The Importance of Proper Lumen and Channel Cleaning
Cleaning requires a variety of methods and detailed processing in the preparation areas of the central sterile processing department. Proper cleaning of lumens, crevices, channels and ports can be very time consuming and requires the use of proper cleaning tools such as delicate channel brushes or lumen flushing systems.
Making sure your decontamination staff are provided with the appropriate resources and the cleaning brushes that accompany your specific inventory is critical. Often specialty devices, like flexible scopes and power equipment will come with cleaning tools with the manufacturer that accompany the instructions for use. These products are designed to be used to clean that manufacturers specific products, with material make up and width, length specifications in mind.
Cleaning verification requires a variety of methods and detailed processing in the preparation areas of the CSSD. Cleaning verification should include primarily a detailed visual inspection as the first initial step in the process. Because our human vision is no where near perfect, we as reprocessing professionals should be using a variety of tools and devices to assist in this inspection process.
Some of the tools and devices that can be useful during inspection and verification include;
- The use of magnification should be included during this step along with proper lighting. AAMI ST79 recommends the use of at least 500-1000 lux at a minimum. This is where the additional light sources on the prep and pack tables and magnification tools can come into play.
- The use of a digital microscope or camera can be utilized to see things magnified at a higher level where the human eye cannot see, these cameras are USB capable and affordable on the market today.
- For lumens and channels the use of a borescope can be used to easily visualize the inside surfaces where the brushing technique should have reached.
- The use of the flushing technique after washing is quite common during the assembly phase of reprocessing. However, it is important not to add any additional chemicals or solutions to freshly cleaned medical devices prior to sterilization unless approved by the manufacturer and recommended in the cleaning instructions.
- Lastly, a more objective and sensitive method would include the measurement of the levels of organic soils or microbial growth left on the surfaces with the use of commercially available tests for residual bioburden. There are several validated testing methods available, check out section D.3 of ANSI/AAMI ST79:2017 for resources on this process.
Promise to the Patient
Reprocessing intricate medical devices is a very challenging, technical and skilled task. It is important for all reprocessing professionals to remember to take time during the cleaning phases of decontamination. Ensuring that all surfaces and hard to reach areas are cleaned where you might not be able to visually inspect easily. All instruments that touch patients are contaminated and each one should be cleaned entirely and in accordance with all recommended practices and instructions. We know this takes time, but it is how we guarantee the safety of our teams as well as the safety of the patient's life.