3m™ attest™ sterile u web meeting 10.21.2010 · 2012. 2. 11. · invest in cssd cssd is the...

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© 3M 2010. All Rights Reserved.

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© 3M 2010. All Rights Reserved.

3M™ Attest™ Sterile U Web MeetingOctober 21, 2010

© 3M 2010. All Rights Reserved.3

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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© 3M 2010. All Rights Reserved.4© 3M 2010. All Rights Reserved.

Mark Duro, CRCST, IAHCSMM Approved Instructor

Manager, Central Sterile Processing Department

New England Baptist Hospital

Boston, MA

[email protected]

Speaker is a consultant to 3M


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.


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


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


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?


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.


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


Kerrison Ronguer

• Difficult to clean

• Slide carriage can harbor debris


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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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



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?


Sterilization and Sterilization Quality Assurance

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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?



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?


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.


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.


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.


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.


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?


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


Next 3M™ Attest™

Sterile U Web Meeting:

� Nov 18, 2010

Thank you!

Register at www.3m.com/AttestSterileU/WebMeetings

3m™ attest™ sterile u web meeting 10.21.2010 · 2012. 2. 11. · invest in cssd cssd is the...

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