Do Sterile Processing Technologies Change Depending on the Region?
Apr 2, 2015 | 9:00 am
As far back as 3000 BC, the ancients used antiseptics to enhance healing and kill germs. Although, they may not have understood specifically how the process worked, they did acknowledge the benefit. Everything from tar, resins, aromatics, fire, salt, boiling water, clean sheets, and finally antibiotics and sterilization has played a part in preventing infection in the human race as the medical profession of the era has seen fit. Now we have come from the archaic ancient ways of the Egyptians to modern technology and much more convenient methods for sterile processing.
Types of Processing
With time and advancement of technology, some of the old ways of the current century have been held in high esteem and kept for the benefit of certain polymers. The type of processing used on an instrument or individual item certainly all depends upon what type of material that item is made of. For instance, a delicate intra-operative scope not made for the pressure of steam autoclaving, would be better processed in a dry type machine like a plasma machine or ethylene oxide gas.
Steam under pressure is a sure thing to annihilate microbes. But, if the instrument is not made to stand up under that type of sterilization, other methods should be employed. Sterile processing with steam sterilization kills 100% of microbes when used properly and certain perimeters are met. It works best for surgical stainless steel, wood, hard rubber polymers, and many types of orthopedic or other metal implants. There are guidelines on issues to be avoided like overcrowding of autoclave carts, proper packing guidelines and daily tests for successful perimeter results.
Ethylene Oxide is death by toxic gas. Problem is, this gas is extremely toxic to human beings. It is good in that it is reasonably priced, and highly effective. The down side is that it deserves much aeration and can be a time consuming process because of the aeration limits. These items simply cannot be pulled out of aeration before the proper time is up because it can and will affect the tissues in a negative, toxic manner, impeding healing.
In 1963, Gluteraldehyde was introduced, the first chemical solution approved by the Environmental Protection Agency (EPA), as a sterilant, for heat sensitive instruments.
The most current addition to the sterile processing group of alternatives is the plasma machines, utilizing hydrogen peroxide type of chemical sterilization. It is wonderful because the time requirement is minimal, and it is effective as any other gas type of sterilization. However, it is a bit expensive, and the machines are extremely sensitive to moisture. One drop of water missed on an instrument can shut down the entire sterilizer until a reset cycle can be administered.
Based on the region where these types of sterile processing are used will determine what type of surgery done the most in that area and what the proper needs are. If a pediatric heart hospital in Houston needs small, fine, titanium instruments, there may be a huge need for plasma machines since steam can cause a spotting or residue on titanium. The same goes for ophthalmic instruments. Cataract surgeons work fast and they require fast turnover times, so steam autoclaving may work for them, if they don’t mind the spotting on the instruments. Technicians working with these instruments on a regular basis know how to clean them properly between cases and they use an abundance of litmus milk to keep down bio-burden and buildup.
If the older hospitals in a particular area have not updated their sterile supply departments, there may be a need to send special instruments out to remote services who can handle the proper sterilization techniques needed. Some physicians will even have autoclaves in their offices in order to handle expensive, specialty instruments they don’t trust to go into the mainstream flow of a huge hospital’s workload.
The technologies may change, depending on the needs of the region, but the standard of care does not. With AAMI standards and the increase of nosocomial infections, hospitals nationwide are brought to a higher standard of practice in the sterile processing areas. Each instrument has a paper trail, each time, each surgery, and each patient. Sterility must be proven beyond a shadow of a doubt for insurability of Medicare/Medicaid assignment for each facility and for prudent and excellent care of every patient, every time.