How training helps hospitals get reprocessing right

By Leslie Small

For sterilization expert Mark Duro, the most important factor in safe reprocessing--or sterilizing a reusable medical device before its next use--is not the what, but the who.

"It all comes back to the people that are doing the reprocessing," Duro, pictured right, the director of sterile processing operations at New England Baptist Hospital, a 141-bed hospital in Boston that specializes in orthopedic procedures, told FierceHealthcare in an exclusive interview. He said that while his hospital uses only certified registered sterile processing technicians who have completed a college-accredited course, only New York and New Jersey require it.

Though there are plenty of guidance documents and software available to help reprocessers, simply following instructions often is not enough to ensure the process is safe, he said, likening such an approach to allowing someone who is not a mechanic to work on a car.

"There's a lot of professions out there that require certification or licensure, but when you think about what we're doing, when it comes to instruments that are going into someone's human body, and there's that chance that someone can get an infection, I think you want to have a trained person handling that equipment," Duro said.

And while staff must take care to exactly follow manufacturers' instructions when reprocessing medical devices, in some cases the instructions themselves must improve, he said.

Indeed, the carbapenem-resistant Enterobacteriaceae (CRE) outbreaks caused the Food and Drug Administration (FDA) to tighten its guidelines for manufacturers, requiring that they prove future versions of the devices can be cleaned safely before they enter the market. That move may have been a reaction to reports that Olympus changed the design of one of its scopes in 2010 and marketed the device without FDA approval and that the device manufacturers' tests of their recommended cleaning protocols were flawed.

Cleaning any type of flexible scope, including the duodenoscope, is a challenge for reprocessers because there are "lots of nooks and crannies where bugs can hide," Duro said.

Though his hospital specializes in orthopedic procedures and therefore does not use duodenoscopes, Duro said Baptist does biological testing on every reprocessing load that it runs. But for complex devices like the duodenoscope, individual testing may be the best way to go, he added.

How training helps hospitals get reprocessing right