ORM February 2023 - 28

Sterilization & Infection Prevention
Continued from page 27
Instrument inspection
The next step is to inspect the instrumentation.
While all instruments are
visually inspected for cleanliness, these
instruments should undergo enhanced
inspection with magnification, borescopes,
or other inspection methods to
verify cleanliness.
Borescopes may be used to visually
check internal channels of instrumentation
for cleanliness and/or damage
following the borescope's IFU. If any debris
or residue is detected, it should be
returned to the decontamination room
to be thoroughly cleaned. No type of
cleaning should be performed in the
preparation and packaging area.
Most importantly, every time electroDO
YOU WANT TO
BE A THOUGHT
LEADER?
WILL YOU SHARE
YOUR KNOWLEDGE
& EXPERIENCE?
JANUARY
2023
Volume 39
Number 1
Education and information for OR decision makers
REGULATIONS
IN THIS ISSUE
INDUSTRY BEATS
New AMDR report strengthens
case for single-use medical device
reprocessing ................................7
Key lessons on supply
management at OR Manager
Conference ..................................9
Scheduling OR travel staff at a
large academic institution ...........11
Reader's choice: OR a.m. top
read stories ...............................13
SPECIALTY STORIES
ASC challenge: Recruiting and
retaining surgical technologists ...24
Tackling internal objections to
single-use device reprocessing ....29
Legal ABCs of drafting contracts
with anesthesia..........................31
Accreditation updates from The Joint
Commission, CMS
A
n important reason for accreditation
from The Joint Commission
is that it allows hospitals to bill
Medicare and Medicaid, under what is
called " deemed status, " says John Rosing,
MHA, FACHE, executive vice president
and principal at Patton Healthcare
Consulting, an affiliate of HBS of Langhorne,
Pennsylvania. Rosing spoke at
the OR Manager Conference in 2022.
Accreditation is voluntary, but if an
organization is not accredited, it is instead
subjected to surveys testing compliance
with the Centers for Medicare
and Medicaid Services (CMS) CondiTECHNOLOGY
State
of natural language processing in
surgery: Part 2
N
IMPORTANT
DATES
Jan 9 - Advanced rate deadline
for OR Business Management
Conference
Feb 5 - OR Business
Management Conference
pre-conference workshop
Feb 6 - OR Business Management
Conference opens
atural language processing
(NLP) has the potential to make
clinicians' work easier, help
meet organizational goals, and promote
quality patient care.
" This technology is something that
can help us as healthcare stakeholders-whether
nurses, administrators, or
surgeons-to access a lot of the health
information and data that are being generated
every day, " says John Fischer,
MD, director of the clinical research
program, division of plastic surgery, and
associate professor of surgery at the
Hospital of the University of Pennsylvania
in Philadelphia. " I see it as a very
useful tool in helping us to make sense
BY CYNTHIA SAVER
of and label a vast array of health information
so we can do a better job of taking
care of our patients. " Dr Fischer is
also a co-author of a systematic review
and meta-analysis on the use of NLP in
surgery.
Part 1 of this two-part series explored
some of the uses of NLP in surgery.
Part 2 discusses the role of NLP
in outcomes and general clinical research,
as well as challenges of the
technology and factors OR leaders
should consider when purchasing products
that use NLP (sidebar, Surgeryrelated
uses of NLP).
Continued on page 19
BY JUDITH MATHIAS
tions of Participation
(CoP), performed by
their state agency acting
on behalf of CMS.
Many CoP still read as
they did in 1965, when
the Medicare program
was first introduced,
and many others have
been added or changed since. Updates
for the CoP are announced by CMS via
Quality, Safety, and Oversight memos
and the periodically updated State Operating
Manual.
John Rosing,
MHA, FACHE
Continued on page 8
Continued on page 15
surgical instruments are processed, they
should also undergo insulation testing.
Damage to insulated instruments can
occur during normal use, processing,
contact with sharp instruments, and high
voltage use; repeated use/processing
can also cause damage to the insulation.
To inspect the insulation, locate the
metal collar at the distal tip. The insulation
should fit tightly against the collar;
this union should be snug, with no
spaces visible. Next, grip the insulation
and try to slide it back. If the insulation
slides (moves), the instrument should
be sent for repair.
There are several types of insulation
testing equipment commercially
available. They typically include various
accessories to test specific instrumentation
and cables/cords. The manufacturer
provides specific information on
how to perform electrosurgical insulation
testing. Each is designed to detect
small current leaks that can place patients
at risk of significant harm.
Other considerations
Any damage to the insulation can compromise
the safety of these instruments.
Damaged instruments must be
removed from service, and the damage
should be addressed according to organizational
policy and procedure.
According to the AORN Guideline for
use of electrosurgical devices, an interdisciplinary
team that includes members
of the perioperative and sterile processing
departments should determine
a standardized communication strategy
and action plan, to perform when an insulation
failure is found during processing.
The communication should include
sterile processing, OR personnel, and
physicians.
Contribute to OR Manager or
submit an abstract to speak
at one of our conferences.
28
For speaking inquiries, contact:
Carrie Shapiro,
OR Manager | February 2023
CMP, senior conference manager:
cshapiro@accessintel.com
Processing personnel should receive
education regarding the processing of
laparoscopic instrumentation, and they
should also receive education in the
use of all testing equipment before use.
Competency should be verified and documented
before first using the insulation
tester. Both the Association for the
Advancement of Medical Instrumentation
(AAMI) and AORN have recognized
the risks associated with insulated laparoscopic
instrumentation and have included
guidance in their standards and
guidelines.
In 2020, an amendment was added
to the ANSI/AAMI ST79:2017 Comprehensive
guide to steam sterilization and
sterility assurance in healthcare facilities;
Amendment A.2 Inspection of insulated
instruments. The AORN Guideline for
use of electrosurgical devices was also
revised in 2020 and includes a guideline
to visually inspect electrosurgical
accessories for damage (eg, insulation
breakage) before and after use and, if
reusable, during reprocessing. ORM
-Susan Klacik, BS, FCS, ACE,
CHL, CIS, CRCST, AAMIF, is
clinical educator at Healthcare
Sterile Processing Association
(HSPA) and its representative the Association
of the Advancement of Medical
Instrumentation (AAMI).
References
Association for the Advancement of
Medical Instrumentation. ANSI/
AAMI ST79:2017 & 2020 Amendments
A1, A2, A3, A4 (Consolidated
Text) Comprehensive guide to
steam sterilization and sterility assurance
in healthcare facilities.
Guideline for electrosurgical safety.
AORN Recommended Practices and
Guidelines. 2022.
International Association of Healthcare
Central Service Materiel Management.
Central Service Technical
Manual 39. 7th ed. Chicago: IAHCSMM,
2007.
International Association of Healthcare
Central Service Materiel Management.
8th ed. Chicago: IAHCSMM, 2016.
International Association of Healthcare
Central Service Materiel Management.
Instrument Resource Manual.
1st ed. Chicago: IAHCSMM, 2018.
www.ormanager.com
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ORM February 2023

Table of Contents for the Digital Edition of ORM February 2023

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