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Proactive vs. Reactive Maintenance

Safety should be the priority in Sterile Processing (SP)

It is important for all sterile processing departments (SPD) to provide high-quality products and medical devices that are safe to use on patients. The sterile processing (SP) environment requires the use of highly technical equipment and machines to prepare surgical instruments by following intense cleaning, disinfection, and sterilization practices. Each piece of equipment or tool used in the department requires diligence, as well as properly maintaining these machines following the manufacturer’s instructions. We rely on each equipment’s ability to function properly and consistently, so it’s important for each SP unit to cater to their equipment needs, and care for them proactively.

The manufacturer of each piece of reprocessing equipment should provide written instructions in their operations manuals on how to effectively use the equipment. They should also provide a technical manual that guides each SP professional with steps to care for, or “maintain” its’ functionality. Avoiding maintenance procedures can cause turmoil and, potentially, unsafe practices for not only the staff members but may also create poor outcomes for patients, affecting the success or reputation of the healthcare institution. We know that the downtime of any necessary tool to keep the department running can cause surgical procedure delays, bottlenecks in production and, ultimately, unhappy customers.

Proactive = Preventative

Being proactive when it comes to maintenance really boils down to a couple main factors in sterile processing. Being an active member of your department who takes the time and effort to make sure the items needed are working and available, not waiting for someone else to recognize and act when issues are seen. Being proactive also means that you should complete a routine assessment of the equipment being used and follow, and execute, the protocols outlined by the manual.

 

  • Checking equipment routinely, (if possibly daily) for proper functionality, by completing an inspection of the device from top to bottom. This includes turning things on that you might not even use that day to ensure it is safely working.
  • Communicating failures, power outages or damage at the time it occurs, and not leaving broken or non-functioning items behind for others to “take care of” or for the supervisory team to report.
  • Ensuring there is a dedicated protocol on who to contact when things are not functioning properly, and work to build a coordinated, multidisciplinary team approach when handling the repair of all items in the department.
  • Creating a checklist that helps staff members identify when things are not working properly and create a backup process to follow when items are down.

 

Making sure you are professionally trained to complete the duties that are outlined in the operator’s manuals is also of importance. For example, if the troubleshooting steps require the use of tools, or are outside of any SP professionals’ scope of practice, these duties should be completed by a trained professional - that’s when routine maintenance comes into effect.

Maintenance Records

Let us look at the primary focus areas for all SPD’s regarding equipment maintenance records.

 

In addition to sterilizer monitoring and record keeping for your processes in the department, it’s critical for SP leaders to ensure that records are kept of routine and non-routine maintenance on each piece of sterilization equipment. Many times, SP leaders can house these records in their reporting system or can work with the Biomedical departments or facilities to ensure all records are retained for an adequate period. The maintenance records should include:

 

  • Date the service or repair was requested. This can help track trends and monitor the repair process in detail.
  • Sterilizer manufacturer, model number and serial number
  • Department, unit or location where the equipment is located.
  • Name of the professional, technician or authorized service tech completing the service or work completed on the equipment.
  • Reason for the service request. What prompted the work order to be placed?
  • Description of the service being performed and what was completed?
  • Date the work was performed.
  • Verification of the title of the professional who acknowledged the completion of the work, the supervisor or the facility personnel approved to sign off, in this case the SP leader, and possibly facilities or Biomedical department.

Scheduled Maintenance

In addition to living more proactively when it comes to the care, use and maintenance of your required tools needed in SP, there is also the scheduled or routine care. These unique duties are usually carried out by selected, trained professionals working as a technical field service representative, biomedical technician, or facilities professional. Regardless of your facility’s protocols or repair process, it’s important to understand that scheduled and routine maintenance must happen to keep the equipment working properly and promote longevity. If the maintenance tasks require special tools, or calibration equipment that can only be used by the manufacture or third-party service provides, they will need to be part of your maintenance process. It’s also important to understand that the frequency of the maintenance depends on how often the equipment is used and can vary from facility to facility. These specific situations always require attention and are much easier to identify when a proactive mentality has been established, and the SP unit isn’t living reactively. Proper care of the equipment, as well as proper usage, will ultimately dictate what this looks like.

 

Living in Reactive Mode can influence your operation

When a sterile processing environment is working in reactive mode, we can usually tell right away. In some cases, we often see the quality of the processes deteriorating, or the outcomes of the department are not of the best quality. It’s important for every SP professional to feel empowered to speak up when something isn’t working properly and document that occurrence. If departments wait too long, it might cost them even more, literally. Costly repairs, ordering parts and larger maintenance issues take time and resources to complete, which in turn causes longer downtime for the department and can lead to case delays or even cancellations. So why wait so long? Living in the reactive mode will only hurt the longevity of your equipment. Investing in, and purchasing, the equipment is just the first step, but being an integral part of the maintenance is also key.

 

Potential tools/equipment to include on your “Initiative-taking Checklist”

 

  • High Temperature Sterilizers
  • Chemical Sterilizers
  • Automatic Endoscope Reprocessing Machine
  • Low Temperature Sterilizer
  • Washer Disinfectors
  • Ultrasonic Cleaners
  • Decontamination Sinks (Plumbing, Drainage, Water Source, Electrical, Ergonomic Functions, Lights)
  • Elevators, Lifts, Dumbwaiters
  • Eye Wash Stations, Emergency Shower Stations
  • Battery chargers, power chargers, light boxes used to test medical devices or scopes.
  • Heat Sealers, Pouch Sealers and Cutting Devices for peel pouches.
  • Incubators
  • Insulation Testing Devices
  • Leak testers for scopes, manual and electronic
  • Instrument marking machines, lasers
  • Printers and all electronic hardware, scanners, printers
  • Inspection Lamps, magnification tools, borescopes

 

Author: Randalyn Walters