2.1 UNLOADING MECHANICAL WASHER DISINFECTOR MACHINES
PURPOSE
To ensure Workplace Health & Safety instructions are followed for staff safety and to assist in the prevention of damage to instruments.
WORKPLACE HEALTH AND SAFETY CONSIDERATIONS:
ˆ Equipment will be hot, wear/use operator hand protection ˆ Do not lift heavy washer disinfector baskets ˆ May be pooling of hot water in anaesthetic/other tubing ˆ Use only designated trolley
OPERATING PROCEDURE 5_
ˆ Take care when opening the doors and unloading, as there may be residual heat and moisture
in the machine
ˆ Check that the load has not been dislodged and that items are not displaced ˆ Unload the baskets, avoiding conditions that may damage the equipment/instruments and that
may injure staff
ˆ Inspect the load, if excess water is noted the following may need to be checked: the machine
temperature, amount of rinse aid going into the machine or the way in which the machine was loaded. If the problem persists report to shift supervisor immediately
ˆ Place instrument baskets into dryer or onto designated work benches if equipment is dry ˆ If staining appears on the equipment, report to the shift supervisor immediately ˆ Return any item that appears dirty or badly stained to the cleaning area
Reference: AS/NZ4187 - Sections 2, 7, 8 & 11
COMPETENT ˆ _ Meets current best practice
requirements. _ Review annually. ADVANCED BEGINNER ˆ _ Requires re-assessment within 1
month.
NOVICE ˆ _ Requires immediate action by
manager to manage risk.
_ Requires re-assessment in 1 week.
2.2 UNLOADING OF DRYING CABINET
PURPOSE
To ensure that all items prepared for sterilising are dry.
NB. Incorrect drying can lead to rusting, pitting and corrosion and affect the sterilants’ effectiveness.
OPERATING PROCEDURE 5_
ˆ Record temperatures and maintenance on a control document - daily
ˆ If the dryer temperature is too hot or too cold report this immediately as over or under drying can have
a detrimental effect on the equipment
ˆ If the machine is a pass through, only open the door on the clean side when the door on the dirty
side is closed
ˆ If items are still wet return to the drying cabinet
Reference: AS/NZ4187 - Sections 2, 7 and 8
COMPETENT ˆ _ Meets current best practice
requirements. _ Review annually. ADVANCED BEGINNER ˆ _ Requires re-assessment within 1
month.
NOVICE ˆ _ Requires immediate action by manager
to manage risk.
_ Requires re-assessment in 1 week.
2.3 ORGANISATION OF PACKAGING TABLE
PURPOSE
To ensure clean, safe work working area that reduces the risk of equipment damage/loss and unsafe work practices.
OPERATING PROCEDURE 5_
ˆ Wrap and pack items on clean, designated work benches, bench space is to remain uncluttered ˆ When sorting items, if unsure what the item is or where it goes, ask for help, as the item may be an
integral part of the equipmentBe responsible for your own workspace and restock equipment as required
ˆ Utilise the department’s manuals, cards or computer for clear identification of instruments and trays. If
information or equipment required is missing, report to the shift supervisor
Reference: AS/NZ4187 - Sections 8 & 11
COMPETENT ˆ _ Meets current best practice
requirements. _ Review annually. ADVANCED BEGINNER ˆ _ Requires re-assessment within 1
month.
NOVICE ˆ _ Requires immediate action by manager
to manage risk.
_ Requires re-assessment in 1 week.
2.4 EQUIPMENT SET UPS
PURPOSE
To ensure consistent patterns/protocols for assembling trays of instruments and other equipment prior to wrapping and sterilising enables efficiency and accuracy of surgical procedures.
OPERATING PROCEDURE 5_
ˆ Check that equipment / instruments are clean, rust and stain free and without damage ˆ Damaged instruments are to be removed from circulation and reported to shift supervisor ˆ Prepare equipment for sterilisation:
ˆ Check multi-part equipment / instruments are assembled and functioning and are then
disassembled or loosely assembled for sterilisation
ˆ Hinged or ratchet instruments are opened and unlocked ˆ Follow the predetermined list or packaging order
ˆ Select the appropriate size tray to assemble instruments giving consideration to size, mass and
contents of tray
ˆ When packaging hollowware sets:
ˆ Opening are to face in the same direction, ˆ Hollowware should not be able to move, and ˆ If hollowware is nestled insert separators
ˆ Remove all spilt or cracked plastic hollow-ware
ˆ If metal hollow-ware is dented in any way, report to shift supervisor
ˆ Individual packs do not include combinations of hollowware, instruments, dressings, drapes or tubing
Reference: AS/NZ4187 - Sections 2, 3, & 13
COMPETENT ˆ _ Meets current best practice
requirements. _ Review annually. ADVANCED BEGINNER ˆ _ Requires re-assessment within 1
month.
NOVICE ˆ _ Requires immediate action by
manager to manage risk.
_ Requires re-assessment in 1 week.
2.5 WRAPPING / PACKAGING / LABELING
PURPOSE
To provide a protective barrier against sources of potential contamination. Wrapping/packaging methods must allow aseptic removal of contents.
OPERATING PROCEDURE 5_
ˆ The method of wrapping shall be envelope fold or square fold technique ˆ Check wrapping material to ensure that it is not damaged before use.
ˆ The type and method of wrapping and packaging is facility specific and in consultation, the Manager of
Sterilising Services and the Manager of Operating Theatres decide the type and method of wraps to be used
ˆ The density and size of the pack is determined at each facility during performance qualification testing ˆ Sharp objects shall be protected with tip protectors
ˆ Assembly of packs shall allow sterilant contact with all surfaces of the pack contents; all hinged
instruments are to be opened
ˆ Internal chemical indicators can be used in wrapped items. This is determined by each facility ˆ Writing on wrapping could damage the integrity of the material
ˆ The tape used for sealing will be specific to the mode of sterilisation (pressure sensitive, non-toxic and
adhere to clean surface);
ˆ Specific indicator tape must be used when sealing wrapped items ˆ Ensure tape is adhered to wrapping/packaging material ˆ Flexible packaging materials
ˆ Correct size pouch for contents
ˆ Hollowware openings are against non-laminate surface ˆ Only write on the outer parameter of the flexible packaging material.
Labelling of packs:
ˆ Prior to sterilising process
o Use a non-toxic solvent based felt tip pen o Pre-printed labels
o Rubber stamps using similar ink o Batch labels (piggyback) o Pre-printed tape
o Write on tape
ˆ Labelling is clear and precise for easy identification and recall if required
o Labelling shall include name of item, signature of person wrapping the item, date item wrapped
Reference: AS/NZ4187 - Section 3
COMPETENT ˆ _ Meets current best practice
requirements. _ Review annually. ADVANCED BEGINNER ˆ _ Requires re-assessment within 1
month.
NOVICE ˆ _ Requires immediate action by
manager to manage risk.
_ Requires re-assessment in 1 week.
2.6 OPERATION OF THE HEAT SEALER
PURPOSE
To ensure correct sealing of the flexible laminated packaging material so that items when sterilised and stored
they are protected against contamination. Correct heat sealing must allow aseptic removal of package contents.
TESTING PROCEDURE 5
ˆ Clean external parts of the heat sealer with a non-linting cloth ˆ Turn the power source to on
ˆ Check the temperature switch on the machine is at the correct setting as per manufacturer instructions
ˆ Run laminate/paper pouches/bags through the machine Test each type of laminate/paper pouches/bags sealing daily and examine for strength and integrity of seal prior to and following the sterilising process
ˆ Record results on the control document
ˆ Inspect for a good closure, continuous, even pressure ensuring no gaps in seal line, report sealing
failure to shift supervisor
ˆ When not operating leave machine switched on in stand-by mode (varies with machines)
OPERATING PROCEDURE 5_
ˆ Engage roller operation as per manufacturer instructions
ˆ Insert unsealed end into machine and seal laminate to non-laminate with a continuous adhesive seal of
3 to 15mm
ˆ When using flexible packaging cut to size from a roll, check the ‘opening’ end, indicated by an icon on
the sealed sides of the roll, and leave sufficient tabs beyond the seal to the cut edge to enable aseptic removal of contents
ˆ Support item on the way through roller.
ˆ When finished place item in a basket to be transported to the sterilising area. ˆ When not operating leave machine switched on in stand-by mode (varies with machines)
MONITORING PROCEDURE 5_
ˆ Monitor temperature of heat sealer
ˆ Every 6-12 months the heat sealer is to undergo preventative maintenance, including temperature
calibration.
Reference: AS/NZ4187 - Section 3, 7 & Appendix F
COMPETENT ˆ _ Meets current best practice
requirements. _ Review annually. ADVANCED BEGINNER ˆ _ Requires re-assessment within 1
month.
NOVICE ˆ _ Requires immediate action by
manager to manage risk.
_ Requires re-assessment in 1 week.
2.7 REPLACEMENT OF STOCK
PURPOSE
To improve efficiency in work practice.
OPERATING PROCEDURE 5_
ˆ Check your stock levels at the beginning of a shift to reduce delays in production. Daily replenishment
of stock is required by all shifts
ˆ If you use the last of the stock in a production area, it is the your responsibility to replace the stock ˆ Know where your bulk storage is located
ˆ If stock in the storeroom is low inform the shift supervisor
ˆ Storage containers / shelves that hold stock are required to be cleaned at regular intervals. Check the
departments environmental cleaning plan
ˆ Identification of stock and stock numbers shall be available ˆ Uphold stock rotation when removing required stock from a shelf
Reference: AS/NZ4187 - Section 9
COMPETENT ˆ _ Meets current best practice
requirements. _ Review annually. ADVANCED BEGINNER ˆ _ Requires re-assessment within 1
month.
NOVICE ˆ _ Requires immediate action by
manager to manage risk.
_ Requires re-assessment in 1 week.
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