Tag Archives: online CE courses

Feb 22, 2017

The value of a positive vaporized hydrogen peroxide sterilization monitoring biological indicator

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The value of a positive VH2O2 BI

Sterilization monitoring expertise 

Since the 3M™ Attest™ System was created, it has monitored over 850 million sterilization cycles worldwide for steam and ethylene oxide. That same scientific research and development is now applied to the vaporized hydrogen peroxide (VH2O2) sterilization modality, which to-date has monitored approximately 500,000 cycles and has since received industry recognition as a 2016 Excellence in Surgical Products (ESP) Award winner!  With all of the information collected over the past four decades from users, we have become experts when it comes to biological indicator sterilization monitoring in healthcare facilities.

Challenging sterilization practices

Asking questions and researching technologies are some of the most important things anyone can do to become better and more efficient – and that is how we work. Biological indicators (BIs) by definition provide a strong challenge – they are the only monitor containing viable microorganisms and are intended to demonstrate whether or not the conditions were adequate to achieve sterilization.  Over the past few months the 3M Monitoring Technical team has been having great conversations about vaporized hydrogen peroxide sterilization. Some users of the 3M™ Attest™ Rapid Readout Biological Indicator 1295 for Vaporized Hydrogen Peroxide have seen positive biological indicators (failed cycles). To some this was alarming, since they have never experienced a failed load with vaporized hydrogen peroxide sterilization – but to us, this was an opportunity to really look at what was happening inside these sterilizers. Working together we discovered some very interesting real world challenges. We found common errors that caused positive BI’s due to the following:

  • Improper loading of the sterilizer chamber
  • Overloading the sterilizer chamber
  • Use of  incompatible materials
  • Over filling rigid containers
  • And, even using the wrong type of packaging

Some of these issues can change the chemistry of the vaporized hydrogen peroxide sterilant resulting in decomposition – meaning the molecular bonds come apart and/or change making the cycle less effective/lethal for some items in the load.

The fact that these conversations are now happening in the industry, and throughout the world, is good news! This dialogue is now helping sterile processing departments learn more and raise the standard of safety they deliver to the operating room and patients. Speed will always be important, but there is also tremendous value with consistency across sterilization modalities, and the advantage of support beyond a single modality. These materials are some of the most common and useful tools we have been delivering users:

For more help and live support you can talk to a sterilization monitoring technical expert by phone (1-800-441-1922, option 2)or submit a question online.

Nov 1, 2016

Sterilization monitoring help is here! Get answers to your questions and learn best practices from experts.

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Sterilization Monitoring Technical Support

Are you a sterile processing manager or technician? Do you need a live technical support team to help troubleshoot undesirable events?

Over the past 30+ years, the 3M Sterilization Tech Line has received thousands of calls from sterile processing managers and technicians who need help or guidance on best practices. Time and time again, sterile processing departments have trusted the 3M team to provide the correct information referencing standard recommendations to help overcome challenges faced every day.

I take my job seriously. From healthcare facilities, to sterile processing departments, to patients, they all depend on us for answers. Each year our team completes many hours of CEUs, engage in national and local sterile processing chapter meetings, attend and participate in the national AAMI standard conferences, and travel globally to take part in the international ISO standards meetings. We stay current on sterile processing best practices, guidelines, and recommendations so we can tackle questions from across sterilization modalities (steam, ethylene oxide, and vaporized hydrogen peroxide).

Sterile Processing technical support; from cleaning to sterilization monitoring is free

We take a firm stance to make sure sterile processing departments get help when they need it. That means when you call one of us, you get support from all of us.

There are a several ways to get help when you need it

  • Submit your question online: a new feature that allows customers to ask a question and have a sterilization monitoring expert call back.
  • Call our 3M Sterilization Tech Line for live technical support: we have always had a technical helpline for quick access to answers. It’s easy to reach an expert at 1-800-441-1922 option 2.
  • We have experts in the field near you!  Typically for complex issues we may send out a Field Technical Consultant who can help troubleshoot at your facility on-site. We investigate at the source, conduct root cause analysis, and provide a solution or two to help your department to keep moving forward.
  • On demand best practice learning and education courses: one of the best things any sterile processing manager or technician can do is to continue to learn. We work hard to make courses convenient about topics that are relevant to issues we hear about.

Some recent interesting questions from sterile processing departments

I thought that I would share a few recent questions/answers 3M has received from sterile processing departments that I think are interesting and may be helpful to you.

Question: What type of BI PCD does AAMI ST-79 say to use for steam IUSS cycles?

Answer: AAMI ST79 10.7.4.1 A representative of the same type of tray to be routinely processed through by immediate-use steam sterilization should be selected to serve as the PCD (BI challenge test tray). Each type of tray configuration in routine use for IUSS should be tested separately.

Question: What Type or Classification of internal chemical indicator should I use for vaporized hydrogen peroxide sterilization monitoring?

Answer: AAMI ST58 2.14 under the note 1 definitions states Chemical indicators Class 2–6 are not applicable to monitoring the LCS/HLD/gaseous chemical sterilization processes described in this document.

Question: I heard ethylene oxide sterilization was banned in my state?

Answer: This is a very common misconception. All 50 states allow the use of ethylene oxide sterilization in healthcare facilities. The facility just needs to follow any state, local or regional regulations for installation and routine use.

For those of you who are reading this and I have had the pleasure of talking with you over the phone or during a visit I just want to say hi and keep monitoring!

Mar 9, 2016

Applying the Science of Human Factors Engineering to Medical Device Reprocessing

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Endoscope Reprocessing with elevator down

You may not have heard about human factors engineering. But without question, the underlying concepts lie at the heart of what you do every day in a busy Sterile Processing department.As you strive to manage and improve processes and procedures to keep your department running efficiently, human factors provides a new perspective, and, quite possibly, new inspiration. Put simply, human factors is the science behind how we as humans relate to our processes, work methods, and environments. Where do we operate at our most productive levels? Where do we make errors? Why, and how, do we improve? A slightly less general view involves engineers solving the problems that arise when humans integrate with devices and systems, using the scientific method – testing and gathering data, rather than depending on common sense or simple “gut feel.” The specifics are exciting. Beginning with medical device manufacturers, human factors can help to design and verify the processes used for medical device reprocessing. It can include how processes and procedures are communicated for maximum understanding and compliance. It can even include the design of the instruments themselves. In your department, applying human factors engineering can help you define processes that can be performed in your specific, real-world environment. It can also help you establish education, training, and competency verification tools to ensure staff have the necessary information and skills. 3M would like to invite you to learn more about human factors. Our educational webinar, How can Human Factors Engineering Concepts be Applied to Medical Device Reprocessing? explores how human factors affects the design of medical devices and processes. You’ll learn about:

  • How human factors engineering affects instrument and instrument set design
  • Proper design and content of Instructions for Use (IFUs)
  • Design of reprocessing procedures
  • Applying protocols
  • And much more.

Facilitated by 3M’s Christophe de Campeau and Dorothy Larson and featuring Susan Klacik, CSS Manager at St. Elizabeth’s Healthcare, Youngstown, OH and educational consultant to 3M Health Care, this presentation also features case studies that illustrate how human factors can make a difference in any department. View this webinar and other webinars about Sterile Processing at 3M Healthcare Academy.

Sep 3, 2015

The Science Behind Patient Warming and the Benefits of Normothermia

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Perioperative Patient Warming

Read the study summary – Target Normothermia: A Global Focus on Inadvertent Hypothermia

Thermoregulation

Under normal circumstances, the body controls its temperature within a very tight tolerance, with the core being 2-4˚C warmer than the periphery. This temperature gradient between the core and the periphery is caused by normal thermoregulatory vasoconstriction. Anesthesia induction results in vasodilation, which allows the warmer blood to flow freely from the core and mix with the blood from the cooler periphery, lowering the core body temperature. Research has shown that in the first 60 minutes under anesthesia unwarmed surgical patients can lose up to 1.6˚C1,a phenomenon known as redistribution temperature drop (RTD).

Unintended perioperative hypothermia

Unintended hypothermia remains a common—but easily preventable—complication of surgery.2 It is estimated that unintended hypothermia, defined as a core body temperature of less than 36.0°C (96.8°F), occurs in more than 50% of all US surgical patients, even those undergoing short procedures (one to one-and-a-half hours).3

Numerous studies have demonstrated that even mild perioperative hypothermia can result in significant complications. Unfortunately, temperature management of the surgical patient remains a secondary consideration in many perioperative settings rather than an essential standard of care.

Benefits of normothermia

The benefits of maintaining normothermia have been thoroughly researched and documented in independent peer-reviewed articles. A number of these studies are randomized controlled studies that document the importance of preventing hypothermia.

In a landmark meta-analysis performed by Chris Brown Mahoney, she captured the essence of earlier research which identified dramatic decreases in the complication rates and the related patient care costs that can be avoided by keeping patients normothermic. Normothermia is a process improvement that touches the entire patient care algorithm. This meta-analysis of 20 studies covering 1,575 patients identified reductions in patient costs in several different areas when normothermia is maintained such as:5

  • Reduction in the use of blood products
  • Shortened length of hospital stay
  • Decreased ICU time
  • Reduced rate of wound infection
  • Decreased likelihood of myocardial infarction
  • Lower mortality rates

There is also a significant financial benefit of reducing hypothermia rates in surgical patients. Maintaining normothermia can result in savings of $2,500 to $7,000 per patient by eliminating the costs of hypothermia-related complications, including surgical site infections.5

Study Summary: Target Normothermia: A Global Focus on Inadvertent Hypothermia

References
  1. Sessler DI, Current concepts: mild perioperative hypothermia. N Eng J Med 1997; 336: 1730-1737.
  2. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 1996;334:1209–1215.
  3. Young VL, Watson ME. Prevention of Perioperative Hypothermia in Plastic Surgery. Aesthetic Surgery Journal. 2006;26(5):551-571.
  4. Sessler DI, Kurz A. Mild Perioperative Hypothermia. Anesthesiology News. October 2008: 17-28.
  5. Mahoney CB, Odom J. Maintaining intraoperative normothermia: A meta-analysis of outcomes with costs. AANA Journal. 1999;67(2):155-164
Aug 25, 2015

Surgical Site Infections Don’t Just Affect Patients

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Surgical-Site-Infections-Don't-Just-Affect-Patients
Surgical Site Infections Don’t Just Affect Patients

Prevention of surgical site infection (SSI) is a major component of patient safety and a very high priority for healthcare facilities. Patients undergoing surgical procedures are at risk of infection, and the role of every healthcare provider is to assist in preventing an infection. A surgical site infection can be minor or it can lead to death. When surgical site infections do occur, the impact is felt by the patient and the patient’s family and/or support system.

The healthcare facility, where the infection occurs, is also impacted. The impact is not only financial but can also adversely affect the reputation of the facility where the surgery was performed. The battle to prevent surgical site infection begins with an understanding of important facts:

Surgical Site Infection is a Common Complication 1

• Up to 60% of SSI may be preventable by use of evidence-based guidelines
• SSI occurs in 2-5% of patients undergoing inpatient surgery
• Approximately 160,000 – 300,000 SSIs occur each year in the US
• SSI represents 20% of all healthcare-associated infections (HAI) in hospitalized patients
• Each SSI increases length of stay (LOS) by approximately 7 – 11 days
• SSI is now the most common and costly HAI
• SSI is associated with 2 – 11 times higher risk of death compared with operative patients without SSI
— 77% of death in patients with SSI is directly attributable to that SSI
• Attributable costs of SSI depend on the type of operative procedure and the infecting pathogen
— Believed to account for $3.5 – 10 billion annually in health care expenditures

Top-Ranking Surgical Site Infection Pathogens (2009-2010)2      

    1. Staphylococcus aureus — 30.4%
    2. Coagulase-negative staphylococci — 11.7%
    3. Escherichia coli  — 9.4%
    4. Enterococcus faecalis — 5.9%
    5. Pseudomonas aeruginosa — 5.5%
    6. Enterobacter spp. — 4%
    7. Klebsiella pneumonia — 4%
    8. Enterococcus spp. — 3.2%
    9. Proteus spp. — 3.2%

How Much Do You Know About Surgical Site Infections?

Test your knowledge and learn more about surgical site infection risk reduction strategies and the role of nasal bacteria. Take the free self-study 3M℠ Health Care Academy course about nasal antiseptics and earn one nursing continuing education contact hour. Or, you can read a summary of clinical data supporting nasal antiseptic efficacy.

 

1Anderson DJ, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 Update. Infect Control Hosp Epidemol. 2014;35(6): 605-627.
2Sievert DM, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemol. 2013;34(1):1-14.