"Water, water, everywhere, nor any a drop to drink," Poet Samuel Taylor Coleridge: The Rime of the Ancient Mariner. If not the most important, water is a critical resource for reprocessing instrumentation and medical devices in Sterile Processing. Poor quality water can have adverse effects on both instruments, equipment, and patient outcomes. It is so critical that, at last, AAMI's TIR 34 is being revised to become a full-fledged guideline very soon.
Water sources are diverse and seasonal. Knowing where your water comes from might not be as important as knowing what is in it. Current trends point towards the development of better water management systems utilizing interdisciplinary teams in healthcare settings. Routine testing to determine water quality when reprocessing medical devices should already be and will be a standard. Critical water and utility water have specifications for hardness, conductivity, pH, chlorides, bacteria, and endotoxins. Whereas utility water is primarily used in the decontamination area for manual cleaning, critical water is used for final rinses both in manual and automated processes and has lower values for each measurement.
In sterile processing, we have developed management programs for equipment and instrument functionality. We test our washer/disinfectors for proper cleaning utilizing cleaning efficiency soil tests. Ultrasonic cleaners are tested with cavitation tests. Bowie/Dick and biological indicators are used to verify sterilization cycles. With some processes like endoscopes, we utilize ATP tests to verify our cleaning processes. Lastly, with each instrument reprocessing cycle we test the functionality of our instruments. The one common factor that we have with all of these processes is water. Poor water quality can affect each one of these processes and potentially harm our patients. So if you are not already there, jump on the bandwagon and develop a water management system now.
At Evolved Sterile Processing, our consultants have a greater focus on sterile processing. With our decades of experience, we will help you develop better processes and educational resources for your staff.
Reference:
ANSI/AAMI TIR34:2014
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