3M™ Attest™ Sterile U Web Meeting 10.21.2010 · 2012. 2. 11. · Invest in CSSD CSSD is the...
Transcript of 3M™ Attest™ Sterile U Web Meeting 10.21.2010 · 2012. 2. 11. · Invest in CSSD CSSD is the...
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3M™ Attest™ Sterile U Web MeetingOctober 21, 2010
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Welcome!
Topic: CSSD 101- What do you expect of your CSSD?
Facilitators: Susan Flynn, 3M IPD
Dorothy Larson, 3M IPD
Speaker: Mark Duro, CRCST, IAHCSMM Approved Instructor
HousekeepingQuestions
Mute feature (*7 = unmute; *6 = mute)
“Chat” feature
Technical difficulties
CE Credits
Post session follow-up
For more information: www.3M.com/AttestSterileUOnline
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Mark Duro, CRCST, IAHCSMM Approved Instructor
Manager, Central Sterile Processing Department
New England Baptist Hospital
Boston, MA
Speaker is a consultant to 3M
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Objectives
Identify immediate needs in CSSD the first day/week on the job as a CSSD, OR Manager or ICP.
Inspection/Audit of newly acquired CSSD .
Understand the capacity and limitations of the CSSD.
Strategies to work as a team (CSSD, OR and IC)to improve overall outcomes.
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Week 1 Welcome to your new facility!
• What are some items you
want to ensure are in place?
• Where do you focus your
efforts?
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Week 1
Conduct an internal audit and inspection
Staffing
Policies and procedures
Manufacturers’ instructions for cleaning and sterilization
Decontamination practices
Tray inspection and assembly practices
Sterilization practices, record keeping and quality
assurance
Sterile storage
Relationship with Operating Room and Infection Control
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Staffing
Adequate instrument technician to OR ratio
Proper supervision and technician structure. Do you have
the right structure for success?
Certification
Assess education level of technicians and supervisors
Prepare weekly in-service and routine staff meetings
How is communication?
Encourage professionalism
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Policies and Procedures
Review all policies and procedures
How do the policies match up to current
recommendations from AAMI and AORN?
Are the minimum policies in place to function?
Establish and prioritize what policies need to be
drafted
Work with IC and OR manger and explain any
immediate needs and why
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Manufacturers’ Instructions
Do you have them?
Where are they?
Does staff know where they
are and do they read them?
Are they being followed?
Do you have the equipment
available to comply with
instructions?
Are they current?
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Manufacturers’ Instructions
Not all instructions provide the
detail needed to effectively clean
Some are vague and leave
CCSD and OR to revert to AAMI
and AORN recommendations
The capture device to the right
was a reported problem from a
Surgical Technologist in the OR.
The issue was investigated and
resolved.
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If it is not clean it is not sterile
• Some cleaning challenges for CSSD
• As newer instruments become more complex, they
become harder to clean. We still have to focus on
the ones that still give us difficulty
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IM Flexible Reamer
• Very difficult to clean
• Flexibility harbors debris
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Kerrison Ronguer
• Difficult to clean
• Slide carriage can harbor debris
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Tray Inspection and Assembly Practice
Ask OR staff what types of errors or
mistakes might be occurring. Are the
OR’s needs being met by the CSSD?
Tray error reporting - OR staff support
needed.
Tray error rates - compile data from
CSSD
Address issues as they occur
Report great service!
We are in this together for the best
outcome for our patients!
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Tray Inspection and Assembly Practice
16118
3122867
32978110
2801897
228715
197470
30273694
12145
3442675 3164
0 500 1000 1500 2000 2500 3000 3500 4000
Trays to Errors
Week 1
Week 2
Week 3
Week 4
Errors ReportedVisiPeel ItemMedium SetLarge SetTotal Items
12,442 ITEMS PROCESSED MAY 2010
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Tray Inspection and Assembly Practice
Is lighting in the area acceptable?
Are inspection tools available? Magnifying glasses,
video magnification and insulation testers are helpful.
Are workstations appropriate?
How are trays being assembled?
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Sterilization and Sterilization Quality Assurance
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Sterilization and Sterilization Quality Assurance
Are sterilization instructions available - are they being followed?
Is there one blanket sterilization cycle run for everything?
What type of testing is done daily?
How are implants being monitored in your sterilizers?
Is every load BI monitoring practiced?
Do technicians understand and are they able to interpret printouts?
Is capacity sufficient for volume?
Are sterilizers loaded properly?
Are sterilizers overloaded?
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Sterilization and Sterilization Quality Assurance
Is the correct wrap/containment system being used?
Are tray weights acceptable?
How are loads being documented?
Are loads allowed to cool?
Is equipment being serviced as needed?
Are staff dressed appropriately?
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Sterilization and Sterilization Quality AssuranceIntegrated Recordkeeping
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Storage
Wrapped trays should be stored single layer on clean dust
free storage shelves.
Storage areas need to be monitored . Temperature up to
74 degrees F. Humidity 30 to 60% and should not exceed
70%.
All floors, walls and ceilings should be made of surfaces
that can withstand frequent cleaning.
Storage should be cleaned daily.
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Relationships with OR and IC
Understand past relationships with CSSD, OR and IC.
Build new relationships with your team.
Speak with OR staff at weekly meetings.
One of the most under utilized sources of helpful
information in the OR can come from the Surgical
Technologist.
If possible rotate Surgical Technologists through CSSD.
Attend Infection Control meetings.
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Improving outcomes with your new team
Understand the needs of the CSSD (staffing-equipment-
education).
Schedule weekly meetings with CSSD Manager and OR
Manager.
CSSD Manager and IC Manager should meet monthly to
discuss sterilization and processing trends and share
information on current processing issues.
Use IC and CSSD networks to discuss issues and share
processing information and guidelines.
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Improving outcomes with your new team
Most CSSD’s were designed as an afterthought.
Poor workflow can affect processing turnover which could
lead to shortcuts. Shortcuts are taken to attain unreachable
goals.
Communication is key. Opportunities for failure can occur
when we don't communicate.
Reevaluate work practices to ensure all practices are Best
Practice.
Trust.
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Invest in CSSD
CSSD is the heart of the hospital.
What is the condition of your heart?
Are you in need of a transplant or some minor surgery?
CSSD needs support from OR and IC to better serve.
As instrumentation becomes more complex, newer cleaning
and sterilization technologies may be required.
Return on investment in CSSD results in better patient
outcomes.
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Team Projects
Reducing tray weights
Implementing every load biological monitoring
Flash reduction / elimination
Rotating CSSD technicians to observe OR cases
Rotating Surgical Technicians in CSSD
Reducing tray assembly errors
Departmental certification
Surgical Services “Pep Rally”
All projects need support from CSSD,OR and IC to achieve results. Below are projects that facilities have recently worked on as a team:
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Questions - Comments?
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References
� Association for the Advancement of Medical
Instrumentation (AAMI). Comprehensive guide to steam
sterilization and sterility assurance in health care facilities.
ANSI/AAMI ST79: 2006, A1:2008 and A2:2009
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Next 3M™ Attest™
Sterile U Web Meeting:
� Nov 18, 2010
Thank you!
Register at www.3m.com/AttestSterileU/WebMeetings