Date of Award
Summer 2024
Project Type
Thesis
College or School
CHHS
Department
Nursing
Program or Major
Direct Entry Master's of Nursing
Degree Name
Master of Science
First Advisor
Pamela Kallmerten
Second Advisor
Elizabeth Evans
Abstract
Background: The Operating Room (OR) faces a significant challenge with the increasing presence of bioburdens on instruments. Research-based on evidence has demonstrated the critical role of precleaning at the point of care with sterile water in reducing bioburden incidence. While current practices recommend the use of an enzymatic solution post-procedure to spray instruments, it is clear that a more comprehensive approach is needed to effectively manage bioburdens and reduce the risk of Surgical Site Infections (SSI).
Methods: Utilizing the Plan-Do-Study-Act (PDSA) model to create a Quality Improvement (QI) solution, the project leader recommended using sterile water at the point of care to preclean instruments while in use. Staff were observed using sterile water, and data on bioburdens were compared pre- and post-intervention to evaluate the initiative's effectiveness.
Intervention: An educational service was provided to reeducate staff on the importance of precleaning instruments and their impact on patient safety. Staff were encouraged to use sterile water at the point of care to reduce instrument bioburdens.
Results: Data analysis showed no significant changes in the presence of bioburdens over the project’s 4-week period compared to the previous period. However, using sterile water at the point of care has made a difference in the quality of used instruments upon arrival at the Sterile Processing Department (SPD). A notable increase (90%) in using sterile water to preclean instruments compared to the 5% observed during pre-intervention.
Conclusion: Implementing this QI project encouraged using sterile water at the point of care to preclean surgical instruments. The continuous use of sterile water at the point of care use could help reduce the number of instruments found with bioburdens. SPD should provide annual educational training to ensure staff are informed on best practices. Creating a policy and educational reinforcement will guide staff on expectations.
Keywords: Surgical Instruments, Bioburdens, Bioburdens on instruments, Quality Improvement, Sterile Water, Surgical Site Infections, SSI, Operating Room, Sterile Processing, Patient Safety
Recommended Citation
Denton, Nicole Dannett, "A Quality Improvement Initiative to Redefine the Process of Instrument Decontamination from the Surgical Field in the Operating Room to the Sterile Processing Department." (2024). Master's Theses and Capstones. 1796.
https://scholars.unh.edu/thesis/1796