Cleaning processes still leave bits of blood and bone on surgical tools
The Center for Public Integrity (CPI) new report suggests that the surgical instruments used in operations just may be contaminated as they emerge from the cleaning process not so clean and sterile as we like to believe.
In an investigation of Methodist Hospital where at least seven joint surgery patients had acquired dangerous infections during a two week period, a tiny video camera had been used to ensure that those places which cannot been seen by the naked eye were clean surgical tools. Found inside the cannulas and athroscopic shavers were human tissue and bone stuck on the shavers. Also found was a bristle from the cleaning brush on the shaver. This investigation had found that the cannulas had not been clean with brushes as required by the manufacturers instructions instead tap water was run through the instruments.
Unfortunately this incident was not an isolated one, unclean surgical tools have been showing up more and more on a regular basis in hospitals and out-patient surgery centers.
There have been numerous cases were unclean surgical instruments are showing up. A Centers for Medicare and Medicaid Services pilot program inspected 1500 outpatient surgery centers and 28% had been cited infectious control deficiencies associated to equipment cleaning ans sterilization.
University of Michigan study had presented the most horrifying information and conclusions to a crowd of around 200 government and industry insiders last summer during an FDA workshop addressing concerns regarding dirty medical tools. As an example, they had examined 350 suctions cups in which had been cleaned and sterilized but what they found was by no means clean or sterile for every suction cup contained blood, tissue and rust.
Due to the results of the CPI investigation, Dr. Nancy Snyderman, NBC News Chief Medical Editor had taken a closer look of a broad range of instruments used during surgical procedures and just how much care is really used when handling them. The results found is the handling of high-instruments can be the weak link for a patient safety net.
Surgery has moved to high-tech devices which has become a big problem. Due to the fact they are no longer made out of just metal and glass leaving some that can melt if you heat them so they actually do have to be cleaned and sterilized by technicians which are not technicians. They are usually located in the hospital basement where the cleaning and sterilization process takes place. The area is usually hot and humid where employees get paid as little as $8.50 an hour to work at a fast pace to keep equipment in rotation. The faster instruments can be placed in the operating rooms the faster patients can be moved through. At large hospitals as many as 40,000 instruments are passed through each day. Leaving new research finding more and more surgical tools leave the basement go into the operating rooms and are still contaminated with blood, tissue and other debris.
However, Sharon Greene-Golden,a central sterile processing manager at Bon Secours Mary Immaculate Hospital in Virginia and president-elect of the International Association of Healthcare Central Service Materiel Management (IAHCSMM), which advocates for the central sterile industry, reports that even the best conditions may make surgical tools tough to clean. Sometimes leaving doctors having to beat the instrument against the table to loosen up bone.
Making matters worse workers feel as if they are forgotten and neglected, feeling pressure from nurses and surgical staff to speed up the process.
New Jersey is currently the only state that requires sterilization workers to undergo training.
The FDA requires medical device manufactures to provide cleaning instructions but they do not require hospitals to report dirty surgical equipment that made its way into operating rooms. Only 25 states have the requirement to report surgical site infections.
Earlier this month New York State Assemblyman Harry Bronson (D-Rochester) and Senator Mark Grisanti (R-Buffalo0 introduced bills that would require profession certification for central sterile workers.
Joe Eaton, investigative reporter for CPI, noted that part of the problem is the increasing numbers of minimally invasive surgeries has prompted the development of smaller more complex instruments made from materials such as plastic and not just glass and steel which are more difficult to clean and require more detailed instructions from manufactures.
According to Eaton in theory if the instrument is truly impossible to clean “it should not end up on the market place.”
Currently according to Eaton the only thing you can do is go to the best hospital you can but even there something could happen.
As a result of this news hitting the media waves, Eaton hopes the story pushes out to a large stage and to the people that set policy.
U.S. News picked the best hospitals of all the 67 hospitals in Detroit and Michigan Metropolitan area.
The best hospitals in Detroit with their ranking are as follows:
Harper University Hospital #2
Henry Ford #3
St. John Hospital and Medical Center #8
Karmanos Cancer Center #21
For Children, Children's Hospital of Michigan was ranked as one of the best.
A full list can be viewed at U.S. Health.