Always Sunny in Sterile Processing: The Real Meaning of Light Duty
While most sterile processing technicians daydream about working in a department with a window, light actually serves an even greater purpose than just raising the morale of your lifesaving team of basement dwellers. From decontamination all the way to sterile storage, those lustrous wavelengths have the power to both help and harm your mission of instrument reprocessing excellence. Implementing the tips in this article will help ensure your department becomes a shining city on a hill, casting light into the dark domain of dangerous microbes.
To see or not to see shouldn’t be the question
First and foremost, it almost goes without saying that every technician in your department must have sufficient light to safely and efficiently do the processing tasks assigned to them. However, with age, many of our older technicians actually need additional levels of lighting to accomplish similar tasks as their younger counterparts.
The AAMI ST79:2017 document explains in section 184.108.40.206 (a) that the Illuminating Engineering Society of North America (IES) has established minimum levels of illuminance which varies by the age of your personnel:
- Persons under 40 years of age require the least amount of illuminance
- Persons 40 to 55 years of age require an average amount of illuminance
- Persons more than 55 years of age require the highest amount of illuminance
In Table 1 of the same section, AAMI ST79:2017 lists the specific work areas/functions that require different levels of lighting depending on the task being done. For instance, general work areas and processed storagerequire the least amount of illuminance, general inspection and sink areas require greater levels, and portions of your workflow where detailed inspection occurs require the highest level of illuminance (anywhere from 1,000–2,000 lux, depending on the age of processing personnel).
Department managers should collaborate with their facility’s directors to ensure these recommendations are taken into account for any upgrades, renovations, or new hospital construction.
Small but mighty: Ancillary lighting
As mentioned in a previous column “Dangerous Decontam,” ancillary lighting in the decontamination stage of processing is a critical piece of department safety and processing efficiency. Lighting should not only be available over each sink bay for activities such as leak testing, manually cleaning, and visual inspection, but adequate illumination should also be present in areas where technicians could encounter a puncture risk, such as unloading soiled instruments from case carts, or loading instrument trays into ultrasonic cleaners or automated washers.
In the assembly areas, table-mounted lighted magnification and handheld battery-powered magnifiers can give your technicians the added visual boost they need to identify potential cracks in box locks and needle holder inserts. Lighted internal borescopes conquer the mysterious darkness of lumened items, such as arthroscopic handpieces, allowing sterile processing professionals to inspect areas otherwise invisible to the naked eye. For any implant restocking duties, recessed lighting on assembly tables can assist technicians in distinguishing minute product numbers on plates and screws.
The ultra helpfulness of ultraviolet light
Ultraviolet light (UV) is one of the most helpful types of light in the sterile processing world. New technologies integrating the power of UV light can change everything from the way your department handles hand-washed items to how you monitor the effectiveness of your cleaning processes.
Some companies have integrated UV light technology into pass-through windows for sterile processing departments to serve as a touchless, chemical-free disinfection stage for instruments not validated to go through the automated washing process, bringing us one step closer to solving concerns around the safe handling of those items. The units can also be used to safely disinfect high-touch items, such as pens, staplers, keyboards, badges, and sticker guns.
Another terrific application of UV light technology is in providing a means of protein detection for the surgical instrument cleaning verification process. Products on the market now allow departments to use a specialized spray on washed instruments that causes any residual protein to fluoresce under UV light. These units can pinpoint areas on the instrument that were not adequately cleaned, and measure the amount of protein present after the cleaning process.
Light, in the form of a fiber laser, can also provide much needed instrument-level tracking and identification capabilities to teams seeking to become compliant with instrument-to-patient tracking guidelines in the industry. These fiber lasers use high-tech light waves to mark instrument surfaces, such as titanium, anodized titanium, aluminum, stainless steel, and plastics with data matrix barcodes and product numbers for full traceability of surgical instruments from purchase through the continuum of patient care.
The downside to luminescence: Blinded by the light
While light can be a tremendous weapon in safely winning the war on microbes, not all light is a welcomed sight in your sterile processing workflow. Processing supplies in particular can sometimes be harmed by certain forms of light and special care should be taken to be aware of and mitigate these risks.
One example comes from tamper-evident container locks for low-temperature sterilization, in which their instructions for use specifically state, “Locks must be stored in a controlled room temperature, away from alkaline chemicals, acids, and sources of light [emphasis added],” and “Extreme storage conditions such as exposure to direct sunlight [emphasis added] and/or storage on top of or near heat source should be avoided.”1
Similarly, many forms of instrument sterilization wrap also have important recommendations regarding light for their products, with one product’s instructions explaining in their general storage (pre- and post-sterilization) section that, “Location[s] should be clean, dust-free, and away from fluorescentor ultraviolet light [emphasis added].”2
As with sterilization parameters and testing procedures, supply IFUs should be regularly reviewed to safeguard your department against inadvertently damaging your products with exposure to certain forms of light that has been recommended against by the manufacturer.
In our missions of mass microbial destruction, light—at the right time and in the right ways—can become the difference between danger and safety, efficiency and ineffectiveness, disinfected and dirty. As you push back against the remaining shadows in your sterile processing workflow, remember to wisely wield the weapon of luminosity at every stage, sending up a signal to microorganisms everywhere that in your SPD, you’re going to leave the light on for them.
Feature articles exclusively for Ultra Clean Systems by Weston “Hank” Balch, BS, MDiv, CRCST, CER, CIS, CHL
Weapon of Mass Microbial Destruction * Professional Clean Freak * Podcast Host * Safety Addict * CS/SPD Consultant
Sign up to read Hank Balch’s biweekly feature in NewSplash!NewSplash is a free weekly digital newsletter dedicated to providing useful information to CS and IP professionals who strive to keep patient safety high.