Spotlight on… sterile services

Michael Binns, quality and training manager with sterile services, explains more about the essential role the department plays in ensuring patient safety and keeping the Trust running.

 

Who are you?

The department is made up of 96 staff who work around the clock to keep CUH, plus external clients such as GP surgeries and neighbouring hospitals, stocked with sterile equipment which is safe to use. This includes instruments for use in theatres and clinics.

 

 

In total, we sterilise around 24,000 items each month including over 10,000 theatre sets.

 

What do you do and why?

Dirty instruments and other items arrive in red boxes or on trolleys. They then go though several processes, including:

1. A 60 minute cycle in a computer controlled washer, consisting of:
1. a low temperature wash at 35ºC
2. a high temperature wash at 60ºC
3. disinfection using reverse osmosis water at 92ºC

 

Items which can be damaged by high heats, such as flexible endoscopes, are cleaned at a lower temperature of 40ºC.

2. Clean items are checked and carefully wrapped in several layers of protective covering. They are sealed with heat sensitive tape which changes colour during sterilisation and acts as an extra safeguard to ensure the process has been successful.

3. The packs are sterilised in the autoclaves using steam heated to 134ºC.

4. Sterilised items are put into blue boxes or trolleys and distributed around the hospital by staff from the department. Boxes are delivered to external clients by the Trust’s courier service.
   
   
5. Barcodes are used to trace every pack that is produced. Each time an item is processed it is issued with a unique unit number so that a complete history can be maintained.

The process usually takes between 18 and 24 hours to complete. However, in an emergency, items can be fast-tracked in four hours.

 

What safeguards are in place?

The department meets the same high infection control standards as operating theatres. A range of measures are in place to minimise the chances of cross contamination while ensuring the sterilisation process has been successful:

• used instruments are washed and disinfected in specialised automated machines
• instruments are checked and packed in a ‘clean room’ environment
• staff wear colour-coded scrubs to show whether they are working in the clean room or the reception area for used equipment
• autoclaves are tested each morning using a pack which changes colour when the steam hits 134ºC to ensure the machines are operating correctly
• if something goes wrong during the cleaning or sterilisation process, an alarm will sound and the process will be started again

The department operates in accordance with ISO 13485-2003 quality standard and is independently audited every six months. The department is registered with the DH as a producer of medical devices.

 

What training do you need?

You need a good education, but not any specific qualifications. New staff spend two weeks in the classroom before going into the department, and receive ongoing training throughout their first year in post.

 

How has the job changed over the years?

The workload has increased as additional operating theatres have opened on site and the department has taken on more contracts with external clients. Staffing levels have doubled over the past 20 years so that the department can continue to meet demand.

 

What does the future hold?

Currently, sets of instruments are traced using a barcode attached to the tray which holds them, which places the emphasis on staff to keep the whole set together at all times. In the future, it is likely that each individual instrument will be marked with its own dot matrix barcode. This will make every piece traceable, but will also increase the amount of time it takes to process each pack as each instrument will need to be scanned at every stage in the process.

 

How can staff help you to do your job?

Make sure instruments from different packs don’t get mixed up and remove any sharps and single use items, such as needles, blades and swabs, before sending them to the department.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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