You never know what can impact our health. Certainly the media does a great job sensationalizing outbreaks. If that’s not bad enough we can have disagreements among “experts” as to what is safe or what can pose a long term risk (aka the vaccine debacle of a falsified study linking vaccines to autism). We know that hand hygiene and disinfection - or lack thereof - can directly impact our health through the spread of hospital associated infections.
The ECRI Institute recently published their “Top 10 Health Technology Hazards for 2020”. The intent of the report is to inform healthcare facilities of potential risks associated with the use of medical devices or systems. The list is compiled from insights gained through investigating incidents, testing medical devices in the ECRI lab, observing operations and assessing hospital practices, reviewing literature and speaking with healthcare providers. The 2020 list includes:
- Misuse of surgical staples
- Adoption of point-of-care ultrasound is outpacing safeguards
- Infection risks from sterile processing errors in medical and dental offices
- Hemodialysis risks with central venous line catheters (will home dialysis increase dangers?)
- Unproven surgical robotic procedures may put patients at risks
- Alarm, alert and notification overload
- Cybersecurity risks in the connected home healthcare environment
- Missing implant data can delay or add danger to MRI scans
- Medication errors from dose timing discrepancies in EHRs
- Loose nuts and bolts can lead to catastrophic device failures and severe injury
When it comes to cleaning and disinfection, sterile processing errors are unfortunately not a new thing. In fact, in the 2018 ECRI report, a similar issue was identified. As we know, failure to follow proper cleaning, disinfecting, and sterilization protocols can result in a compromised device—and devastating effects for patients. As our healthcare expands beyond hospitals to outpatient or ambulatory care clinics, medical offices or home care services we run the risk that these settings do not have infection control practices, certified medical device reprocessing technicians or practices in place to audit, monitor and validate that reprocessing practices are being completed appropriately.
What’s concerning is that while we know incorrectly reprocessed devices can be a source for infection transmission we have not yet found a way to stop this from happening. Certainly, factors such as not cleaning and disinfectant or sterilizing correctly are obvious issues which leads us to question what training is needed and/or how frequently re-training is required. But aside from human factors what else is at play? Is the equipment becoming too complex? In our need to increase throughput and provide services to as many patients as possible are we not giving enough time to correctly reprocess the devices we are using? Due to the cost of the devices, do we run with too lean of an inventory? We need to be contemplating more than just the physical reprocessing of devices as the risk; we need to stand back and look at things from every angle.