curious how you all check lumens in P/P

[cnits]

How do you all check lumens in prep and pack top see if they are clean. If you run a brush, or blow them out with a syringe isn't that an unaceptable action to perform in the assembly area. If they are dirty you have the chance of contaminating your work area. Then where do you keep the brush that you do this check, and lastly do you all keep water or alcohol to flush them with?

[DIANE TAPPAN]

We use distilled water to flush our lumens out. We keep 2 small bowls on our work station. We flush with a syringe. We also have various sized brush's we keep on a notebook ring. We brush then we flush, the brush may loosen some bioburden and flushing helps remove any enzyme or residue from washing. If bioburden is found we bring instr. and brushes back to decon. Wipe our table with disinfect wipes and wash hands. Brushes and bowls are sent threw washer on a daily basis.

[cnits]

But do you leave these basins of water and brushes out when a JCAHO Survey is coming through the department? I doubt that they would accept the reason for brushes and water in p/p area. Surely, there is a way to perform this that is an acceptable method that we don't have to hide our "stuff" when surveyors come through.

[DIANE TAPPAN]

Yes we leave the brush's and bowls out when jcaho comes in and during when our infection control team comes around. They have questioned us on occasion and simplity tell them that all instr. need to be inspeced prior to sterilization. AMMI guide lines said that all lumens must be flushed with distilled water just prior to sterilization. I believe that has changed, but you still need to remove any residues from enzymes etc. This is just a inspection if you find to much bioburden on the pack and prep area then you should retrain your decon. staff. For ETO or Sterrad you should syringe 10 ML of alcohol followed by air not more than 20 psi, to help facilitate drying. I've also had some rep's come in for educational seminars and question us. We ask how would you check a suction? I think we educate them. You know you can never *** U ME that it's clean. Just make sure you don't have cleaning supplies at your hand washing sink. All failed instruments need to go back to decon.. PS basins are just 3 or 4 inch bowls not big cleaning basins.

[cpdguy]

This article was just in HPN. It might help.

http://www.hpnonline.com/inside/2010-03/1003-CSsolutions.html

[fkrizman]

Curious how often you find something in lumens in the pack and prep area that does not appear to be clean??
What is your process for stopping this from happening again?

[cpdguy]

Their is an article that appeared in Zen Sterilization about 3 years ago on lumens. Had some great idea.

You should find that article.

Also an article in AORN in 2007 addressed this topic of checking instruments.

Some people on the clean side use a "pipe cleaner" and push it into the lumen and if it is clean it is OK; if not they send it back to be recleaned.

Some flush hydrogen peroxide 3% into a lumen and if it bubbles; that means it is dirty and they send it back to be recleaned; the down side to that is you have to still clean it becasue you cannot leave residual hydrogen peroxide inside the lumen.

Their are commerical product that you can use to test lumens for bioburden that has peer reviewed data behind their method.

Stopping this from happening, is having a policy that you make sure you keep the inside of the lumen wet after surgery ( that is where it starts) and then have a process that will actualy clean them. I would use a sonic that allows you to have a pulse flush method ( hook up the lumen) and flow water ( cleaning solution ) flush into the lumen while it is being sonic cleaned.

Dr. Alfa wrote an artice on this very subject about 3 years ago. I would also suggest reading that article.

Hope this helps

I am in the process of writing an article on lumens and hope to have it done in a few months.