Sterile Processing Department Division Officer Naval Hospital Camp Pendleton Carlsbad, California, United States
Description: I. After internal checks identified areas of improvement on point-of-use decontamination practices throughout NHCP, a leadership team from Sterile Processing Department focused on measures to establish uniform policies and streamline educational channels. The team was led by LCDR Angela Cummiskey, Division Officer of Sterile Processing Department who conducted inspections and coordinated with Public Affairs Office for filming of the Point of Use/ Decontamination video. II. Quarterly NHCP clinic inspections conducted by LCDR Angela Cummiskey showed areas for improvement on command compliance of POU/ decon practices and care of instrumentation processes. Further, the high personnel turnover made retaining knowledge and proper turnover of instrument care and decon processes a challenge. To establish uniform policies and procedures for the proper care and handling of contaminated instruments, research and standards were compiled from ANSI/AAMI ST79 (2017), AORN (2019), and BUMEDINST 6220.9B (2018) to draft a script for a POU/ Decon video to be utilized throughout NHCP Main Operating Room and 13 clinics. The video linked to the command page and posted in every clinic’s decon room via QR code would allow access to proper steps and transfer of knowledge consistently throughout the command contributing to a streamlined process on point-of-use cleaning. III. The fundamental principle as recommended by current ANSI/AAMI guidelines is that reprocessing of soiled instruments should occur as soon as possible. However, in many medical/dental treatment facilities the immediate containment, transportation, and initiation of definitive cleaning might not be feasible, so visible soil and material should be removed at the point of use. IV. Using these standards and NHCP SOPs, a script was drafted outlining the recommended steps of POU pre-cleaning and transportation of contaminated instruments. The script was routed through the Directorate and a 6:26minute video filmed with Public Affairs Office. The video was linked to a QR code and posted in 13 departments decon rooms. V. Clinics were inspected on 7 factors within a “POU/removal of gross soil” category and on 4 factors within a “transportation” category. After only a month of implementation, spot inspections conducted showed a dramatic increase in compliance across clinics in the “POU/removal of gross soil” category – 99% compliance compared to prior month’s inspection at 91%. VI. Prompt POU pre-cleaning removes bioburden and foreign material, prevents the formation of biofilm and improves the efficiency and effectiveness of the decon process, ultimately prolonging the life of instrumentation and the quality of instrumentation utilized in surgery. Procedures for safely transporting contaminated instruments from point of use to a sterile processing location are important because patients, personnel and the environment can be exposed to potentially disease-producing microorganisms during transport.