Does your EP cables reprocessing hold up to Joint Commission scrutiny?

Hospitals routinely reprocess reusable instruments in their Central Service or Sterile Processing & Distribution departments. Routines here are set up to effectively and safely make the reusable devices/instruments ready for another use, theoretically based on manufacturer instructions about cleaning and (sometimes) testing. However, Central Sterile departments, like so many other departments in hospitals, are also under pressure to conduct the reprocessing of reusable devices in an efficient and economical manner, and such objectives can easily clash with the formal demands for safe and effective reprocessing. When processes are standardized to increase efficiency, it is easy to skip steps or fail to accurately identify devices and treat them according to device specific instructions.

Electrophysiology (EP) cables are a great example of this: There are literally hundreds of different cables connecting EP devices to capital equipment – and they all pretty much look alike. In fact, in some cases, the brand/model is not even clearly displayed on the cable. Further, some EP cables are designated “single-use” by the manufacturer, while reusable cables can be reused 5 times, 15 times, 25 times; it varies from cable to cable. Central Sterile technicians literally have to know all the different cables, accurately identify them, clean them according to their specific instructions, and count how many times they have been used. Instead, it is tempting to simply reprocess an EP cable as many times as it can before it “breaks”; in fact, this may be the only practical way of handling the cables in a busy Sterile Processing department. However, this can create disruption to routines before or during procedures and cause significant delays while another cable is located.

 

...it is tempting to simply reprocess an EP cable as many times as it can before it “breaks”...

 

Additionally, the hospital risks Joint Commission surveyors catching this practice, which is not a risk worth taking.

It’s a real challenge: Most cleaning instructions are very broad, ‘The cable can withstand cleaning with soap solutions or alcohol,’ while others are more extensive and specific; they may require special treatment of the connector or even that the cable is tested before sterilization and reuse. Add to this that EP cables come with a manufacturer-determined and FDA-regulated maximum number of times the cable can be used. Most CS/SPD departments just don’t have the capacity or work routines to ensure cables are cleaned exactly to instructions, that they are tested, and that the number of uses are counted. 

At Innovative Health, we have received reports from several of our hospital partners across different regions of the U.S. that the Joint Commission is “cracking down” on Central Sterile departments that can't accurately track how many times an electrophysiology (EP) cable has been used and that don’t test and clean cables to manufacturer specifications. The focus of the Joint Commission seems to be on confirming that cleaning methodology is standardized across device categories and follow the appropriate instructions for use from the manufacturer. We do not know what has caused this focus, but the introduction of more single-use EP cables that cannot/should not be sent to the Central Sterile could be a contributing factor. Hospitals are just not used to distinguishing between different EP cable types. Central Sterile staff actually need to ensure their staff members can identify individual cables and treat them according to their specific use instructions: Reusable cables are different from non-sterile cables, which are different from single-use cables. If not, there is a risk that single-use cables are reused several times, cleaning is inadequate or no testing is conducted.

 

We have the capacity to clean, test, cycle count and sterilize (as of today) 107 different EP cables...

 

At Innovative Health, we experience that a growing number of our hospital partners send their EP cables with used single-use EP devices to our reprocessing plant. We have the capacity to clean, test, cycle count and sterilize (as of today) 107 different EP cables to meet all Joint Commission requirements – and to avoid taking a chance that the cable still works...

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