An Association of Perioperative Practice (AfPP) request for information from members on the standard of outsourced decontamination of surgical instruments has seen three-quarters of those with experience of such services critical of their effectiveness.
- Patients waking up to be told surgery had not happened because instruments had been wrongly labelled off-site.
- Instruments being returned with blood and bone clearly visible.
- “Much longer” turnaround times for instruments sets being cleaned and returned than originally promised.
Diane Gilmour, AfPP decontamination lead, said: “If we can’t rely on the very tools of our trade to be back, complete and clean in order for operations to go ahead, patient safety is bound to be compromised. In some instances an operating list may be determined by which instruments are available, rather than by clinical need, and the fast-tracking procedures are simply too slow.”
The Association says its findings echo those in an NHS Decontamination Programme report, which apparently revealed that 1,765 operations had been called off “at the last minute” in 2005-2006 because of instrument problems. Diane Gilmour added: “When lost or broken instruments and mixed up trays become more and more frequent then patient safety is a serious risk.
Practitioners and patients need to be assured realistic deadlines are now being set to ensure these problems will be reduced to acceptable levels within a short space of time.”
Martin Williams, chairman of The Institute of Decontamination Services (IDSc), the professional body for those working in decontamination of reusable surgical instruments in the UK, responded: “The Institute recognises the provision of decontamination services has changed significantly since the Department of Health National Review, but also the significant improvements in the standards to which these services are expected to operate.
“The National Decontamination Programme was devised to promote public sector partnerships to provide state-of-theart facilities offering an alternative to the significant investment that would have been required to replace poorer standard departments within the NHS. There is acknowledgement there have been teething problems with a number of service providers.
However, the statement regarding cancelled operations related to instrument problems quoted figures which are somewhat out-of-date, and came before the first supercentre had been built. Mechanisms are being put in place to prevent services transferring to off-site facilities until checks have been undertaken on both parties’ readiness to move services to a different service provider.
“The AfPP statement also suggests that three quarters of the association’s members with experience of outsourced decontamination services who responded reported negative experiences. However it did not say how many members or the number of hospital sites this represented. Nor did it say if they were asked if those with in-house on-site services had similar concerns.
“Irrespective of the location of decontamination services, the standards to which equipment needs to be reprocessed remain the same, and both the user and the service provider need to work together to achieve these and ultimately safeguard patient interests.”
