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The Work of Nurses in the Central Sterile Supply Department and Its Implications for Patient Safety

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The Work of Nurses in the Central Sterile Supply Department and Its Implications for Patient Safety | EDITORIAL | THE WORK OF NURSES IN THE CENTRAL STERILE SUPPLY DEPARTMENT AND ITS IMPLICATIONS FOR PATIENT SAFETY DOI: 10.5327/Z1414-4425201600010001 he association of health care and infections is consid- the health team have an integrated view of the challenges ered a significant public health problem. The process- and resources needed to fight those. T ing of health products is considered a complex activity When considering the complexity of the CSSD mission, within the context of health facilities, whose main objec- the work processes in this place cannot be considered sim- tive is to avoid the occurrence of any adverse event related ple, repetitive, and of minor importance within the insti- to their use. Nowadays, not only the potential transmission tution. Nowadays, the CSSD practices are based on scien- of infection-causing microorganisms is concerning, but also tific evidence, which point out to severe consequences for their toxic products or the occurrence of reactions because the assistance given to patients when recommendations of residues from products used for cleaning, disinfection, are not followed, such as undervaluing stages of material and sterilization of health products. processing, thinking that a process may substitute another, A circumstance recently broadcasted in the media and that flaws may be compensated. Thus, the monitoring reports that the lack of sterilization of instruments used in of each phase in the processing of health products as well a cataract surgery campaign caused the contamination of as the description of all standard operational procedures 22 patients by Pseudomonas bacteria, resulting in numerous are considered essential1. consequences, such as sight loss, removal of the eyeball, The attitude of each employee working in the CSSD and in addition to other intangible losses, thus, confirming the the work of nursing supervisor directly influences the fea- failure of the safety standards regarding the surgical instru- sibility of the safe care toward the surgical patient, even if ments used in those procedures. the care is indirect, ensuring the reproducibility of the pro- Failures in cleaning, disinfection, and sterilization of cess in its entirety. These attitudes permeate the possibility health products may result in significant institutional cost, of tracking all the phases of material processing regarding and patient morbidity and mortality. Proper cleaning, disin- hospital infection control in case of a necessary recall of fection, and sterilization procedures have been emphasized in health products. various publications documenting the rise in infection after It is noteworthy that statistical measures are important inappropriate processing of items of patient care. so that the goals are defined, increasingly challenging the The main target in this context, the Central Sterile Supply perception of safety regarding the infections of surgical sites. Department (CSSD) is characterized by unique characteris- Such goals may only be achieved through constant efforts tics, daily challenging the manager in this area with regard from a multidisciplinary team, involving professionals of to the environment, the structure, and the proper processing the Hospital Infection Control Service of the CSSD, in the of health products in a safe, efficient, and a financially -via Surgical Center of Clinical Engineering, the Supplies, the ble way. For such, professionals in this department should be Hospital Hygiene Service, the management, and adminis- aware of up-to-date market trends, technological advances trative sectors, which interact in the context of prevention associated to the complexity of surgeries and the surgical practice to hospital infections. instrumentation design and still must follow the rules, laws, Managers responsible for these teams need to master the and recommendations to their practice, in addition to attend skills that are relevant to their fields in order to avoid errors client’s expectations. that cause violations of the security process, thus respecting In a broader understanding on the determination of the the surgical patient who becomes more fragile during sur- health–disease process, it is important that professionals in gical procedures. | 1 | REV. SOBECC, SÃO PAULO. JAN./MAR. 2016; 21(1): 1-2 MORIYA GAA, TAKEITI MH Giovana Abrahão de Araújo Moriya Márcia Hitomi Takeiti PhD in Nursing Master in Nursing Coordinator of Nursing in the Material and Sterilization Center Head Nurse of the Production, Sterilization and Control (Centro de Material e Esterilização – CME) of the Sociedade of Material and Equipment Section Secção de Produção, Beneficente Israelita Brasileira Albert Einstein Esterilização e Controle de Materiais e Equipamentos – SPECME) Director of the Education Committee of National SOBECC– of the Heart Institute of Hospital das Clínicas in the University Administration 2015/17 of São Paulo (InCor HC FMUSP) – São Paulo (SP), Brazil President of National SOBECC – Administration 2015/17 REFERENCE 1. Gil RF, Camelo SH, Laus AM. Atividades do enfermeiro de centro de material e esterilização em instituições hospitalares. Texto Contexto Enferm. Florianópolis. 2013;22(4):927-34. | 2 | REV. SOBECC, SÃO PAULO. JAN./MAR. 2016; 21(1): 1-2 | ORIGINAL ARTICLE | BIOSECURITY IN CENTRAL STERILE SERVICES DEPARTMENT: THE DOUBTS OF PROFESSIONALS* Biossegurança no Centro de Materiais e Esterilização: dúvidas dos profissionais Bioseguridad en el Centro de Materiales y Esterilización: dudas de los profesionales Solinei Paulo Borgheti1, Karin Viegas2, Rita Catalina Aquino Caregnato3 ABSTRACT: Objective: This work aims at knowing the doubts health professionals may have about biosecurity in Central Sterile Services Department (CSSD), and reflect upon the answers. Methods: This is a qualitative, descriptive exploratory study. The research was about a well known Brazilian website, which offers a discussion list by e-mail. 2,260 messages were sent to this list in 2014. The sample was composed by 109 messages containing topics about bios- ecurity in CSSD; interpreted using the Bardin’s Content Analysis. Results: Four theme categories emerged from the most frequent questions: chemical solutions, equipment and materials, Law, and process validation. Both in questions as in answers analyzed, there was a strong relation between the CSSD and Hospital Infection Control. Conclusions: Most professionals who referred questions were nurses. The most frequently asked questions on biosecu- rity related to the solutions used, equipment and materials. The answers were based on existing legislation and issued by professionals with experience. Keywords: Equipment safety. Nursing. Materials. RESUMO: Objetivos: Conhecer as dúvidas dos profissionais da saúde sobre biossegurança no Centro de Materiais e Esterilização (CME) e refletir sobre as respostas emitidas. Método: Estudo exploratório descritivo qualitativo. O cenário da pesquisa foi um site nacional reconhecido que dispõe uma lista de discussão por e-mail. O corpus foram 2.260 mensagens enviadas à lista de discussão em 2014; a amostra foi composta por 109 mensagens com conteúdo relacionado à biossegurança no CME. Utilizou-se para interpretação dos dados a Análise de Conteúdo de Bardin. Resultados: Na análise emergiram qua- tro categorias temáticas das dúvidas mais frequentes denominadas: soluções; equipamentos e materiais; Legislação; e validação do processo. Evidenciou-se forte relação entre CME e Controle de Infecção Hospitalar (CIH), tanto nos questionamentos quanto nas respostas. Conclusão: A maioria dos profissio- nais que encaminharam dúvidas foram enfermeiros. As dúvidas mais frequentes sobre biossegurança relacionavam-se a soluções usadas, equipamentos e materiais. As respostas foram fundamentadas na legislação vigente e emitidas por profissionais com experiência. Palavras-chave: Segurança de equipamentos médicos. Enfermagem. Material. RESUMEN: Objetivos: Conocer las dudas de profesionales de la salud sobre bioseguridad en el Centro de Materiales y Esterilización (CME) y reflexionar sobre las respuestas fornecidas. Método: Estudio exploratorio descriptivo cualitativo. El escenario de la investigación fue un sitio electrónico reconocido que dis- pone de una lista de discusión por correo electrónico. 2.260 mensajes fueron enviados a la lista de discusión en 2014; la muestra se compuso de 109 mensa- jes con contenido relacionado a la bioseguridad en el CME. El análisis de contenido de Bardin fue empleado para la interpretación de los datos. Resultados: Emergieron en el análisis cuatro categorías temáticas de las dudas más frecuentes, denominadas: soluciones; equipamientos y materiales; legislación y valida- ción del proceso. Se evidenció una fuerte relación entre el CME y el Control de Infección Hospitalaria, en tanto en los cuestionamientos y en las respuestas. Conclusión: La mayoría de los profesionales que refirieron las preguntas eran enfermeros. Las preguntas más frecuentes sobre bioseguridad eran relaciona- das a las soluciones utilizadas, a los equipos y los materiales. Las respuestas se basaron en la legislación vigente y fueron emitidas por profesionales peritos. Palabras clave: Seguridad de equipos. Enfermería. Material. *Article produced from the Completion work of the Nursing course of the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) in 2015. 1Nurse by the Nursing course of the UFCSPA – Porto Alegre (RS), Brazil. 2PhD in Biomedical Gerontology; Professor of the Graduate Course in Nursing at the UFCSPA – Porto
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