Chapter 1 (Intro to SPD)

Minimally Invasive Surgery

A Surgical procedure performed in a manner that causes little of no trauma or injury to the patient; it is ofter performed through a cannula using lasers, endoscopes or laparoscopes. compared with other procedures involve small incisions, less tissue damage and bleeding, smaller amounts of anesthesia, less pain and minimal scarring.

One-Way Flow

Soiled Area → Clean Processing Area → Sterile Storage Area

Area’s of SPD

• Decontamination

• Preparation and Packaging(prep and pack)

• Sterilization

• Sterile storage/distribution

Decontamination

To make safe by removing or reducing contamination by infectious organisms or other harmful substances to an acceptable level.

Working in the decontamination area requires

• A thorough knowledge and understanding of microbiology and the decontamination process

• The ability to identify and clean a wide variety of medical devices

• Knowledge about cleaning and disinfecting agents and their proper use

• Proper protocols for waste disposal and transportation of contaminated items

• Operational of cleaning equipment, including:

  • Washer-Disinfectors

  • Ultrasonic cleaners

  • Cart washers, etc.

1st step of sterilization process

Cleaning

Cleaning

The removal of all visible and non-visible and any other foreign material from medical devices being processed.

What does PPE stand for? Definition, What does it include?

Personal Protective Equipment

-Minimizes exposure to blood borne pathogens and other contaminants

It includes fluid resistant protective clothing, disposable gloves, eye protection, face masks and shoe covers.

Preparation and packaging

-after items are safe for handling they are delivered to the prep and pack area of the SPD.

-each item should be carefully inspected for cleanliness, proper function and possible defects

-instruments and other devices should be inspected, packages and labeled in preparation for sterilization

During preparation and packaging what should SPD technicians must be able to do

• Identify hundreds of surgical instruments

• Understand how instruments are manufactured and constructed

• How to test the instruments

• How to best maintain instruments

• Select the proper packaging system

• Use proper techniques for wrapping & packaging items for sterilization

Sterilization

Process by which all forms of microbial life, including bacteria, viruses, spores and fungi, are completely destroyed.

Items to be sterilized must be properly…

Identified so that the correct methods are parameters for sterilization are followed

SPD technicians must understand…

• Principles of sterilization

• Factors that can be compromise sterile packaging

Instructions for use (IFU)

Information provided by a device manufacturer that provides detailed instructions on how to properly use and/or process the device

Sterile storage and distribution

The supply area of SP is dedicated to the storage of sterile instruments and clean or sterile supplies.

The major portion of work in sterile storage and distribution involves

Receiving, storing and dispensing supplies and sterile instruments

Major focus of sterile storage and distribution is?

Servicing the OR and using a case cart system

Case cart system

An inventory control system for products/equipment typically used in a OR that involves use of an enclosed or covered cart (generally prepared for one surgical case and not used for general supply replenishment)

Case cart

A cart prepared for an individual procedure. Case carts usually contain all instruments, supplies and utensils needed for a specific procedure

Doctors preference card

A document that identifies a physician needs for a specific medical procedure preference cards usually contain information regarding the instruments, equipment, supplies, and utensils used by a specific physician. They may also include reminders for the staff of the physicians preferences regarding patient’s draping, Instruments and supplies.

Case cart pull sheet (pick list)

A list of specific supplies, utensils, and instruments for a specific procedure. SP Technicians use these lists to assemble the items needed for individual procedures.

When are instruments and supplies generally gathered

The day or evening before they will be used

Supply chain management

Department that procures and distributes resources and manages supplies, goods, and services to provider’s and patients

Sterile storage & Distribution SPD technicians must be familiar with…

• Inventory control and supply distribution

• Surgical specialties and procedures

• Sterile storage and handling requirements

• Computer systems relating to inventory and cast carts

• Acquisition and disposition of supplies

• Resolution of supply problems

Personnel working in the sterile storage area needs to know?

-Knowledge of every item

-How it’s used

-Where it is located

-The process for obtaining it

-Inventory control and supply distribution

-Surgical specialties and procedures

-Sterile storage and handling requirements

-Computer systems relating to inventory in case carts

-Acquisition and disposition of supplies

-Resolution of supply problems

Some SPD process specialty procedure carts

Such as isolation, urology, and emergency carts

• These carts must be cleaned, inventoried and restocked between patient use

• Some patient care equipment may be processed and stored

Why must air pressure levels be maintained?

Two control air movements, proper air pressure control helps to prevent the flow of bacteria laden particulates and dust from soil to clean areas.

Loaned instruments

Are brought in for specific patient procedure, for evaluation of new technology or to use while existing devices are being repaired.

• There should be a designated location and processes for receiving, processing, distribution, cleaning, and returning.

The processing cycle

• After use, items that can be re-processed or returned to the decontamination area to start the process all over

• Each step in the process items are inspected to ensure that they are clean, in good repair, assembled, and processed correctly, not compromised(packaging)

The most basic level of infection control to prevent transmission of infectious organisms as a result of contact with:

• Blood & body fluids

• Non- intact skin

• Mucous membranes

Standard precautions

Method of using appropriate barriers to reduce the risk of transmission of blood-borne and other pathogens. The standard applies to all patients, regardless of diagnosis or presumed infection status.

Healthcare associated infection (HAI)

An infection that is not present when a patient is admitted to a healthcare facility. If the infection develops in a patient on or after day, three of admission to the healthcare facility, the infection is referred to as HAI.