1. Short summary / abstract
This report provides an update on the progress made towards compliance with best practice following the publication of the “Comprehensive Report: A review of the decontamination of surgical instruments in the NHS in England” (2001) which provided background information relating to the development and implementation of a decontamination programme aimed at improving the quality of surgical instrument reprocessing across the healthcare sector in England.
It shows that data collected and analysed between November 2001 and August 2003 demonstrated a significant “step change” occurred with respect to improvement across all aspects of the decontamination life-cycle.
A series of assessments of decontamination facilities were undertaken, and the information was used as a focus for future work and investment.
The document outlines
How and where the data was collected and analysed and what was reviewed e.g. working practices, facilities and equipment and the local actions agreed where immediate work was necessary to improve standards.
Where investment was made e.g. replacement of equipment, purchase of additional instruments, upgrading facilities
The support provided in expert advice to the NHS and implementation of local medium and long term plans
The launch of ‘A National Decontamination Strategy for Modernising the Provision of Decontamination Services’ in July 2003
Future work and ongoing initiatives relating to decontamination
Revision of existing guidance
Surgical instrument tracking and management systems
Revised guidance for upgrading and building new decontamination facilities
Development of national training schemes
The application of national registration schemes to demonstrate compliance
The establishment of the Engineering and Science Advisory Committee on the Decontamination of Surgical Instruments including Prion Removal (ESAC-PR)
The report provides case studies to illustrate the effects of the investment programme and a chronology of the decontamination development programme from December 2001 to February 2005.
2. What question is the document addressing?
The report provides an update on progress towards compliance with current best practice guidance on decontamination of reusable surgical instruments in the NHS in England
3. Type of study
Review process/statistical analysis and case studies
4. Methods valid & appropriate?
Yes
Comments:
In September 1999, following concerns surrounding the theoretical transmission of vCJD the DH commissioned a snapshot survey of the decontamination of surgical instruments in a range of NHS hospitals, private and voluntary organisations and general medical and dental practices in England. Following the findings of this survey the National Decontamination Programme was launched in October 2000. This document reports on progress made to modernise the service in acute NHS hospitals it does not include any developments in general medical and dental practice or independent sector facilities
5. Results / recommendations reliable?
A systematic evaluation of information was undertaken to identify major risks and in addition to mathematical analysis of the data a risk analysis was undertaken to assess the elements of the life cycle using “Failure Mode Effect Analysis” (FMEA) to identify the key elements of the decontamination cycle which presented the greatest risk
6. Any major problems and biases?
Full detail of the review programme methodology are not included to be able to assess reliability of systems used and analysis of data URLS for references would have been useful
7. Any other important / relevant studies which confirm or contradict?
1. National Decontamination Strategy for Modernising the Provision of Decontamination Services NHS Estates (2003) http://www.dh.gov.uk/assetRoot/04/12/02/35/04120235.pdf
2. Decontamination Review: report on a survey of current decontamination practices in healthcare premises in England (December 2001) NHS Estates http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4120912&chk=lqhPNX
3. A Review of the decontamination of surgical instruments in the NHS in England (December 2001) http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4120912&chk=lqhPNX
4. HSC 2000/032: Decontamination of Medical Devices Department of Health (2000) http://www.dh.gov.uk/PublicationsAndStatistics/LettersAndCirculars/HealthServiceCirculars/HealthServiceCircularsArticle/fs/en?CONTENT_ID=4002990&chk=sHEhLb
5. Sterilization, Disinfection and Cleaning of Medical Equipment: Guidance on Decontamination from the Microbiology Advisory Committee to Department of Health, Medical Devices Agency http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary=true&ssDocName=CON007438&ssTargetNodeId=575
8. Keywords
decontamination surgical instruments reprocessing reusable medical devices best practice vCJD survey sterile services departments (SSD)
Reviewer's Details:
| Name: | Sue Wiseman |
| Post: | Nurse Consultant –Infection Control, DH |
Affiliations
(Society / Organisation / Advisory Committee): | Member Advisory Committee on Dangerous Pathogens
Health Protection Adviser Royal College of Nursing P/T
Member Infection Control Nurses Association |
*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.