The Joint Commission recently announced a focus on the interpretation of standards and survey process related to sterilization using steam. Now the field is preparing to address this renewed focus.
"Let's be clear that these standards are not new standards—these are just receiving critical attention as they should," says Jodi Eisenberg, MHA, CPMSM, CPHQ, CSHA, program manager of accreditation and clinical compliance at Northwestern Memorial Hospital in Chicago. Eisenberg is an advisor and regular columnist for Briefings on The Joint Commission.
This increased focus is well timed as there has been news of incidents involving exposure to infectious body fluids from other patients via equipment that had not been appropriately cleaned, disinfected, and sterilized.
Cleaning equipment, along with the ubiquitous topic of hand hygiene, is among the most important parts of the process for preventing transmission of infection. It appears that the initial focus of these new initiatives will be on Central Sterile Processing. The Joint Commission surveyors will be focusing on observing instruments from the time they leave one operating room to when they are returned. They will be observing the instrument cleaning process and surveyors will be looking for appropriate personal protective equipment as well as reviewing sterilization logs.
"I agree that this is a critical process and will be a challenge for some organizations," says Eisenberg. "An additional area of focus for organizations needs to be on the decentralized process for cleaning and disinfection."
In many areas, the centralized process for cleaning has been replaced through the use of chemical sterilization agents being used in departments and areas outside Central Sterile Processing, she adds.
Economically, this process seems to be less expensive because it takes less time and uses fewer resources.
However, in some cases, organizations have taken this critical cleaning element and delegated it to people who may not be trained appropriately or may not understand the appropriate procedure or details of decontamination, thereby increasing the potential of cleaning and disinfection errors.
"The result is an inconsistency in the cleaning and disinfection standards across the organization," says Eisenberg.
In order to address this in your organization, the first step is to delineate an inventory of units or departments using chemical sterilization agents to clean equipment. The staff conducting hazard surveillance within an organization may already have this inventory completed. Using a decentralized sterilization inventory tool, organizations can identify where this decentralized sterilization is occurring, what products are being used, and what equipment is being processed.
Once the data is collected, a review of the procedures should occur to determine the appropriateness and consistency.
"The goal is not necessarily to eliminate the decentralized sterilization, but to ensure its integrity and safety," says Eisenberg.