Its Monday. You just clocked in at the clinic you work at, set your stuff down and are into your first cup of coffee when you hear, "Surveyors are here!!!". You expected today to be just like any other day. You would care for your patients, help the provider with some minor procedures, get those instruments cleaned and hopefully have enough time to use the bathroom and eat lunch. You thought wrong. A nicely dressed Registered Nurse sent from the Regulatory Body your Hospital Contracts with walked through the door and is immediately asking questions. She walks over to you and says, "they told me that you know the process to clean the instruments used in this clinic"..........(Moment of Silence).

Through the years I have seen this happen over and over to staff members that the clinic assigns the duty of instrument processing to. Again and again we see the same breaks in process that allow the surveyor to ring up that o so hated condition level finding. Saying all this, I am going to list a few things that I know surveyors are looking for in the clinic setting involving instrument processing. 

  1. Starting at the bedside
    1. What is your process to get these instruments to where they need to be?
      1. Make sure that you include in your explanation that at the bedside you wipe any gross debris from the instrument, place the instrument in a rigid container labeled biohazard for transport, and spray or wipe the instruments with an enzymatic solution that keeps the instruments wet until they are processed.
      2. Our Clean Slide Box is a great solution for transport. It is a rigid container with a sliding sign that indicates whether the box being used is clean or contains bio hazardous material. The steps are as follows: Slide the sign to biohazard and place instruments in the box for transport. Transport items to where they are processed. Remove items from the box and clean the inside of the box with an approved disinfectant. Slide the box to clean and transport any processed items back to the clinic.
  2. In the Processing Room (if your clinic has one)
    1. Can you show me how you process these instruments?
      1. Make sure you include in your explanation you follow a linear pathway and that you process your instruments from dirty to clean. This means that the once the instruments go from dirty to clean, they do not go backwards through the path into a dirty area. 
      2. The Clean Step provides a great visual guide for surveyors and allows them to see the linear pathway in vibrant color. The foot prints read dirty, cleaning, and clean and should be arranged in that manner. These steps can be used in your restrooms for hand hygiene guidance for children and adults, your sterile processing department, waste management, etc. 
      3. Also make sure that you label any solutions that you have in containers for disinfection, wear the proper PPE for disinfection, and document in your logs appropriately
  3. Storage
    1. Can you show me where you store these instruments?
      1. Make sure you explain that the instruments that have been processed are stored in a clean storage room. Also include that you check the instruments packs for integrity and if there are any defaults in the packaging.

All in all a survey is not a comfortable experience but if you have a great understanding of your process, it is much easier when the day comes.

Stay Clean my friends,