Droplet dispersal in decontamination areas of instrument reprocessing suites

Abstract

Background: Personnel working in sterile processing or endoscope reprocessing departments are at high risk of exposure to tissue, blood, and patient fluids when decontaminating reusable medical instruments and equipment. The effectiveness of protective measures for reprocessing personnel has not yet been systematically evaluated in real-world settings. Objective: This pilot project aimed to identify reprocessing activities that generate splashes, determine how far droplets can travel in decontamination areas, and assess personal protective equipment exposure during routine activities. Methods: Moisture-detection paper was affixed to environmental surfaces and personal protective equipment in a sterile processing department. Droplet dispersal was assessed after personnel simulated performance of routine reprocessing tasks. Results: Visible droplets were generated during every reprocessing activity except running the sonication sink. Droplets traveled at least 3 feet when filling a sink, brushing a ureteroscope, and using a power sprayer to rinse a basin. Some activities dispersed droplets up to 5 feet from the sink. Personal protective equipment was splashed during most activities and did not prevent skin exposure even when properly donned and doffed. Conclusion: This hypothesis-generating pilot project found that routine reprocessing activities generated substantial splashing, and currently recommended personal protective equipment did not adequately protect sterile processing personnel from exposure.

Adoption of Improved Reprocessing Decreased Microbiological Non-Compliance for Bronchoscopes

“…New data published in a recent study, in fact, suggest that personnel who process reusable endoscopes may be frequently exposed to tissue, blood, and patient fluids even when wearing recommended PPE. The first real-setting evaluation of PPE effectiveness for reprocessing personnel found that PPE does not provide adequate protection [ 35 ].…”

Clinical Issues—November 2022

“…However, in a more relevant pilot study conducted in a sterile processing setting, researchers found that droplets may travel farther than 4 ft from the decontamination sink during endoscope processing, and possibly more than 5 ft during some activities 4 . In this study, researchers used moisture‐detection paper placed at varying distances between 3 and 5 ft from the decontamination sinks to detect visible droplets during several routine endoscope‐processing tasks.…”

Clinical Issues — August 2023

“…The endoscopy storage cabinet should not be located inside an endoscopy processing room that uses a one‐room design or inside the dirty workroom of a two‐room design 1 . Researchers of a study on splash generation and droplet dispersal in a high‐level disinfection unit found that droplets generated during endoscope decontamination processes can travel from 3 to 7.25 ft from the decontamination sink 6 . The maximum distance that aerosolized droplets can travel from the decontamination sink during endoscope processing is unknown; additional research is needed to evaluate interventions that prevent droplet dispersal.…”