With the recent headlines about dirty surgical instruments, and the need for monitoring the cleanliness of medical devices, especially surgical instruments, I felt this should be addressed again.
I am reminded of two sayings I have heard over and over in my 40+ years in the medical field. First, if a medical device is not clean it is not sterile. Second, I would rather have a medical device that is clean but not sterile used on me as a patient than a dirty but sterilized device.
While there is continuing debate on how clean is clean, the minimum standard is visually clean. If you can see dirt or a stain on a device, re-clean it. You first ensure you have a solid visual inspection process, and then once a stain/spot is noticed, you then identify what that stain/spot is so you can start solving the issue.
Stain on a plate of stainless steel:
Far too many times, I have seen instruments that should never have been put in an instrument tray that have spots on them. Staff assume they're just water spots and let them go into a tray to be used. Many of the spots may be just hard water, but others could be residual protein left from the cleaning process. Regardless, they should never go into a tray and should always be sent back to be re-cleaned.
I feel your pain. I have traveled the same path of being called into a room and trying to answer questions like: "Why is this instrument dirty", "How could you allow this to happen", "If you don't solve this, your job is on the line. Fix it now!".
In my view, having a dirty instrument make its way into a surgical tray is not acceptable in today's practice. We have simple-to-use technology that can prevent this, and when used as part of a quality management system, can dramatically reduce incidences of dirty surgical instruments reaching the next patient.
