Effectiveness of autoclaving in sterilizing reusable medical devices in healthcare facilities

Panta, Gopal; Richardson, Ann; Shaw, Ian C.

doi:10.3855/jidc.11433

Cited by 38 publications

(28 citation statements)

References 32 publications

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“…Moreover, several papers were pilot or preliminary studies. Numerous authors contended that presurgical care, which includes SP, has been overlooked in IPC research (O’Hara et al, 2015) and that SP in LMICs has been understudied compared to HICs (Fast et al, 2017; Forrester et al, 2018c; Panta et al, 2019a).…”

Section: Resultsmentioning

confidence: 99%

“…Previous literature has examined challenges associated with access to safe surgery in LMICs, including resource constraints and limitations in surveillance (Allegranzi et al, 2011). Much of the evidence currently available on SP, however, concerns circumstances and practices in HICs (Nyberger et al, 2019; Panta et al, 2019a). While IPC initiatives in LMICs have shown effectiveness in reducing the incidence of SSI (Allegranzi et al, 2018) and in promoting practice changes (Jones et al, 2015), these programmes have not included SP and comparatively little is published about the role of SP in safe surgery and IPC initiatives.…”

Section: Introductionmentioning

confidence: 99%

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Sterile processing in low- and middle-income countries: an integrative review

Cuncannon

Dosani

Fast

2020

Journal of Infection Prevention

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Background: Worldwide disparities in surgical capacity are a significant contributor to health inequalities. Safe surgery and infection prevention and control depend on effective sterile processing (SP) of surgical instruments; however, little is known about SP in low- and middle-income countries (LMICs), where surgical site infection is a major cause of postoperative morbidity and mortality. Aim: To appraise and synthesise available evidence on SP in LMICs. Methods: An integrative review of research literature was conducted on SP in LMICs published between 2010 and 2020. Studies were appraised and synthesised to identify challenges and opportunities in practice and research. Results: Eighteen papers met the inclusion criteria for qualitative analysis. Challenges to advancing SP include limited available evidence, resource constraints and policy-practice gaps. Opportunities for advancing SP include tailored education and mentoring initiatives, emerging partnerships and networks that advance implementation guidelines and promote best practices, identifying innovative approaches to resource constraints, and designing and executing quality assurance and surveillance programmes. Discussion: Research investigating safe surgery, including SP, in LMICs is increasing. Further research and evidence are needed to confirm the generalisability of study findings and effectiveness of strategies to improve SP practice in LMICs. This review will help researchers and stakeholders identify opportunities to contribute. The burdens of unsafe surgery transcend geopolitical borders, and the global surgery and research communities are called upon to negotiate historical and present-day inequities to achieve safe surgery for all.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sterile processing in low- and middle-income countries: an integrative review

Cuncannon

Dosani

Fast

2020

Journal of Infection Prevention

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“…Various studies have reported HAIs linked with inadequately sterilized medical devices in different places [12][13][14][15][16]. A recent review found steam sterilization failure rates ranging from 1.5 to 43.0% worldwide, with higher failure rates in developing countries [17].…”

Section: Introductionmentioning

confidence: 99%

Compliance of primary and secondary care public hospitals with standard practices for reprocessing and steam sterilization of reusable medical devices in Nepal: findings from nation-wide multicenter clustered audits

Panta¹,

Richardson

Shaw

et al. 2020

BMC Health Serv Res

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Background Reusable medical devices in healthcare facilities are decontaminated and reprocessed following standard practices before each clinical procedure. Reprocessing of critical medical devices (those used for invasive clinical procedures) comprises several processes including sterilization, which provides the highest level of decontamination. Steam sterilization is the most used sterilization procedure across the globe. Noncompliance with standards addressing reprocessing of medical devices may lead to inadequate sterilization and thus increase the risk of person-to-person or environmental transmission of pathogens in healthcare facilities. We conducted nationwide multicenter clustered audits to understand the compliance of primary- and secondary-care public hospitals in Nepal with the standard practices for medical device reprocessing, including steam sterilization. Methods We developed an audit tool to assess compliance of hospitals with the standard practices for medical device reprocessing including steam sterilization. Altogether, 189 medical device reprocessing cycles which included steam sterilization were assessed in 13 primary and secondary care public hospitals in Nepal using the audit tool. Percentage compliance was calculated for each standard practice. Mean percentage compliances were obtained for overall primary and secondary care hospitals and for each hospital type, specific hospital and process involved. Results For all primary and secondary care hospitals in Nepal, the mean percentage compliance with the standard practices for medical device reprocessing including steam sterilization was 25.9% (95% CI 21.0–30.8%). The lower the level of care provided by the hospitals, the lower was the mean percentage compliance, and the difference in the means across the hospital types was statistically significant (p < 0.01). The mean percentage compliance of individual hospitals ranged from 14.7 to 46.0%. The hospitals had better compliance with the practices for cleaning of used devices and transport and storage of sterilized devices compared with the practices for other processes of the medical device reprocessing cycle. Conclusion The primary and secondary care hospitals in Nepal had poor compliance with the standard practices for steam sterilization and reprocessing of medical devices. Interventions to improve compliance of the hospitals are immediately required to minimize the risks of person-to-person or environmental transmission of pathogens through inadequately reprocessed medical devices.

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“…Economic implications of SSI often result in higher health care cost, prolonged clinic stays, induced stress on the patient and their families [2,7]. It also financially burdens the healthcare system, creates additional workload for the healthcare workers, precipitates extended disabilities and sometimes death [1,2,8].…”

Section: Introductionmentioning

confidence: 99%

Low-cost biofuel-powered autoclaving machine for use in rural health care centres

Ahmed

Ibitoye

Zubair

et al. 2020

Journal of Medical Engineering & Technology

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Surgical site infections (SSIs) in developing countries have been linked to inadequate availability of sterilising equipment. Existing autoclaves are mostly unaffordable by rural healthcare practitioners, and when they managed to procure them, the electricity supply to power the autoclaves is epileptic. The solar-powered autoclave alternatives are too bulky with a very high initial cost. Hence, low-cost biofuel-powered autoclave becomes an attractive option, and this study sought to present the design, development and clinical evaluation of the device performance. With the global drive for the adoption of green energy, biofuel will not only reduce greenhouse gas emission but also provide revenue for local producers and reduce biomass associated health complications. The theoretical energy requirement for the sterilisation process was calculated. The standard pressure and temperature needed for sterilisation were tested to be 121 C and 15 psi. The device was also clinically tested with Staphylococcus aureus bacteria obtained from the

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Effectiveness of autoclaving in sterilizing reusable medical devices in healthcare facilities

Cited by 38 publications

References 32 publications

Sterile processing in low- and middle-income countries: an integrative review

Sterile processing in low- and middle-income countries: an integrative review

Compliance of primary and secondary care public hospitals with standard practices for reprocessing and steam sterilization of reusable medical devices in Nepal: findings from nation-wide multicenter clustered audits

Low-cost biofuel-powered autoclaving machine for use in rural health care centres

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