Uphill grime: process improvement in surgical instrument cleaning

Area of Science:

• Healthcare
• Medical Device Safety
• Quality Improvement

Background:

• The US Food and Drug Administration (FDA) issued a critical alert regarding cross-contamination risks associated with arthroscopic shavers.
• Concerns over medical device reprocessing methods prompted a quality improvement initiative at a university hospital.

Purpose of the Study:

• To evaluate the efficacy of automated instrument reprocessing for surgical instruments.
• To identify optimal cleaning processes ensuring verifiably clean surgical instruments.
• To address concerns highlighted by the FDA's medical device alert.

Main Methods:

• A quality improvement project focused on suction tips, chosen for their frequent use and susceptibility to organic debris.
• Various cleaning processes and products were tested on different types of suction tips.
• The study aimed to determine the effectiveness of manufacturer-recommended cleaning protocols.

Main Results:

• The project revealed significant amounts of residual organic debris on instruments even after cleaning.
• Manufacturer-recommended cleaning methods, representing current practices, were found to be ineffective.
• Unexpected debris was detected in areas where instruments should have been completely clean.

Conclusions:

• Current standard practices for surgical instrument reprocessing are inadequate.
• There is a critical need for improved and validated methods for cleaning surgical instruments, particularly complex ones like suction tips.
• Further research and development are necessary to ensure patient safety and prevent device-related infections.