The sterility of the operating room (OR) is not just a recommended practice, but a requirement that must be met to ensure the safety of patients. Equipment cleanliness has a direct impact on patient safety, and it is your first line of protection against surgical site infections (SSIs). Being a medical specialist, it is essential to follow strict standards of cleaning OR equipment to obtain the best results in the surgical field and guarantee the health of your patients. This article will take you through the steps and considerations that are needed to keep your OR equipment as clean as possible — from all the way to knowing what contaminants are to how to sterilize effectively.
Understanding the Types of Contamination and Risks
In order to clean OR equipment, you need to understand the types of contaminants that are present and pose significant risks. An example could be microorganisms which can attach to surfaces and quickly produce protective barriers called biofilms, which are extremely hard to eliminate after formation. Moreover, organic matter (blood, tissue and other bodily fluids) also supports the growth of many pathogens. You also have the problem of killing highly resistant infectious proteins known as prions and these require special processing. In addition, there is a risk that environmental contaminants, such as air particles and dust may unwillingly contaminate sterile fields.
Pre-Cleaning and Point-of-Use Treatment
The task of attaining a clean surgical instrument starts right after the instrument is used with important pre-cleaning and point-of-use treatment. The cleaning process should be started as soon as the procedure is completed to avoid the drying of organic matter onto the surfaces of instruments, as its removal in the future will be incredibly hard to complete. The use of special enzymatic cleaners is essential since these products possess enzymes that effectively disintegrate protein and other organic substances. In the process of being transported to the decontamination area, instruments must be maintained in a wet condition, which can be achieved by wrapping in a wet towel or soaking in an enzymatic solution. Moreover, when cleaning multi-part instruments, you have to disassemble them fully to reveal all the surfaces so that they can be thoroughly cleaned.
Best Practices and Methods for Cleaning by Hand
Automated systems are more advanced, but manual cleaning is also a central part of instrument cleaning, but it needs to be done with a lot of precision. You need to choose and use the right brushes and detergents that suit your surgical instruments’ designs and materials. It is important that the entire surface of the instruments be totally immersed in the cleaning solution so that the detergent can perform its tasks throughout the surface. Then, vigilant scrubbing is what is required to physically clear all the visible debris and bioburden of each instrument. After scrubbing, it is of uttermost importance to rinse extensively with water to eliminate all traces of detergent, which would otherwise inhibit any further sterilization procedures. Lastly, you are expected to visually check every instrument and see whether it is clean before moving it to the next phase of processing.
Automated Cleaning and Disinfection Methods
Automated cleaning and disinfection processes are key factors to increase efficiency and reusability of surgical instruments. Ultrasonic cleaners, say, will use high-frequency sound waves to form microscopic bubbles that collapse and literally knock out the debris on the most delicate surfaces and crevices of your instruments. Washer-disinfectors are advanced devices which offer an automated wash, rinse and heat disinfection cycle to standardize cleaning. You must really make sure that instruments are properly loaded into these machines, because they can undermine the ability to carry out efficient cleaning cycles due to overloading or poor placement. Moreover, it is really important to follow the manufacturer’s set time and temperature of each cycle because it ensures the best cleaning and disinfection results.
Sterilization Procedures and Monitoring
Sterilization is the final action that makes the instruments safe to be used after proper cleaning and disinfection. You will normally use the usual sterilization techniques of high-temperature steam sterilization (autoclave). Many surgical institutions use such reliable systems as the Midmark m11 autoclave that demonstrates a stable performance that can be used in a clinical setting.
Where heat-sensitive objects are concerned, alternative low-temperature sterilization techniques like ethylene oxide or hydrogen peroxide plasma are used. After sterilization, instruments should be well packed; they should be wrapped properly or in hard containers to maintain their sterility until the moment of use. You should strictly apply biological and chemical indicators to ensure that every sterilization cycle is effective. A record should be maintained of all sterilization instruments to facilitate traceability and quality assurance. Lastly, sterile objects should be kept in controlled conditions to avoid any possibility of recontamination before being introduced in the OR.
Conclusion
The sheer dedication to complete cleaning and sterilization procedures of all OR equipment is not only indispensable but also a part of a healthcare provider’s daily activity. The knowledge of the type of contamination and proper pre-cleaning, the usage of manual methods, as well as the use of high-quality automated systems all lead to a sterile surgical environment. Finally, the direct correlation between scrupulous equipment hygiene and favorable patient safety outcomes cannot be overrated. These are rigorous cleaning measures to which you should be committed, as these are the foundation of responsible and quality surgical care.
