РЕШЕНИЯ ДЛЯ СТЕРИЛИЗАЦИОННЫХ ОТДЕЛЕНИЙ

Sterile Processing Solutions

 

STERILE PROCESSING SERVICE (SPS)

PLANNING AND DESIGN CONSIDERATIONS (SPS)

The Sterile Processing Service main function is to ensure adequate and timely provision of properly cleaned, disinfected and sterilized semi-critical and critical Reusable Medical Equipment (RME) for all supported clinical procedure rooms in the facility (ORs, DTRs, Specialty Procedure Rooms, etc.). Thus, instrument sets, patient care equipment, and other medical devices must be processed and distributed in an accurate and timely manner so that veterans care is not adversely affected. SPS workflow begins with the recapture of all RME at the point of use and ends with reprocessing and packaging of sterilized RME before delivery to the point of use. Thus, SPS’s role in the provision of quality healthcare services to Veterans is of utmost importance. The Sterile Processing Service role and function at the Department of Veterans Affairs is regulated through various Directives, Handbooks and Policies; refer to the most current. The following documents were reviewed during the development of this Design Guide: VHA-D-2009-04; VHA-D-2009-31; VHA-D-2009-62; VHA-D2010-18; and VHA-D-2011-37. 

Based on PG-18-9: 285 Sterile Processing Service is organized into six functional areas:

1: Decontamination Area

1. Receive, decontaminate and prepare instruments for sterilization.
2. Specific Activities: Receive soiled instruments and case carts, chemical disinfection of Reusable

Medical Equipment (RMEs), cart cleaning, automated cleaning of instruments, instrument

loading into reprocessing equipment, and manual cleaning of instruments.

Equipment: ссылки на каталог

Decontamination sink:

–             Three-basin sink with counter for two-room –

–             Two-basin sink for one-room   

Decontamination Room – Endoscopy

–             Two-basin sink with a backsplash at least 12 inches high-

Instrument Air*:

Sterile Processing vs. Endoscopy

• Instrument air provided for both

–             Endoscopy Processing room

–             Sterile Processing room

• Necessary for drying/clearing lumens

Pre-cleaning systems

TBJ’s Hydro-Force rinse system

Disassembly details

Key Surgical’s Mesh Bag helps keep small parts together

Harmful fumes and odors

Belimed Protect family line

Instrument complexity

Summit Medical’s General Purpose Brushes

Visual inspection

Flexible Inspection Scope from Healthmark Industries

Ultrasonic Cleaners

Ultrasonic Cleaners are often used as the first step in the reprocessing of RMEs. This piece of equipment uses sound waves, water, and detergents to provide an initial cleaning of the instruments. Ultrasonic Cleaners may be either freestanding or tabletop.

Washer / Disinfectors

After the instruments are manually cleaned, they are passed through a Washer / Disinfector and proceed from Decontamination (soiled) to Preparation and Assembly (clean). Washer / Disinfectors use water and detergents to process instruments following manual decontamination and/or ultrasonic cleaning. After this process, the instruments are considered “clean”.

Waste Management

Provide appropriate waste receptacles strategically located for the collection of non-infectious waste that occurs from normal Sterile Processing Service operations. Regulated medical waste containers/receptacles, and sharps collection containers shall be available in the Decontamination and Soiled Workroom to handle items that may inadvertently arrive in SPS from user areas. Linen hampers may also be located in the Decontamination and Soiled Workroom to collect soiled reusable surgical towels that may be returned with certain instrument sets.

 

2: Scope Processing Area

1. Receive, decontaminate, clean / disinfect and store all types of scopes.
2. Specific Activities: receive soiled scopes, chemical disinfection of scopes, automated cleaning of

scopes (AER), manual cleaning of scopes, and scope storage and staging.

 

 

Equipment: ссылки на каталог

Washer / Disinfectors

After the instruments are manually cleaned, they are passed through a Washer / Disinfector and proceed from Decontamination (soiled) to Preparation and Assembly (clean). Washer / Disinfectors use water and detergents to process instruments following manual decontamination and/or ultrasonic cleaning. After this process, the instruments are considered “clean”.

Automatic Endoscope Reprocessors (AER)

AERs are a fully automated device for testing and high-level disinfection of various types of flexible fiber optic scopes. These devices are used to minimize hand washing and eliminate soaking scopes in toxic chemical agents. AERs can foster standardized scope re-processing and promote consistent levels of disinfection.

3: Preparation and Assembly Area

1. Inspect, repair and test RMEs and assemble into Instrument Sets along with prepackaged soft

goods.

2. Specific Activities: instrument testing and inspection, instrument packaging and wrapping,

inventory of single instruments, instrument maintenance and repair, and instrument tracking.

Equipment:

 

4: Sterilization Area

1. Sterilize Instrument Sets.
2. Specific Activities: monitor sterilization cycles, maintain sterilizers, cooling and handling of

sterilized packages, and infection prevention and control.

 

Equipment: ссылки на каталог

Steam Sterilizers

Steam Sterilizers reprocess instruments that can withstand a high temperature. Sterilizer units are available in various types including cart and floor loading, single door and pass through, and free standing and recessed.

Low Temperature Sterilizers

Low Temperature Sterilizers are used for instruments that cannot withstand high temperature sterilizations. Most commonly used is Gas Plasma in which instruments are sterilized using hydrogen peroxide. Older models use a plasma form of hydrogen peroxide while the later technology uses vaporized hydrogen peroxide. This process may be used to sterilize metal and non-metal instruments and moisture sensitive instruments. Desirable features of HP sterilizers include data and network connectivity, easy to clean surfaces, and multiple cycle options.

EtO Sterilizers

A less commonly used Low Temperature Sterilizer system uses ethylene oxide (EtO). This gas is extremely flammable, is toxic, and has been classified as carcinogenic. As a result, this method of sterilization has been phased out of most SPS departments.

 

5: Receiving, Storage and Dispatch Area

1. Assemble Case Carts with Instrument Sets and additional medical instrumentation and stage

them for transport to the point of use.

2. Specific Activities: store sterile supplies and instruments; assemble case carts, track, and

dispatch of sterile supplies to Surgical Service and other clinical areas.

Equipment: ссылки на каталог

 

6: Staff and Administrative Area

1. Space for staff and administrative functions.
2. Specific Activities: provide office and workstation spaces, conference and training areas, and

staff lounges, lockers and toilets.

Equipment: ссылки на каталог

 

Equipment list:

Washer-Disinfectors

Steam Sterilizers

WASHING AND DECONTAMINATION SYSTEMS

Plasma sterilization https://www.steris.com/healthcare/products/mobile-sterile-processing/

V-PRO® LOW TEMPERATURE STERILIZATION

LIQUID CHEMICAL STERILIZATION

SURGICAL INSTRUMENT CLEANING CHEMISTRIES

STERILITY ASSURANCE & MONITORING

STERILIZATION POUCHES AND TRAYS

PERSONNEL MONITORING

DEVICE COMPATIBILITY MATRIX

STERILE PROCESSING DEPARTMENT ACCESSORIES