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Sterile instruments vital link to patient recovery by Dick Peterson Public Relations It takes more than a modern operating room with the latest technology and the best surgical team to put a patient back on the mend.  It takes sterile instruments—reusable, often delicate and precise tools that have been expertly cleaned and sterilized to protect the patient from infection. Goes without saying, doesn’t it?  Actually, it’s not said enough, say Dave Hutto and Verna Bugg. It’s not said enough that this mostly unseen and indirect patient care service is a vital link to successful, infection-free patient care and recovery. “Everything we do here depends on having sterile instruments. We’re the key to making the OR look good,” said Hutto. Hutto, who manages the main and ambulatory operating rooms, and the Sterile Processing Department (SPD), and Bugg, the SPD coordinator, said that the sterile processing of reusable medical instruments affects every patient coming through the medical center.  Calling the SPD the medical center’s “germ killers,” Hutto said the highly technical and thorough processes used to clean and sterilize instruments— to kill those germs—is based mostly on the kinds of instruments being cleaned and how quick a turn-around is needed so they can be used again. “Turn-around time is important,” Hutto said. “It affects cost; it means the hospital won’t have to buy more.” When used medical instruments from the OR come to SPD, located on the first floor at the rear of the Children’s Hospital, they are first decontaminated. Organic matter is removed by thoroughly washing them mechanically or by hand. Some have to be disassembled in the process. They are then washed, rinsed and undergo a lubrication process before drying. At this point they are still not sterile, but they are reassembled, inspected to be sure they are in working order and not damaged. Each instrument is wrapped and computer-tracked to be sure it is not slated for recall, or to document any damage. Bugg said three sterilization methods are used depending on the type of instrument being used, the material it’s made of and how fragile the instrument might be. She listed steam under pressure, ethylene oxide gas (which requires 12 to 15 hours of aeration to remove traces of the chemical), and a hydrogen peroxide-plasma solution used in a Sterrad machine. The department sterilizes more than 10,000 instrument sets and individual items each month. Of course, safety is a major concern, so SPD workers follow strict accountability and safety guidelines set by the Centers for Disease Control and Prevention, the Association for the Advancement of Medical Instrumentation, the Food and Drug Administration, the Association of Operating Room Nurses, and the Occupational Safety and Health Administration. “We’re the first line in minimizing hospital infections,” Hutto said. “Our job affects a patient’s health, length of stay, recovery time, and the cost of medical care.”