Ever wondered how instruments are cleaned through our Sterile Services Department (SSD)? Ever given this vital department a thought at all? Our hospitals couldn’t function without them, the team ensures that all instruments that are used, inside theatres or in clinics, are sterile and available, often working through the night to ensure that all patients are able to have their procedure.
Since merging with Hinchingbrooke, the workload has doubled, and the team sterilise items from between 40 and 50 GP practices and 20-30 local podiatrists on top of that. There are also 2 members of staff permanently in Endoscopy doing 60-70 scopes a day.
Recently a brand new tracking system called SSD Man has transformed the way the department works. PCH is a pilot site to showcase to other SSDs, and Nikki Overy (Sterile Services Quality Assurance Manager) helped to tweak the system to produce something that saves a lot of time for staff.
Orders come in daily via email, so they have a list of everything needed for the next day. Staff click the button next to the set requested as it arrives, and these are signposted on the screen as flashing so that staff know the equipment is needed without the need for a supervisor.
The dirty instruments are delivered and collected throughout the day 7 days a week in special colour-coded containers, and are taken to the Dirty Utility area where each set is checked very carefully against a printed list, any particularly dirty items are hand washed separately and replaced in the container.
These go firstly through a pre-wash, which disinfects the instruments and takes 45 minutes. These machines lead through into the Inspection & Assembly area, which is a Class 8 clean room installed with Hepa filters and monitored with settle plates to measure dust. If the pressure in this area drops, an alarm sounds in the office and everything is covered, or returned to the dirty area for re-cleaning.
Once the trays are disinfected, the instruments are checked against the bar code on the printed list and all items are checked by code for cleanliness, such as putting it up to the light to check inside. Some codes are so tiny on the instruments that staff have to use magnifying lights.
The containers are passed for cleanliness, scanned again, and sealed in the container with a green plastic tag that will break if the container has been tampered with; it also has a pink steam indicator on it that turns brown when it’s been through the sterilisation machine.
All disinfected and checked instruments next go into the steam sterilisers – autoclaves (see top right). These use a pulse mechanism, where all the air is sucked out of the chamber before steam is pumped in at a temperature of 134-138 deg C, over and over again, then reaches temperature and holds that temperature for 3.5 minutes over a total time of a 45 min cycle. The trolley of instruments is pushed into one side of the machine chamber, and comes out on the other side with a print out of statistics including max and min temperature as evidence that the container is compliant.
The trolleys of trays are then left in the cooling area before being stored or put straight on a trolley for the relevant hospital that has requested the set. (See below)