OR Manager - September 2019 - 18

INDUSTRY SPOTLIGHT
header
Patient safety
HEINE
'Coming clean' in the SPD requires collaboration and
competency-Part 1
ADVER TORIAL
Q: Your company has chosen not
to migrate from reusable to disposable
products. What has led you to maintain
your commitment to reusable products?
There are two main reasons. The first
goes back to one of the founding principles
of Helmut Heine, Sr., who believed
that if his name was on the product, it
should be of the best quality. Ultimately,
our laryngoscope systems are designed
to allow the provider to have the best
view possible to perform the intubation
safely, quickly, and efficiently. When
providers go with disposable products,
quality is taken out of the equation and
replaced with a focus on low price.
The second reason is in the same vein.
HEINE designs quality products that will
last for 10-plus years. This duration is
not only more cost-effective than disposables,
but also more environmentally
responsible. As a manufacturer, we are
committed to environmental and sustainable
business practices.
C
ontaminated surgical instruments
made ECRI Institute's
2019 annual top 10 list of
health technology hazards, coming in at
number five: " Mishandling flexible endoscopes
after disinfection can lead to
patient infections. " Number two on the
list in 2018 was " Endoscope reprocessing
failures continue to expose patients
to infection risk. "
* Process and Work flow
OR Sets up Case
It's not only endoscopes that are of
concern. ECRI Institute's Patient Safety
Organization, which hosts a voluntary
database of events, contained more
than 1,000 events related to the effects
of contaminated instruments between
January 1, 2015, and June 30,
2017. The events fell into one of three
categories: device, surgery/anesthesia,
or healthcare-acquired infections. These
categories are among the Common Formats
from the Agency for Healthcare
Research and Quality, which are used
to promote consistent collection and
analysis of safety data.
A random sample of 536 events related
to contaminated instruments revealed
six types of failure modes:
* immediate use steam sterilization
(IUSS) (60%)
* unsterile instruments (34%)
* a vendor instrument issue (16%)
* sterilization quality issues (8%)
* human factors (7%).
Q: You have spoken candidly about
properly designed reusable products
and the limitations of those designed
for single use. Please explain for our
readers and tell us what sets your product
apart from the competition.
To create a properly designed reusable
product, we spend more than a year
speaking to all stakeholders who interact
with our laryngoscopes. Through that
process, we outline the characteristics
of the ideal reusable solution. When a
manufacturer builds a product based
on stakeholder input and is able to
check all the boxes identified during
the design process, the results can be
powerful. Instead of just a tweak or
* bioburden or contaminants on instruments
(34%)
Not only do such failures pose a
patient safety threat, they can also expose
healthcare organizations to negative
publicity and possibly litigation. A
recent Google search for " dirty surgical
instruments " produced 601 results, including
reports from local and national
news affiliates.
Part of the problem can be traced to
pressures on the sterile processing department
(SPD). " Surgical volumes are
higher in many areas, with inadequate
instrument availability, increased complexity
of instruments, and not enough
18
14
OR Manager | September 2019
| April 2019
| September 2019
Christian Berling, HEINE USA
Vice President of Sales and Marketing
A PROPERLY DESIGNED REUSABLE
PRODUCT CAN BE CLEANED AND
STERILIZED EFFECTIVELY. IT IS
THAT SIMPLE.
OR Performs
Case
OR Breaks Down
Case
OR Pre-cleans
Instruments
INSTRUMENT PROCESS AND WORKFLOW
Each step in the process below must be analyzed to ensure high quality.
SPD Sterilization
SPD - Prep and
Pack
SPD
enhancement to an existing product,
we leverage stakeholder insights to build
the ideal product. That is why, with the
HEINE laryngoscope system, the user
doesn't compromise on performance,
reliability, cost, safety, or impact on the
environment.
Q: What are your customers most
surprised to learn about the benefits of
reusable laryngoscope systems?
Number one, they are surprised to find
out that they will save money by investing
in the best product on the market. When
making the initial investment, customers
find our products are not the cheapest;
however, due to their quality and longevity,
they provide a return on investment
in less than three years compared with
disposables or cheap reusables.
Instruments into
storage
Cases picked
and put on case
carts
decontaminates
and cleans
Instruments
transported to
SPD
Source: ECRI Institute, Plymouth Meeting, Pennsylvania.
Used with permission.
Q: To what extent do you factor the
Joint Commission (JC) audit process
into development of your product?
This has become a huge consideration
for us. We need to understand the world
our customers exist in, not just from a
patient care standpoint but also from an
accreditation one. The JC is important
in terms of the direction we anticipate
the audit process will be heading in the
coming years. For example, we designed
the EasyClean laryngoscope handle
to be sterilized, even though only one
state (California) in the country currently
requires it, based on the assumption that
the JC may potentially make sterilization
a nationwide standard. If that happens,
our handle will be compatible because
we have been focused on the current
and future audit process.
staff or under-skilled staff, " says Gail
Horvath, MSN, RN, CNOR, CRCST,
senior patient safety analysis IV and
consultant for ECRI Institute, Plymouth
Meeting, Pennsylvania.
When leaders of the OR and SPD collaborate
with each other, their teams,
and other experts, they can reduce instrument
contamination. Part 1 of this
two-part series discusses the scope of
the problem and prevention strategies.
Part 2, which focuses on how to investigate
potential contamination and correct
the situation, also reviews design
and equipment considerations.
Behind the errors
Most people come to work wanting to do
a good job, so why do events such as
contaminated instruments occur? In a
2012 article, Chobin categorized possible
reasons into processes and people.
The second thing that people find surprising
is that HEINE's laryngoscope system
has a handle that does not have to
be disassembled in any way to be sterilized.
A battery or bulb does not have
to be removed, either. This is such a
departure from every other reusable
product that it has become one of the
product's " wow " factors.
Q: As a German-based company,
how does your international presence
inform your approach to U.S. customers?
As a global company that serves end
users in more than 100 countries, HEINE
has a collaborative and supportive
culture that encourages best practice
sharing from different markets and
countries. Two of the biggest influences
our international presence has are
product quality and longevity. In our
home country of Germany, we have
distributors and customers who have
been using our products for decades.
This history of quality and performance
reinforces our message to our U.S. customers
that quality products should,
and can, last for years. This is especially
important in markets where disposables
and knock-off products are prevalent.
Process factors
* complex surgical instruments that
are difficult to clean or can't be disassembled
to clean
* ambiguous or missing manufacturer
instructions for use (IFU)
* loaner instrumentation not accompanied
by training for staff on cleaning
and sterilization
* lack of sterile processing input for
instrument and device purchases to
be sure the SPD can meet IFUs
* insufficient inventory that results in
shortcuts and IUSS.
People factors
* insufficient staff
* poorly paid technicians
* high turnover rates
* rushed orientations and training
* no incentives to become certified
* lack of opportunities for staff to adwww.ormanager.com
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OR Manager - September 2019

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