Question

Briefly (in 1-2 paragraphs) present the central ideas of the article “Designing the Sterile Processing Department” by Felipe Mejia and a final paragraph reflecting on its relevance to the discussion of departmental workflow.

Answer 1

“The term 'central,' suggests that services are centralized. The activities of reprocessing soiled goods and sterilizing devices to ready them for the next procedure are conducted in one centralized location.The design criteria will depend on the needs of the OR( operating room ), such as the number of operating suites, expected use, the type of cases that will be performed and the distance between OR and sterile processing. Armed with this information, you canassess the type and quantity of equipment needed to wash the soiled goods; specifically, the number of washers, automated or manual, size, type and numberof cart washers.

The next step is the selection of fixtures and support equipment for the decontam area. The type and number of washers will dictate the number of sinks, washer-ultrasonics, hoppers, etc.  Moving on to the clean side, again, based on the number of washers, it is possible to determine the number and type of steam-sterilizers, gas-sterilizers, plasma sterilizers and other equipment.

Washer Selection:- The key to determining the number of washers is assessing a theoretical average number   of trays and basins per procedure and the average number of procedures per day.

Fixtures and Equipment in the Decontam Area:-Plan for a hopper near the entrance to the decontam area. The next requirement is a sink-station with multiple sinks and counter space to unload soiled items in need of pre-wash. In addition, a number of ultrasonic cleaners may be required.

  Cart Washer:- The key in determining the size and number of cart washers needed is toestimate the average number of carts per surgical procedure. Options include wiping the carts manually, assuming that it will take no more than 10 minutes to wash and dry a cart. If this option is chosen, a washing room with a spray gun is recommended. The cost of this option will be mostly labor, water and chemicals.

Sterile Processing Department Work Flow

The concept of work flow refers to the movement of both people and items through the work area. Work flow progresses from dirty to clean in the sterile processing department in terms of instrumentation, equipment, and carts.The control of traffic through the department must be monitored and maintained by sterile processing technicians at all times. Only allowed entry should be: employed technicians, other approved facility staff, approved vendors, approved service technicans, etc.

In terms of the flow of individuals through the department, movement from clean side (assembly or sterile storage) requires the donning of appropriate PPE prior to entering the decontamination side (soiled side). Prior to moving from soiled (decontamination side) to clean side (e.g., assembly) PPE is to be removed completely and the individual should wash their hands before entering the clean side.

Sterile Processing Work Flow Charts:- first step (Docontamination); second step (Assembly); third step (sterile storage); fourth step (distribution).

• Decontamination - Soiled receiving -Sort & Soak -Cleaning (manual and/or mechanical)
• Assembly - Inspect (for cleanliness and functionality) -Assembly/Preparation -Wrap or containerize (packaging) -Sterilization
• Sterilization Storage - Storage of processed goods
• Distribution -Distribution of sterile goods per facility protocol and need