When preparing for a surgery, patients may have concerns regarding a variety of factors, such as the skill level of the surgeon or the estimated length of recovery.
But what many patients do not consider is the sterility of the medical instruments that are being used. The use of questionably dirty medical instruments is becoming a major issue in hospitals across the U.S.
The Detroit Medical Center is one such center that has had longstanding issues regarding how surgical tools are cleaned by its central processing department. The department was recently under review by state licensing officials for claims of broken and dirty instruments that have caused a wide array of issues within DMC. The Detroit News cited that there had been numerous surgeries ranging from minimally invasive to critical that were cancelled due to the issue.
“You can see the numbers that you’re up against. You only need one that’s contaminated to go back up to the OR, and you suddenly have the risk of a patient infection or even worse.” Jim Schneiter, President of America’s MedSource Inc.
The example of the DMC is but a small piece of the larger picture when it comes to the threat of dirty medical instruments.
In a single hospital, hundreds of thousands of instrument sets are processed monthly which means there is ample room for human error. Hard to detect hospital-acquired infections as a result of improper sterilization techniques have become more prevalent over the past few decades.
Why are we now seeing an issue with the sterility of medical instruments?
The main culprits of the issue seem to be pressures put upon workers that are performing the cleanings, and also the increased prevalence of laparoscopic tools.
“Thirty or 40 years ago, you didn’t have (surgical instrument) cases with 400 pieces in them,” said Jahan Azizi, retired clinical engineer for the University of Michigan Health System. “They have not hired people to keep up with the explosion in instrumentation.”
The tools of the past did not require the level of education and training that these smaller, more compartmentalized surgical instruments of today do. When blood and debris builds up on the tools, it can lead to “drug-resistant superbugs” like those found in the duodenoscope infection outbreak where nearly 200 patients were infected due to contaminated medical equipment.
In addition to hospital specific investigations, efforts are being made on a wider scale to mitigate the risks of dirty medical instruments. The CDC issued its Guidelines for Disinfection and Sterilization in Hospitals in 2008, and though it is voluntary it contains the industry standard for cleanings.
Schneiter stated that, “cleaning begins the moment the instrument is taken from a surgeon’s hands. The moment you put it in fluid that stops the coagulation process.”
Hydrogen peroxide gas plasma, dry heat, and the use of various chemicals are just a few of the sterilization techniques mentioned. The FDA is also doing their part, working with medical equipment manufacturers to better understand the root causes of bacterial outbreaks and how to prevent them.
Aptly named, Enclothed Cognition is the official Medelita blog for medical professionals interested in topics relevant to a discerning and inquisitive audience. Medelita was founded by a licensed clinician who felt strongly about the connection between focus, poise and appearance.
