Dirty to Clean, Clean to Sterile: Understand the flow. | July 14th, 2009 | Author: admin

In any clinical setting, from a dental office to a surgical suite, the single most important aspect of healthcare design is maintaining a sterile environment. This is because the greatest risk factor for a patient is infection. Nosocomial infections are infection as a result of treatment in the healthcare setting, but secondary to the patient’s original condition.

It is estimated that 88,000 people died of complications surrounding nosocomial infections in the US each year. By comparison, about 7,000 die each year in the US from medication errors. (2005 data)

There are numerous opportunities to spread infection in the healthcare environment. This topic alone can fill volumes. This post will focus on what an architect should know about the flow of sterile instruments in the surgical setting.

Know your flow.

Understand the route a surgical instrument will take in your department. It is different than that of the patient or staff. Start in the operating room.

1. Sterile instruments are placed into the room by staff for use in the next procedure.

2. After a procedure is completed, instruments are taken out of the room for cleaning. This room may be called clean-up, decontam, soiled utility, or simply “dirty”.

3. The instruments are cleaned of visible debris, deemed “clean” and moved to an assembly area.

4. In the assembly area, they are placed into a tray (also called a cassette) and typically enclosed in a sterile wrap. (It looks like a gift wrapped package in a blue paper towel. But, no bow.)

5. The wrapped instruments are then placed into a sterilizer where they are exposed to a process that will kill any microscopic organisms still alive. Steam, hydrogen peroxide and Ethylene Oxide are the most common.

6. The wrapped tray containing the sterile instruments is stored for use in the next procedure.

It is critical to understand the flow of patients, staff and instruments within the surgical setting. The progression from dirty to clean to sterile should be easily identifiable as you review the space. There are plenty of books dedicated to this topic. Take a weekend to become familiar and a month or so to become an expert.

Remember that almost 90,000 people die each year from infections introduced to them in the healthcare environment. Don’t expect this 5 minute read to place you in a position to solve the problem. Do your research and learn how you can make patients safer as a result of better design.

Start by becoming familiar with the tools of the trade:

Tags: Eto, Hydrogen Peroxide, Plasma, Steam Sterilization, Sterilzation, Temperature Sterilization, Ultrasonic cleaner

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