The Joint Commission Issues Safety Tips for Reprocessing Critical Gear

By Jonathan Springston, Editor, Relias Media

Healthcare providers sterilize and reuse surgical tools and other critical care device daily, but protecting patients starts with understanding and closely following reprocessing guidelines. This week, The Joint Commission (TJC) issued some helpful tips and reminders.

“Because of the costs of physical space, supplies, equipment, and personnel to perform reprocessing and sterilization of reusable devices, some organizations choose to use disposable instruments and devices for critical procedures in some or all areas of their facility. For organizations performing reprocessing, ensuring that those instruments and devices are reusable — that they are in good condition, and can be cleaned and sterilized following validated manufacturer’s instructions — is critical to patient safety,” TJC wrote in its advisory.

Standardizing procedures; following manufacturer’s instructions; and providing education, training, and competency testing for staff creates the foundation for reprocessing safety.

“Manufacturer instructions may contain the maximum number of reprocessing cycles validated for a particular item, provide a description of when an instrument is no longer appropriate for reprocessing, or may make a statement that organizations must inspect for wear and tear and determine when the items ‘useful life’ is over,” TJC wrote. “With the large number of instruments that some organizations are required to reprocess every day, ensuring careful inspection and application of the manufacturer’s instructions about useful life can be a challenge. Especially if the organization does not have replacement instruments and access to maintenance or refurbishing resources.”

TJC’s advisory includes a special section on single-use devices (SUDs), medical tools meant to be used by one provider during one patient interaction only one time. In the United States, there are some special circumstances under which SUDs can be reprocessed, but the FDA restrictions are severe, and TJC estimates “only a fraction of SUDs” could be reprocessed properly.

“Although they may look identical to a reusable instrument or device, SUDs do not have validated instructions for reprocessing and may not be designed to allow for thorough decontamination after use,” TJC cautioned. “SUDs also may be made of lower-quality metals or components that will not withstand the cleaning and sterilization processes and may deform, rust, pit, chip, or crack if they are subjected to reprocessing methods used in healthcare facilities.”

During the worst of the COVID-19 pandemic, amid a persistent shortage of personal protective equipment, the healthcare industry was forced to improvise. Some organizations found ways to reprocess certain items, especially N95 masks, to conserve supplies. Although the FDA eventually called on the industry to cease this practice, the results of a study released last month indicate reprocessing a certain single-use N95 is safe if there is a supply shortage in a future pandemic.

For more on this and related subjects, be sure to read the latest issues of Hospital Employee Health, Hospital Infection Control & Prevention, and Infectious Disease Alert.