Steps to help ensure proper reprocessing
VA incident gets lawmakers', lawyers' attention
Medicare's new Conditions for Coverage for ambulatory surgery centers (ASCs), which took effect May 18, include a requirement that ASCs must adhere to professional acceptable standards of practice for infection control. One key to avoiding liability in that area is proper instrument disinfection and sterilization.
The ramifications if the standards are not met can be serious and costly. More than 10,000 veterans might have been exposed to HIV and hepatitis over five years at three Veterans Affairs (VA) facilities while undergoing colonoscopies and other procedures, according to a recent media report.1 The equipment at three VA facilities had not been properly cleaned, according to the report. The VA also is investigating whether there is a connection between improperly sterilized endoscopy equipment and six veterans' positive HIV tests, according to The Associated Press. In response to the incidents, the veterans are being tested, lawmakers are investigating, and lawyers are running Internet ads related to the incident.
To ensure members of your reprocessing staff are meeting the standard of practice, consider the following:
• Hire the right people.
Tammy Turner, RN, clinical manager/administrator at Endoscopic Services in Wichita, KS, looks for applicants who are detail-oriented and "perfectionistic," among other qualities. Turner doesn't automatically hire a technician simply because he or she is a certified medical assistant. "I can always train them the way we want things done here, and maybe they haven't already developed bad habits," Turner says.
Her thoughts on experience are echoed by Stephanie A. Diem, RN, clinical director at Washington Square Endoscopy Center/PHGI Associates in Philadelphia. "We almost prefer individuals with no experience so we can teach them properly," she says. Her center hires graduates of accredited medical assistant programs or surgical technology programs.
Some managers, such as Tammy Mathews, FNP, administrator at Digestive Disease Center of Central New York in Liverpool, prefer to hire techs who have prior hospital experience. They already are trained and come from a facility that meets accreditation standards, Mathews says.
• Give them proper training.
At Endoscopic Services, "the reprocessors/medical assistants are trained by an experience reprocessor, and they remain in training — for an acceptable time frame of course — until they understand the process and can perform it properly," Turner says.
The center also uses a training video supplied by its vendor, Olympus America in Center Valley, PA.
At Washington Square, reprocessors are given hands-on supervised training for at least eight weeks with print material and video training. "They are trained by senior technicians who have attended basic and advanced continuing education seminars through Olympus University," Diem says, refer to Olympus' courses that offer continuing education units. "We keep a 'dissected' scope, so they can understand the intricacies of the scope," she says.
• Offer continued education and training.
At Endoscopic Services, the vendor conducts yearly inservices for the entire staff on reprocessing. Also, reprocessing staff participate in continuing education courses. "At times, the reprocessors have gone to the Olympus warehouse to see the inside of the scopes, how they are made, and how to reprocess," Turner says. Annual competencies address reprocessing.
Any updated literature that Turner finds through the Society of Gastroenterology Nurses and Associates (SGNA) or her vendor are posted on a communication board.
At Washington Square, the vendor has participated in educational seminars during special occasions such as celebration of Gastrointestinal Week. Also, "as new technology or standards become available, senior technicians train and implement and monitor," Diem says. "Senior technicians perform PI [performance improvement] monitoring activities and implement interventions as needed," she says. Her center is signing up all of its technicians to attend basic training at Olympus University, Diem says.
Each Washington Square senior technician has been certified as a GI technical specialist (GTS) and an advanced GI technical specialist (AGTS) through SGNA. (Editor's note: For more information, go to www.sgna.org/Education/associates.cfm.) "Other staff members are encouraged to become certified," Diem says. The center pays for the certification, and many have completed their GTS, she says.
Proper hiring and training can lay the groundwork for an infection control program that meets accepted standards of care, sources say. Members of Turner's staff tell her, "We know what we want in our body, so we don't cut corners and do it right the first time!"
Reference
- Pifer-Bixler J. VA looking into possible contamination at medical facilities. CNN. April 7, 2009. Accessed at edition. cnn.com/2009/US/04/07/va.investigation/index.html.
Resources
Olympus offers several resources:
- For information on Olympus University, go to www.olympusuniversity.com/medical/default.aspx.
- Olympus offers free training videos on reprocessing of Olympus GI endoscopes and bronchoscopes, as well as ultrasound endoscopes. To obtain videos, go to www.olympusamerica.com/cds.
- Additional information on proper reprocessing, care and maintenance instructions, government and industry guidelines, and infection prevention and educational information can be found at www.olympusamerica.com/cds.
The Certification Board for Sterile Processing and Distribution offers a new certified flexible endoscope reprocessor exam. Additional information is available at sterileprocessing.org.
Additional reprocessing information is available through Myendosite.com and Disinfectionand Sterilization.org.
Medicare's new Conditions for Coverage for ambulatory surgery centers (ASCs), which took effect May 18, include a requirement that ASCs must adhere to professional acceptable standards of practice for infection control. One key to avoiding liability in that area is proper instrument disinfection and sterilization.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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