterilization
• The need for additional employees for increased case loads

The Tempest was designed for both cannulated and non-cannulated instruments and has an “ultrasonic only” cycle.

Take a look at the Tempest washer in action, (animated version).
http://www.youtube.com/watch?feature=player_embedded&v=3YNOlthDSY8

Different Models and Capacities:
The 4000 does 24 cannulated instruments and has 2 baskets for the cannulated instruments and 2 baskets for all the other instruments. It is a 4 basket unit.
The 2000 does 24 cannulated instruments and is a 2 basket system.
The 1000 does 12 cannulated instruments and is a 1 basket system.

Many hospitals are throwing away instruments prematurely that they cannot clean because of bio-burden build up/residual. The Tempest does not allow bio-burden build up, thereby extending the life of these instruments. This can save hospitals thousands of dollars in new instrument replacement cost.

If common homeowners can own an automated cleaning system, (a dishwasher), why shouldn’t every CS department have one that can clean more effectively than any human can? CS workers continue to be an integral part of the department and monitor the equipment with dramatically improved results.  Midbrook believes the hard working individuals in this most important department need an extra hand, an important addition to their ‘Tool Box’.

We wouldn’t accept the cost and inconvenience of throwing away our dishes. Why should we have to replace our costly medical devices when an advanced washing system can repurpose them to a safe state of clean?

Unclean surgical instruments bring serious consequences in healthcare costs, transmission of infection and human tragedy. Lets all come to the new standard of clean that the Tempest can deliver and put a stop to more heartbreaking postings about unnecessary adverse events.

Modern Surgical Instruments Require Advanced Cleaning

Technological advancements in medicine have led to more precise and narrow surgical instruments intended to save lives and minimize recovery time.  But often, the biggest threat to a patient is the bioburden and bacteria trapped inside the instrument from a previous patient.

The variations and subtle differences between surgical instruments pose challenges for manual cleaning.

Unclean Surgical Instruments CANNOT be Sterilized

As medical instruments have become more intricate, the same features that enable a surgeon to perform a minimally invasive procedure cause a nightmare for Central Sterile Technicians. Narrow lumens, bends, changing diameters, and other features common in modern surgical tools create barriers for manual brushing. Bioburden (including blood and other human residue) may become packed inside of instrumentation, creating a risk for infection and cross-contamination between patients. Although the instrument will be sterilized, the sterilization process is ineffective if bioburden is present.

Interior Lumen AFTER Sterilization

Interior Lumen AFTER Sterilization

Interior Lumen AFTER Sterilization

These images show the interior lumens of surgical instrument AFTER they had been manually brushed and sterilized per the manufactures’ instructions.  Often times, a sterile crust is formed over the live bioburden and can be peeled away or re-moistened; thereby exposing live bacteria.

HOW CLEAN IS CLEAN?

In most industries, a cleaning process starts by defining how clean is clean? The process ends only after the items being processed are validated – meaning that they are checked to ensure that they meet defined standards.

When Midbrook began working with the healthcare industry to develop cleaning and decontamination solutions, we were surprised to learn that many of the cleaning methods used in healthcare settings lacked a final validation step. Rather, in healthcare, the focus seemed to be on the process – in other words, validation only answered the question of: were all steps followed correctly?

Simply following cleaning steps does not guarantee a clean outcome – especially since variations in soil content and soil level can exist from instrument to instrument. Furthermore, processes that rely on manual cleaning are subject to human variables and errors – missed steps, distractions, and mix-ups.

That’s why other industries focus on results.  For decades, automated machinery has cleaned automotive and airplane parts with higher efficacy than hospitals clean surgical instruments.  As surgical instruments become more complex, the healthcare industry should adapt technologies that other industries use to clean intricate parts.  The results could reduce the transmission of HAIs from dirty surgical tools and save lives!