What Do You Know About Pre-Treatment?
When does pre-treatment happen?
Immediately after use of reusable instruments
A new MA is learning the proper procedure for pre-treatment, and they ask you "why are we supposed to make sure that the red biohazard bin isn't too full?"
How do you respond?
1) We have to make sure that the bin can properly close and lock
2) We have to make sure that the instruments stay moist to prevent development of biofilms
How should instruments be positioned prior to spraying/soaking/rinsing?
In an open position
Which articles of PPE should you wear during the pre-treatment process? (& why do we wear that PPE?)
-Gloves - prevent transmission of pathogens & prevent exposure to enzymatic spray
-Eye Protection - prevent exposure to enzymatic spray
-Mask - droplet precautions r/t COVID-19 infection prevention
Why do we pre-treat reusable instruments?
To prevent the build up or adhesion of inorganic or organic materials to the surface of instruments.
Your teammate has a very demanding provider schedule today and your provider is on PTO this week.
They just finished up a procedure and were informed by their provider that another patient is still waiting for a BP re-check.
Your teammate is thinking out loud and states "I will re-check that blood pressure since that's fast and then I'll clean up the procedure room"
How do you respond?
You should offer to re-check the patients blood pressure while they clean up the procedure room
-It is important to clean up procedures and pre-treat instruments immediately after use (prevent biofilms and prevent forgetting about cleanup)
True or False: Enzymatic sprays are considered detergents & are the clinic equivalent to sterilization
False!
Enzymatic sprays are NOT detergents
Pre-Treatment is NOT equivalent to sterilization
How often should you change out the sponge, gauze, or brush used to remove VISIBLE soil from instruments?
After each use.
What delicious dish of food was used as an example for pre-treating reusable instruments.
Caked on spaghetti!
An MA is cleaning up the procedure room after an IUD insertion. They notice that there are instruments left in the biohazard bin from an earlier procedure.
Since the instruments in the bin aren't from them, they decide they are not responsible for cleaning them. The MA decides to carry their instruments to the utility room, but ensuring that they are pointed down and they walk slowly.
Did the MA handle this properly? Is there anything else the MA could have done?
No. We should never transport used sharps without a puncture resistant, closed/locked, & properly labeled bin.
(Risk for pathogen exposure)
The MA should have brought all instruments to the utility room to clean immediately and notified NQS.
Where in the clinic do you spray the reusable instruments with enzymatic spray?
In the red biohazard tray, in the utility room
*Never in the sink, enzymatic sprays should not enter water supply, they are extremely toxic to aquatic life
What is the final step of the OR Region Reusable Instrument Pre-Treatment Procedure?
Remove gloves and wash hands.
What is Pre-Treatment?
prelimary cleaning to remove anything that may interfere with sterilization or disinfection
An MA notices that the latch of the reusable instrument transport bin is broken, what should the MA do?
1) DO NOT USE this bin
2) Notify their CCC
3) Use a different, appropriate bin if needed
What role do enzymatic sprays/detergents play in the pre-treatment process? (aka why do we use them?)
They prevent adhesion of surgical soils to the surfaces of surgical instruments and scopes
-keep the instruments/scopes moist and begin breaking down blood, fat, and proteins prior to sterilization
Describe how biohazard trays and bins should be kept when not inserting instruments
Closed & Locked
What steps are included in "Pre-Treatment"
1) Manual Friction
2) Enzymatic Soaking
3) Spray gel to keep instruments wet
The patient is at the clinic to have skin biopsy of a suspicious mole and is lying on the procedure waiting for the procedure to begin.
While setting up, the MA notices dried blood on one of the instruments.
1) What should the MA do?
2) What is one reason dried blood may have been present?
1) The MA should remove all instruments and supplies and begin a new set-up.
The sterile field would be considered contaminated, and use of improperly sterilized instruments may spread deadly pathogens
2) The instrument wasn't properly cleaned before it was sterilized and packaged
What brand of enzymatic spray is used at PMG Bethany?
Getinge Clean Ready-To-Use Renuzyme Foam Spray
What qualities must the container have when transporting used instruments from the procedure room to the treatment room?
1) closed
2) puncture-resistant
3) labeled "Biohazard"