Open Forum

We (like many of you) have several off-site clinics that require transport of dirty instruments to central. sterile for reprocessing.  Our current process is to place instruments in the stericycle container at the point of use, take them to the dirty utility room and then transfer into a larger puncture proof container where they are sprayed with pre-Klenz and then transported by a courier at the end of the day. Infectious disease has just told us we can no longer do this as the risk to staff when we transfer the instruments is too high. What do others do? I want to ensure safety of staff and compliance with HLD standards. Thanks in advance.  

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Patricia Hughes DNP RN NE-BC
UK HealthCare
Lexington KY
(859) 323-4413
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Hi! For further clarification, at what point is the risk too high for employees?  At time of transfer into a larger puncture proof container, would be my assumption.  Currently, we spray instruments with pre-Klenz in the patient rooms and then transport to dirty supply room in the clinic to process. How are you transferring the dirty instruments from the room to the dirty area where the large puncture proof container is?  Is patient room to dirty room transport the root of the risk? 

How many procedures are you performing in a day? Just instruments or do you have scopes as well?  We are working to redesign our sterile processing now, moving sterilization out of the office and into Central Processing at our main hospital. Do you have problems with instruments being returned in a timely manner and could you share your check in/check out process to track the instruments?  I look forward to gaining your insight.

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Crystal Richards, BSN AMB-BC
Clinical Nurse Manager
Emory Healthcare
Warner Robins GA
crystal.richards@emoryhealthcare.org
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Reprocessing in ambulatory clinics is always a challenge but we have created standard workflows for all of our clinics who reprocess within our clinical spaces or those who use an external reprocessing department (eg. CSPD).  Like Crystal, I have questions related to what Infection Prevention (or Infectious Diseases) is really saying.  If they think the risk is too high, did they tell you why or did they offer you any solutions?  I'm happy to discuss off-line with you about our processes.   Unfortunately, this subject matter is just too cumbersome to put in an email.  I've been working on this at our academic medical center for 7 years and it continually evolves, requires a lot of observations and individualized workflows, and takes some time and effort.       

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Sherry Banez-Muth, MSN, RN
Chief Nursing Executive
WashU Medicine
St. Louis, MO
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