It is a regulatory requirement to clean and disinfect medical equipment before being used on a patient. Such a practice is also simply the right thing to do. We need to keep our patients and hospital personnel safe.
While that outlook is a no-brainer, the cleaning and disinfection of medical equipment is a complicated responsibility that relies on a thorough understanding of the equipment, its use, workflows, and effective cleaning practices.
Without that knowledge, even the best of intentions can result in troubling consequences. In fact, medical devices can be damaged because of inappropriate cleaning products or practices. The ECRI Institute named that problem as one of its selections for the top health technology hazards of 2017. The damage could be the result of fluid intrusion or chemicals eating away at the cases and parts of the devices. Plastic parts on pumps, scopes, and even robots are not meant to be soaked with liquid so powerful that it will start to break down the plastic.
Responsibility for the cleaning and disinfection of medical devices and equipment typically rests with a hospital’s sterile processing department (SPD). But as the professionals who service and maintain medical devices, we’re in a position to see problems (perhaps the corrosive effects of a cleaning agent), and we have a crucial role to play in the fight against healthcare-associated infections or HAIs.
Our role can manifest itself in two ways. First, when we see equipment that we believe has been damaged by corrosive cleaning products or improper procedures, we must speak up. In my department, we take pictures of the device, open a work order, and make note of the damage and the steps we took to remediate the damage. We will then report the issue to the department that uses the equipment to make sure cleaning is done correctly (this is often hard to find out). An example of this would be if several infusion pumps were delivered to our shop with damage related to cleaning or transport. We would report the problem to the user department and our delivery department.
Second, our partnership role with our sterile processing colleagues also comes into play when we come across contaminated equipment. We have all seen equipment that is filthy when it comes to our shops to repair. In my department, when we see such equipment, we note it through our intradepartmental reporting process as a “non-safe” issue. The report would make its way to the individuals who could act on such matters (again not the easiest process).
I’d like to hear about your experiences. Have you come across equipment damaged during cleaning? What do you do about that? Who keeps track of damaged devices by cleaning products and/or processes? What’s your relationship with your hospital’s SPD?
Second, what is your department’s policy when dirty equipment comes to your shop? How is it handled?
My colleague Rich Fechter and I will speak about infection control and damaged equipment at June’s AAMI Annual Conference & Expo in Austin, TX. I look forward to seeing you. Also, if you’d like to exchange ideas before then, please email me at email@example.com. Let’s start a fruitful and spirited discussion about the major role that the HTM community can play in keeping HAIs down in our facilities.
Donald Armstrong, CBET, CHTM, works in the Clinical Technology and Biomedical Engineering Department at Stanford Health Care in California. He is a member of AAMI’s Technology Management Council.