By Sue Klacik, BS, CRCST, CIS, CHL, ACE, FCS, Clinical Educator, HSPA
The Association of periOperative Registered Nurses’ (AORN’s) Guideline for Design and Maintenance of the Surgical Suite was updated and released in June 2023. The guideline addresses design layout and equipment used in these areas as well as recommendations for functionality, energy and cost efficiency, workflow and emergencies; physical security measures; considerations and safety measures for new construction or renovation; planning for unintended utility service interruptions; restoration to full functionality; maintenance of structural surfaces; and the design, monitoring, and maintenance of the heating, ventilation and air conditioning [HVAC] system for the perioperative area – and certain sections and additions directly affect sterile processing areas.
In recommendation 3 Designing the Surgical Suite, a new recommendation was added that reflects the ANSI/AAMI ST79:2017 Comprehensive guide to steam sterilization and sterility assurance in health care facilities amendment for Environmental Services/fans/food and drink (regarding sprinkler systems). It is recommended to implement policies and procedures for cleaning, disinfecting, maintaining and repairing the sprinkler system.
Section 11 Sterile Processing Areas provides recommendations for SP design considerations. New recommendations for the design and equipment used in SP have been added, with security systems and one-way workflow now included in this section.
Additions to the section addressing the decontamination area include:
- space to collect disposable items to be sent to a third-party reprocessor
- space and location for vertical soaking containers
- space for staging dirty case carts if used
- ergonomic work counters of nonporous materials
- source of critical water for final rinsing
- record-keeping area
- instrument air outlet or portable compressed air for drying instruments
- automated testing equipment such as leak testers
- storage for decontamination supplies including medical device decontamination chemicals, cleaning verification supplies, environmental cleaning supplies, safety data sheets, manufacturers’ IFU, linen storage and trash disposal, and PPE
- space for processing patient care equipment
- space for receipt of loaned instrumentation
- space for potential future needs
Additions for SP’s clean side include:
- ergonomic work counters with space to accommodate the volume of equipment assembly (e.g., magnifying lights) for the procedures performed in the facility (e.g., cleaning nonporous material design) and the expected staffing levels
- space for instrument lubrication
- space for monitoring and record-keeping supplies
- record-keeping area and accessories for computers if used
Note: The complete revised edition has been updated in the AORN eguidelines at www.aorn.org/eguidelinesplus and will be in the 2024 print version (available for purchase on the AORN website at www.aorn.org).
AAMI Approves Two New Working Groups
The Association for the Advancement of Medical Instrumentation (AAMI) approved two new working groups to provide guidance for processing medical devices in health care facilities: AAMI ST-WG45 Processing of tattoo machines and accessories in health care settings and AAMI ST-WG61 Chemical Sterilants Hospital Practices.
Health care facilities use medical tattoos to treat a condition, communicate information or mark a body location. For example, tattoos are used as fiducial markers to aid in guiding radiotherapy. AAMI ST-WG45 will develop a new technical information report, AAMI TIR117/Ed.1 Guidance for processing tattoo machines and accessories in the health care setting. This document will provide health care personnel with information about point-of-use treatment, transportation, testing (where applicable), cleaning, disinfection, sterilization, packaging, and storage of tattoo machines and accessories used in health care settings.
AAMI ST-WG61 will develop TIR118/Ed.1 Guidance on ultraviolet (UV) disinfection for medical devices in health care facilities to provide recommendations about the use of ultraviolet (UV) disinfection for medical devices and patient care equipment in health care facilities. Specifically, the document will include comprehensive information for health care personnel regarding the processing of reusable devices and accessories to render them safe for patient use.
