high-tech flushing system), sinks of adequate height, width and depth,
the proper chemicals, appropriate PPE, a sharps container, pre-process-
ing equipment (such as standalone ultrasonic washers), and any other
supplies needed to safely restring and sort stainless steel instruments.
Back to the brushes for a moment: Make sure these are organized and
easily identifiable. Many an internal scope channel has been damaged
by incorrect or compromised brush usage.
Ensure OR ownership: first things must be first. As important
as the proper tools are in the hands of a competent, well-func-
tioning decontamination team, the SPD department is actually the
second set of eyes to guard against possible microbial mistakes. The
first opportunity to tackle potential processing pitfalls actually hap-
pens immediately post-op, before the instruments ever leave the OR.
Ensure your nurses and techs in the room are aware of the necessity
of post-op prep of their instrument trays, such as removing any inserts
(such as Fogarty clamps and Brainlab tracking balls), disposing of
(ahem) disposables (such as plastic/rubber attachments, suture and
single-use towel clips), removing gross bioburden (blood, fat, tissue,
bone), restringing of ring-handled instruments (on a low-tech stringer
or high-tech restringing technology), flushing any suction devices
(such as Frazier, Andrew or abdominal suctions), and finally, pre-
treating the instruments with a low-tech damp towel or high-tech pre-
treatment solution). To win this war on decontamination oversights,
we need our partners in the OR to begin the process as soon as possi-
ble. Every minute counts.
Post it, train it, do it. Finally there's the idea of repeatable excel-
lence. A decontamination technician is only as good as his habits;
his habits are formed by his training; and his training (hopefully) is
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