DS 34 - Centralizing High-level Disinfection Resulted in Improved Workflow and Decreased Utilization of Manpower Hours

Background: Decentralized pre-cleaning and high-level disinfection (HLD) increases manpower hours and risks for inconsistent practices.
Strategies to foster consistent practices and efficient workflow when handling contaminated probes at the point of care include standardizing processes, coordination between clinical and HLD staff, and staff education about safe probe handling.

Methods: A multidisciplinary team (Nursing, Infection Preventionists, Procedural Technicians, and Sterilization staff) brainstormed on redesigning processes regarding contaminated probes. In order to ensure consistent pre-cleaning steps, transporting and storing of probes and timely HLD, a centralized model with dedicated and trained staff was suggested. The team reviewed the phases of decontaminating probes. Risk points were identified including inconsistent use of lint-free wipes and/or pre-cleaning sprays, delayed transport of pre-cleaned probes, inappropriate labeling of probes and increased turnaround time for processed probes. A Reference Guide was developed to promote consistent pre-cleaning, transporting, HLD and storing of probes in the five decentralized clinical areas.

Results: A four-month review of manpower utilization using the decentralized process revealed a total of 273 probes processed with manpower utilization time totaling 1,918 minutes (31.9 hours; 1 probe for 7 minutes). When a centralized HLD process was used for the same number of probes, the manpower utilization time was 639 minutes (10.6 hours). A Centralized process is able to provide HLD for 3 probes per 7 minutes. The centralized HLD process allowed the organization to save 21.3 hours which represents a 66.7% improvement in manpower hours compared to the decentralized process. The redesigned process reinforced consistency for cleaning and disinfection. Of note, processed probes were returned to clinical and procedural areas without negatively affecting probe turnaround time to clinical units.

Conclusions: The redesigned process for high-level disinfection improved efficiency, promoted consistency and sustained compliance with safe practice standards on probe processing without a negative effect on turnaround time.