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The Eyes Have It: 3 Reasons to Say “Yes!”​ to Inspection Microscopes in Your Sterile Processing Department

It has never been easier to thoroughly inspect surgical instruments during the reprocessing cycle than it is in today’s sterile processing industry. More and more vendors are coming out with new inspection devices that span the spectrum from low-tech, handheld magnifiers up to thousands of dollars’ worth of computerized visual-enhancement software than can autofocus, record, and document what technicians are seeing on the screen or inside lumens.

In spite of the progress of inspection technology itself, many frontline sterile processing technicians are still struggling to get access to these tools at their particular facilities. To help you make the case for the importance and value of these awesome accessories to assembly excellence, I’ve put together three reasons you should be giving your administrators to convince them to sign that purchase order and equip your team for the hard work of surgical instrument reprocessing quality.

  1. Seeing it and stopping it
    The first and most obvious reason your team should have inspection microscopes in the assembly area is because your technicians have to be able to see bioburden and instrument damage in order to stop it from going on into the operating room suite. While gross debris and large damage can often be seen by the unaided eye, many types of residual bioburden can lurk within serrations, hinges, locks, and other crevices that simply cannot be seen without the help of magnification. One flake of bone from a previous surgical procedure that drops into an open incision of a new patient can undermine the entire aseptic technique of the OR, land your hospital on the front page of the local newspaper, and lead to potential lawsuits if or when that patient comes down with a surgical site infection. One crack in the handle of a pediatric chest retractor in an ER trauma tray can lead to a potentially deadly delay of care for a 12-month-old victim of a stray gunshot. The minute errors missed in inspection can have major impacts at the very times when our clinicians need these devices to be sterile and operational the most. Without inspection microscopes, sterile processing teams are being asked to do the impossible.

  2. Training for excellence
    Outside of the primary use for inspection microscopes is another tremendously important one: new employee training and competency. As with any detail-oriented task completed under time constraints (like every sterile processing assembly area requires), the training process for new staff is often an arduous one. Thousands of instrument variations must be learned, hundreds of tray names memorized, inspection points identified, packing protocol understood, and on and on. Inspection microscopes give preceptors the opportunity to highlight the critical importance of the instrument pre-cleaning & manual/automated cleaning process, along with the key areas of inspection required for new technicians to evaluate particular types of instrumentation. In addition to hands-on training with these tools, department educators can build a library of microscope images for use during the training period and competency completion that demonstrate various types of instrument damage, bioburden retention, and other quality factors that must be addressed by technicians during tray assembly. If we seek to train new hires to adequately inspect our surgical instruments, trainers and educators must have access to the inspection tools required to do so.

  3. Holding repair vendors accountable
    The third reason that inspection microscopes are a must-have in your sterile processing department is because they give your team a valuable accountability tool when engaging with and directing the partnership you have with your surgical instrument repair vendor. Keep in mind, this point is not about any kind of “gotcha” journalism that you use to attack your repair technician. However, due to the complexity of surgical instrument repair and the varying levels of training, experience, and quality output of these professionals, you owe it to your patients, surgeons, and your budget to regularly take stock of the state of your daily and weekly inventory repairs. Inspection microscopes allow you to take photos of specific instrumentation before and after they return to you from the repair van or off-site repair lab. These records can then be given directly to your repair vendor for transparency purposes, sent to complaining surgeons as evidence of requested repairs, and kept on-hand for any repair contract negotiations that may happen in the future. The more your know about the true quality of your repairs, the better equipped you will be to improve the process.

A final word on department toys
Every parent has seen the scenario that inevitably happens a few weeks after Christmas or birthday presents are unwrapped to squeals of joy and happiness. Some of those toys that seemed so amazing at first have now ended up unused, gathering dust in the corner of the room. While the analogy is not quite the same when we look at inspection microscopes in sterile processing, the outcome easily can be. Even the best tool, if left unused, serves only to give your department a false sense of quality and safety, eventually just taking up space in some cabinet or drawer of a prep and pack table.

The reasons given in this article are not just reasons to purchase these devices (or approve them from an administrative perspective), but they are also the very same reasons to commit to using these devices on an instrument-by-instrument basis. If your technicians can’t see bioburden, they can’t protect your patients from it. If new technicians are not trained with proper tools to understand the likely hiding places of debris and common areas of instrument damage, they will struggle to uphold the quality standards you set out for them. If you are unable to provide transparent accountability for your instrument repair program, either your budget or your patients may one day pay the price.

Inspection microscope tools are out there. Now the only question is what are you going to do about it?


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

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