Reprocessing of  instruments

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• Difficult to clean lumens or occluded joints and surfaces
  
• Fixation of material not removed during cleaning
  
• True cost involves counting and checking every item
  
• Increased off site processing
  
  

•  Item Cost £1 to £16
  
• Extra cost and time for manual or non standard processing
  
• Loss of control offsite
  
• Extra equipment for offsite processing
  
• Fixation risks instrument damage
  
• Threat to service quality from dirty instruments
  
• Over reliance on ultrasonic machines

“Two factors that affect the ability to clean instruments are the performance of the washer-disinfector and the condition of the instruments to be re-processed.”

“Features of the device, which make access difficult, are for example: acute angles, coils, long or narrow lumens, specialist surface coatings.

MHRA Device Bulletin 2000(04) Single-use Medical Devices: Implications and Consequences of Reuse.

Estimates about the cost of re-processing surgical instruments vary dramatically, and raise questions concerning the items that are included:-

o        Is the cost only for consumables?

o        Does the cost include staff time?

o        What is included for counting and checking in and out?

o        How are non standard items removed from trays accounted for?

DGH = District General Hospital