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“Everything we do is about quality and patient safety,” says Debbie Church, Medical Device Reprocessing supervisor. “If we don’t follow our standards and procedures, there’s a risk of infection transferring from one patient to another when that equipment is reused. We may not provide direct patient care but we have big patient impact.”
More than 8,000 surgeries took place at the IWK last year. In that same time period, care was provided for almost 15,000 inpatient admissions and there were well over 200,000 visits to IWK clinics. That’s a lot of care, and a lot of equipment.
Preparing that equipment for use between patients is a never-ending task and is the responsibility of the IWK’s Medical Device Reprocessing team (MDR). MDR is made up of 22 specifically trained technicians, MDR/operating room liaison, Sherry Piercey, supervisor, Debbie Church, and manager, Carolyn Doucet.
It’s their job to ensure that all reusable critical, semi-critical and non-critical medical devices used between patients are cleaned, disinfected and/or sterilized to the highest level. To do that takes a lot of time, documentation and adherence to strict quality standards.
Even seemingly simple devices, such as scissors or a multiple instrument set, can require nearly four hours of work across many steps, all with their own required steps and record keeping, to prepare for use.
To start, items should be pre-cleaned at the bedside or in the operating room.
They’re then contained and transported to MDR.
Once items arrive to MDR, they’re completely disassembled or opened to expose all surfaces and sorted according to the specific cleaning method required for each item.
MDR technicians then manually clean items to remove remaining debris. Some devices, like hinged instruments or scissors, and suctions, are also placed in an ultra-sonic wash to further clean and remove debris trapped in hard to reach places.
Items are further cleaned and thermally disinfected in the washer/disinfector machine before being inspected for cleanliness and functionality. They’re reassembled according to an exact write-up and picture based on manufacturer instructions. This could be as simple as assembling something with one to two instruments or as complex as an implant tray with hundreds of screws and plates.
Now clean, but not yet sterilized, items are paired with an internal integrator and then appropriate packaging is applied and labelled according to the owner. Each package has an external indicator added to differentiate between sterilized and not sterilized.
The packaged devices are now ready to go into the sterilizer as the final step to be ready for use again.
Monitoring of sterilization is documented and maintained for quality assurance.
To top it off, those devices also need to be processed according to their unique manufacturer’s instructions which outline what needs to be done to ensure all cleaning, disinfection and sterilization parameters are met.
“We might have two devices and they may look totally identical but they’re from two different manufacturers, so it’s two totally different processes,” says Wade Paris, MDR technician. “It takes many procedures and processes to get equipment on the shelf.”
MDR is a high-volume, 24/7 service but attention to detail, quality and thorough record keeping are essential to their success and the safety of IWK patients.
“Our motto is the patient always comes first, which our highly qualified technicians implement daily in their work,” says Church.