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/ IDI - Irish Decontamination Institute / Education / Recommendations / Recommendations by the Quality Task Group / Cleaning / [17] Quality Assurance on the Unclean Side of a CSSD (Part 2)

Recommendations by the Quality Task Group
[17] Quality Assurance on the Unclean Side of a CSSD (Part 2)

Procurement of reusable instruments

Checking criteria

  • Define participants: hygiene commission, purchasing department, CSSD management
  • Queries catalogue (example: minimally invasive instrument(s)):
    • Is reprocessing possible?
    • Can automated cleaning and disinfection be performed?
    • Can automated cleaning and disinfection be performed with the existing procedure (e.g. Vario programme with thermal disinfection at 93 °C and 10 min hold time), cleaning agents and inserts?
    • Are the instruments to be sterilised?
    • Can the existing sterilisation procedures (e.g. steam sterilisation at 134 °C) be used?
    • What changes and additional purchases are needed?
    • Are revalidation procedures necessary?
  • Review manufacturers and suppliers in respect of service, consultation, repairs
  • Costs
  • Competencies and procurement

Records

  • Instructions from the manufacturers of the instrument(s), washer-disinfectors, cleaning agents and disinfectants
  • Capacities
  • Disposal regulations
  • Internal logistics, e.g. collection and delivery service.

Documentation

  • Minutes showing adoption of resolutions, additional measures required, competencies as well as justification of purchase or rejection
  • Schedule for implementation and, if applicable, for training, briefing, inclusion in the cleaning and disinfection plans and working instructions

Requirements for CSSD personnel

  • Are extra working hours required?
  • Is the personnel complement sufficient?
  • Plan for additional training and briefing measures

Stainless Steel Surgical Instruments Straight from the Factory

Checking criteria

  • Packing and storage
    • Remove as directed protective covers, protective foils
    • Check for damage during transport or storage
    • Dry storage, protect against medicament vapours
  • Introduction into the instrument circuit
    • Carry out prescribed preliminary measures before placing in circulation, e.g. run once or repeatedly through the cleaning, disinfection, drying, control, packing and sterilisation cycle.

Records

  • Manufacturers instructions
  • Existing internal working instructions that have already demonstrated their value
  • Brochure "Proper Maintenance of Instruments"

Documentation

  • Updated working instructions
  • Confirm implementation of defined measures:
  • what, how, how often checked by whom?

Requirements for CSSD personnel

  • Train personnel in repetitive defined procedures
  • Brief in special procedures

Disposal and Transport

Checking criteria

  • Consult with OR, the wards, as applicable, the external collection and delivery services and/or contractor - define participants
  • Define subject catalogue
    • Open hinged instruments
    • Place in suitable trays - quantity/container and close the disposal container
    • Do not place disposable items in the trays, but in the waste
    • Do not pour residues of skin disinfectants, Ringerís solution and drugs into the disposal container
    • Define how modular instruments are to be handed in (dismantled or not)
    • Secure sensitive special instruments e.g. microsurgical instruments or rigid endoscopes for transportation
    • Define dry or wet transportation, preliminary treatment e.g. wipe off, rinse etc. (if necessary, different instructions for running operation and weekend/emergency)
  • Define competencies
  • Check the working instructions

Records

  • Information on the manufacturers
    • Handling, handing in, dismantling as applicable, supports
    • Disinfectants for wet transportation, cleaning and disinfectant effect, e.g. effective against hepatitis B viruses as per certificate
    • Information on risk of corrosion during longer exposure times
  • German Society for Hygiene and Microbiology (DGHM) list
  • Guideline of the Robert Koch Institute (RKI) on requirements for processing instruments
  • Accident Prevention Regulations for the healthcare sector

Documentation

  • Working instructions
  • Organisation of collection and delivery service
  • Cleaning and disinfection plan
  • Training schedules for the CSSD, surgical and ward staff

Requirements for personnel

  • Appropriate protective clothing and measures for taking in non-disinfected instruments and utensils
  • Working instructions for taking in items, preliminary treatment and other final working steps.
Recommendations AK "Qualität"
with kind permission of
mhp-Verlag GmbH

What criteria should be taken into account on selecting reusable instruments?

What records facilitate selection?

What records are required for documentary purposes?

What requirements are to be addressed to personnel?

What must be borne in mind in the case of stainless steel instruments straight from the factory?

What records can be consulted?

How should disposal and transport be organised?

What records are needed for organisational purposes?