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Reprocessing of the surgeons tools

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Each and every hospital around the world got a Central sterile supply department (CSSD). These departments come in different sizes depending on the activity in the hospital. People in these departments are doing a very important job, because their main focus is patient safety and the prevention of hospital associated infections. I have been working for some years in the CSSD, and I have been asking myself many times: Does the hospital management, the suppliers, the surgeons, the peri operative nurses and hospital staff in general got the enough knowledge about reprocessing of the surgeons tools?

An instrument set

What is the surgeons tools?

The “tools” I am talking about is actually a medical device, an instrument made of different components. Each instrument is made to serve a specific purpose like cutting, desiccation or holding tissue. The length on each instrument will differ too depending on the tissue to operate in, and if the patient is a child, adult, slim or obese.

Some are power tools like a saw or a drill. Other instruments are more or less made of stainless steel, but even these instruments will corrode if they are not being taken properly care of.  Each instruments got a name and most of these instruments are named after famous surgeons.

 

The CSSD staff

People working in a CSSD got different background. They can be nurses, peri operative nurses, technicians and so on. But they all need a basic knowledge how to maintain and take care of each instrument. Each and everyone need knowledge about microbiology, hygiene, chemistry, metallurgy, physics, technical and IT skills.

I can´t write about all the topics whish are important in a CSSD. But the staff are taking care of the cleaning and disinfection, control of  the instruments, wrapping of instruments sets, sterilizing and the storage of each sterile product. But it is not a quick fix job. Each step means a lot of work like controlling the disinfector, controlling the autoclave, rewash, sending an instrument for repair, oiling the box lock, change an instrument, update the content list, wrapping the instrument, putting a set in a container and more. To put an instrument set in an autoclave depends on the different instrument sets which are ready for sterilizing. There must be a thought behind each step in the CSSD to make sure that you and I can be operated safely.

But despite this knowledge the CSSD staff need, they are like lowest in the hierarchy. Why?

Over time with a lot of lifting of 8 -10 kg´s instrument sets, the staff get problems with muscles and joints. The job is very stressful, because there is often no correlation between the work to be done and the available staff. We all know that chronic stress may cause a burnout. Burnout is dangerous in the CSSD because you need to be concentrated when you are doing the instrument control.

Chronic stress and diseases

Reprocessing

In my department we say that it takes 3 hour to reprocess an instrument set. But our customers don´t believe that. So do they have any knowledge about reprocessing of the surgeons tools? Apparently not.

The washer disinfector use one hour. After the washing the instruments hold 90 degree and need to cool down, before you can hold them. The control time may take up to an 1.5 hour. It depends whether you have to rewash it in the washer machine. It may be repeated if the instrument is very dirty. First when it is visually cleaned you can wrap and sterilize it. The sterilizing process take about 1 hour, and if there are errors in this process, you have to unwrap and rewrap. When the sterilizing process is done, the instruments need to cool down before storage or sending to the customers. It takes no time to make an instrument unsterile or dirty, but the reprocessing takes at least three times more.

But it seems like the staff in the operating room forget that the CSSD is serious business. Each step is important to keep the instruments sterile.

Cooperation with customers

It seems like production and the usage of single use instrument is a trend. That is good. But it is not to your benefit that single use instruments come to the CSSD for reprocessing. It happens when the operating room staff want to save money.

The industry makes a lot of money  for in some occasion tiny little parts, and I find it unethical. Single use instruments being reprocessed is dangerous, because you change the instruments features. The risk is lack of strength and danger of breakage. Yesterday I experienced some handles that don´t tolerate liquid. These handles were actually not a single use instrument.

So suppliers must take their responsibility. Reprocessing must be the first thing you want to know something about before you buy it. The instruments are expensive, but a patient with infection is even more expensive and could actually be lethal.

 

It takes no time to make an instrument unsterile or dirty, but the reprocessing takes at least three times longer.

 

So you see I got reasons to ask; is there any knowledge about the reprocessing of the surgeons tool? It doesn’t seem like there is…..

Chronic stress and diseases

Burnout- will I ever recover?

https://wp.me/pb4jAC-s8

 

 

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Google- friend or enemy?

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My blog has unfortunately become a non-hobby blog, and more in the addition category. It is not what I have planned, because my creativity is at its peak now. Instead I am struggling with things I don’t want to spend my leisure time on. Like Google……

Google- friend or enemy?

Google has been working fine until now, and all of the sudden its not……

I am not good with computers and programming, and I often struggle with guidelines and procedures when it is written in English. To read long explanations where you don’t get to the point and the links are linked up with other links makes me really impatient…..

I have tried to verify my web site in the search console. The problem is that I got two Gmail accounts. One account is for business and work, and the other account for private e-mails. So when I think I have logged in to my business account it has been switched to my private account. That is very annoying.

So in the search console I am declined with the message: «You don’t have the access. Is it yours, verify your domain». I find that very strange because Google knows everything about me and my accounts. Because When you are signing up for a Gmail account you need to add a second e-mail address for security precautions……..

My advice to you

If you want to make a Gmail account, I would advice you to use a second e-mail from a total different provider. Another tip is not to use the same profile picture on both accounts. That is another way to divide your accounts from each other.

I have made these mistakes and they have made me struggle. To verify my owner ship in Google you have to copy a specific Google verification code, and paste it in Yoast SEO webmaster tool. That is super easy, but not with Google…..It keeps on switching the accounts.

I don’t know how many times I have copied and pasted a code, but I am constantly declined.

Other options

I know there is other options to verify my site like pasting the gtag in the head snippet…So if someone would tell me how and where to do that I would be really happy. I am knew in WordPress so I am really careful when it comes to making changes. https://hobbiesofmine.blog/2019/08/03/beginner-in-wordpress-blog/

So today I downloaded a plugin called WP global site tag, because I do have a Google analytic Id.

The final solution

I struggled with WP global site tag too. But my solution was the plugin «Head, foot and post injections» in WordPress, and Google tag manager. In the tag manager, under the administrator tab, I generated some codes under « install Google tag manager». One code was pasted in the <head> section of the plugin, and another code was pasted right after the <body> tag. The best part of it, I could not go wrong. The plugin took care of the rest. And voila….The plugin did the rest for me.

No wonder I ask the question is Google – friend or enemy? So now I have experienced problems with the most famous search engine and affiliate links within a six months period. What would be next?

https://wp.me/pb4jAC-hD

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My Sony noisecancelling headphones

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Have you ever got a gift you didn’t know you needed, and which after a short while meant the world to you? That is the story about my Sony noise canceling headphones.

Headphones, as we all know,  come in different variants and mostly wired. They also come with ear plugs that almost don’t seem to fit the ear tubes. They seem to pop out like pop corn in the micro wave. You can just feel how they are slipping out of your ears and in the next minute they are on the shoulder or the chest. How annoying isn’t that? And those wires I always seem to forget. A little step aside, and the phone is in the floor with a «big bang». I started to use a little fanny bag, but then I have to struggle with the zipper to reach the phone.

Last christmas, as a chrismas gift, I was so lucky to have these beautiful headphones.

Since last christmas me and my headphones have developed a kind of symbiotic relationship. If I don’t have my headphones around my neck I feel naked. It is just like driving a car without a car belt. It is unthinkable since the car belt is mandatory.

Technical my headphones are called LE_WH-1000XM3 to be precise. They come in a nice little bag with connectors to pc, radio and a charger. I have only used the charger so far, which is a little bit to short to be honest. I found out I could charge the headphone with my phone charger. In that way the headphones could charge safely at the table. They can connect to any device with Bluetooth and the reach is approximately 10 m.

You can easily choose between ambient sound control on or ambient sound control off, and noise canceling. So if you listen to music or an audio book, you can choose to hear human voices or you can shot them nearly all out.

I listen a lot to audio books and music. It has become so much easier when I don’t have to think of the wire all the time. My Sony noise canceling headphones have also been a must during this summer, because of some couples of sea gulls nesting on a neighboring roof.

Children with ADHD and Tourettes with sleeping problems will benefit using this type of headphones at bedtime and as a noise cancellor at school. Children with ADHD and Tourettes got sleeping problems. That is a part of the diagnosis and a part of medication.  These children are very audio sensitive, so the noise canceling function is an advantage for them. So while they are in bed they could listen to affirmations, mindfulness or just an audio book.The headphones are very comfortable to wear than ordinary ear plugs and much easier to accept. I write about ADHD and medication in https://wp.me/pb4jAC-1Z

After I started to use the headphones,  I have realized that we are surrounded with a lot of unhealthy sounds. I don’t understand how I have managed without them. Personally when I realized that I have become so very audio sensitive. Maybe I should get an appointment to the psychologist…..

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The Vestfjord

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I guess we all got a childhood kingdom with good and bad memories. My kingdom is divided from the mainland by the Vestfjord. A fjord with a hell of an impact on me and my emotions related to the ocean.

It is very strange how you change the perspective after living in a different place for several years. I was 16 when I moved from Værøy in Lofoten to Bodø for highschool. I was young and felt I didn’t fit in. No friends, no family, no money, no clothes, no everything. How I envied the teenagers who lived with their parents and had enough of everything! I was so determined I should never ever live in Bodø, but I am still here. That’s the irony of life. It makes me think of some words of wisdom:

The life is happening when you are planning something else

In highschool I travelled home every weekend, every fridays via Røst. The travel was back then a 7,5 hours travel over the Vestfjord in all kind of weather. The ferry, m/s. Mosken, was by origin a remodeled trawler and no weather could stop it (so it seemed). Some time I felt I had been beaten by King Kong and King Neptune because I was so seasick. A really knock out! The passengers laid everywhere, under and upon tables and in the corridores. You had to be careful where you went and hold on to something really hard, because the waves made you walk in places you really didn’t plan to go.

I found out early that the best place to be was on deck in fresh air. In the 80’s the smokers sat everywhere and that didn’t actually help, since I so easily got seasick. I also hated the smell of the diesel once I stepped onboard.

After a strenuous travel, nothing was better than the bed at home, where I after some minutes shivering finally got a good night sleep. And sundays I had to return to Bodø and often with da Capo.

A lot of things have become better since the 80’s. No smoking and no smell of diesel onboard. Most of the ferries crossing the Vestfjord these days are using gas. I am so positive and surprised about the comfort onboard. And crossing the Vestfjord takes only 5 hours via Moskenes in Lofoten. And where do I still live? In Bodø and I wouldn’t live anywhere else.

A modern gas ferry
M/s Mosken

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The last few days in Umeå, Sweden

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We have now spend 5 lazy days in Umeå, Sweden at First camp. It is like little Norway because there are norwegians everywhere spiced with some finish, dutch, germans and some swedish people in between. The First camp is an expensive place even with our caravan and you even got to pay for a non- existing internet. And if you are travelling with a teenager that is a must. So next year I’ll bring my «mobile router or broadband» along. Well internet and television have never been a big issue until the kids became teenagers. I really don’t want it but the holidays are not just mine…. Finally you can take a shower without paying «shower money». I don’t know how many times I stood in the shower and there was no money at the card….

In perspective this is just trivialities. I feel so ashamed! These issues don’t matter at all. Yesterday there was a tragic plaincrash in Umeå where nine people lost their lifes. I am thinking on them, their families and friends