[Reprocessing of medical devices in clinical and practical routine]

Clinics and hospitals are facing increasing challenges due to changes and reforms regarding the hygienic perspective on surgical procedures and the reprocessing of medical devices. Differences regarding the implementation of provisions in the individual German federal states add to the difficulty of maintaining an overview of all provisions. The KRINKO Recommendations for the Prevention of Nosocomial Infections (2018) and the Requirements for the Reprocessing of Medical Devices (2012) are the central documents for surgical operations. Regarding infection hygiene, it is no longer reasonable and expedient today to differentiate between outpatient and inpatient procedures. Patient factors such as previous illnesses, previous surgical procedures, obesity etc. have come to play a more important role in the risk assessment of the entire surgical unit. More and more importance is being attached to the consideration of surveillance data.For the reprocessing of medical devices, there are also different risk assessments depending on the construction and use of the medical device. The steps required for reprocessing are determined by such assessments. A focus on reprocessing may be expected for the validation of processes. Achieving and, in particular, documenting a reproducible, hygienically correct reprocessing is associated with a high organisational effort. For manual as well as automated reprocessing, instructions have to be created for each task, and these instructions also have to be documented and monitored. For automated reprocessing, compliance efforts are a bit lower. Regular training and further education are essential in each case.In addition to economic issues regarding reprocessing, we are faced with problems financing today's high hygienic requirements. Negotiations involving the National Association of Statutory Health Insurance Physicians are ongoing. How successful they are remains to be seen. Health insurance companies are taking a rigid stance these days.