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transoprt of dirty instruments

transoprt of dirty instruments

posted by Tracy Porter on Aug 2, 2017 12:11 pm

What are ASC's using for transportation of dirty instruments? Can you describe the process? How far is you decontam room from your OR's? If you do use case carts where do you store them between cases and how do you clean them? Im coming from a small 3-6 room ASC....thanks in advance

Re: transoprt of dirty instruments

posted by Karen Gabbert on Aug 3, 2017 10:09 am

We use stainless steel covered steam pans we purchased at a restuarant supply store.  We transport them on a small rolling table to the decontamination area.  It is across the hall for one of the 4 OR's but the other 3 are a little farther down the hall.  They are easily cleaned in the instrument washer after each use.  They are kept outside the OR room and pulled in after each case to be loaded.  Super simple!
 

Re: transoprt of dirty instruments

posted by Abdul Soomro on Aug 3, 2017 1:13 pm

We use stainless steel case cart with door closed for transportation , for case pulling the instruments with supplies , we put case cart in OR , after case dirty instruments foamed and put back in the same case cart and transport to Decontaminate area , clean and put in washer then assembled again for sterilization.
case cart also go through case cart washer.
 Our SPD department is in basement, we use elevator.

Re: transoprt of dirty instruments

posted by Sharon Donahue on Aug 3, 2017 1:59 pm

We use a case cart that sits in the hallway outside the OR's. Since we only use this for transporting dirty instruments, we wipe it down w/ sani wipes after emptying in decontamination. Our sterile processing area is not connected to the OR hallway.

Re: transoprt of dirty instruments

posted by Judith Boehm on Aug 4, 2017 9:20 am

We purchased autoclavable containers with lids following a surveyor request of a manufacturer's IFU for cleaning and sterilization of the containers we were using.
We currently have two operating rooms.
The containers fit on a small table with wheels or on top of a ring stand to transport down the hall to decontamination.
Our instrument washer only does low level disinfection which we were told was insufficient for processing the containers.
Our case carts are used only to transport clean and sterile supplies to the operating rooms prior to the case and are stored in our sterile supply room in between cases.

Re: transoprt of dirty instruments

posted by Ellen Bencken on Aug 10, 2017 8:32 am

Our furthest OR from decontam is 20 feet.  We used closed "plastic" containers with inner baskets, that are biohazard marked.  We recently had JC and they were pleased with our process.  We have no room for case carts.  Our pick bins are 14gallon tubs.
Ellen Bencken RN BSN CNOR eChapter Past-President

Re: transoprt of dirty instruments

posted by Tracy Porter on Aug 11, 2017 10:27 am

could you send me a picture of the "plastic tubs" you send the dirty instruments out in to tracy.porter@shawneemission.org
we also used big gallon totes for our sterile supplies and rooms are close to the decontam room and have no where for storage

Re: transoprt of dirty instruments

posted by Elizabeth Austin on Aug 12, 2017 11:52 am

Hi Tracy,
Please find the link below-I will also forward it to your email and will compose a resource page for the Specialty Assembly Group (so as to facilitate communication with future requests):
https://www.quickmedical.com/healthmark-instrument-sterilization-tray-systems-sst-2136.html?utm_source=google&utm_medium=shopping&utm_campaign=google_shopping&sku=54122&gclid=CjwKCAjwzrrMBRByEiwArXcw2xD7L0YV_WGNIiKRo1THbxa3cEd8JSsxNp7cET-oD9-OiX2CF8UUIRoCdzkQAvD_BwE

SST-Instrument Retrieval-SST Trays
https://www.hmark.com/ssttrays.php

We have these trays with lids in every size to accommodate safe transport of instrumentation post surgery or procedures.

There are carts that have reversible lids-such as green for clean and red for contaminated and trays slide in and out easily.
(I have no financial interest in Healthmart).  
I am interested in finding out what you decide.
All the best,
Elizabeth A. Austin 
DNP, RN, CNOR

Re: transport of dirty instruments

posted by Barbara Friscia on Aug 13, 2017 7:20 am

Our closed door metal carts are used to transport sterile and clean items to the OR and then used at the end of the procedure to transport the dirty instruments to decontam. Dirty instruments are in metal container system and wire baskets The carts are processed through a washer.

Re: transport of dirty instruments

posted by Donna Sennott on Aug 14, 2017 2:47 pm

It is true that these standards have come under increased scrutiny by TJC.
We just had them in our facility and received a citation based on our point of use decontamination.
We currently use a gel based product that is a lubricant only and helps the instruments stay wet.
When a procedure is done at the bedside the items need to be taken to the dirty utility room  in a closed, covered , watertight, and impervious container.
If there is no cover they need to be draped with a towel. Some staff are saying this towel must be wet, and placed directly on the instruments,  based on what the surveyor said.
No where in the manufacturers IFU does it say the towel is necessary except for transport purposes.
Can anyone shed some light on this for me?

 

Re: transoprt of dirty instruments

posted by kathleen halleck on Aug 14, 2017 3:39 pm

We have a 4 room OR. One case cart by OR 1 and 2. The other by 2 and 4. After each case we spray gel on instruments . After all cases are done or cart gets filled we then have SPD take care of cleaning the cart and their contents. The carts live in our clean CSS.

Re: transport of dirty instruments

posted by Connie Garrett on Aug 14, 2017 5:40 pm

Good afternoon from Florida, as the practice representative on the coordinating council; I will answer your question as best that i can.
      Fortunately, I am "very" familiar with your subject. I manage all of the RME or reuseable medical equipment competencies in the operating room of 10 rooms for 47 staff members. The buzz word is "bioburden". The goal is to prevent bioburden from drying on the instruments before they are delivered to the SPD or decontamination point.
One issue that you have pointed out is "nesting" of instruments. Instruments must be sprayed with enzymatic solution at the point of care and prior to being delivered to SPD. The only exception to enzymatic solution is eye instruments in which case a non enzymatic product must be used to prevent bioburden from drying and causing TASS a very negative outcome.  https://www.aao.org/clinical-statement/recommendations-regarding-use-of-enzyme-detergent-.  The instruments must be escorted to SPD immediately following the  procedure they were used in and if you cannot prevent drying during travel; that is where the wet towel comes into play; to slow down the drying process during transport. The instruments must be contained in a closed container system. We have  dirty elevator and use our case carts as one mentioned above, at the end of the procedure to place our dirty instruments, in an "orderly" fashion and after they are sprayed with enzymatic and according the the manufacturer's IFU or instructions for use. The point is to prevent bioburder build up within lumens which can occur when drying is allowed prior to decontamination.
When the procedure is completed; Joint commission will expect the instruments to be escorted as mentioned above after each procedure. If you are placing trays in closed carts and holding them until they are full; you aren't meeting the standard and will be written up for that practice. If you need evidence; there are 3 very good guides: AORN for OR instrumentation and guidance; as well as CDC. I would also include AAMI and (ISHM) for SPD and decontamination guidance. This practice also pertains to endoscopes, cystoscopes and any items used for surgical procedures and invasive diagnostic procedures. The terms used are Critical, Semi-critical, and non-critical RME.
https://www.iahcsmm.org/