Skytron Blog

At some point, our Sterile Processing (SP) Departments must say goodbye to the old and hello to new and updated capital equipment. We see this quite often when it comes to ultrasonic washer-disinfectors. Facilities are limping by on outdated ones that don’t have the necessary capacity. It is likely no longer meeting the demands of your growing case volumes and complex instrumentation.

In this write-up, we’ll walk through the types of ultrasonics available, examine your asset-to-need ratio, and outline steps to help you secure capital equipment approval from decision-makers.

Types of Ultrasonics to Consider

 
According to AAMI ST79/2017 7.6.4.3.3 on selecting mechanical and disinfection equipment, there are various types of ultrasonic cleaners, each suited to different reprocessing needs:

1. Ultrasonic Cleaning Equipment: Standard units that use ultrasonic waves to clean instruments.
2. Ultrasonic Irrigators: Specialized for flushing narrow lumens and complex devices.
3. Ultrasonic Irrigator Washers: Combine cleaning and irrigation functions.
4. Ultrasonic Irrigator Washer-Disinfector: Adds disinfection capabilities, offering a more complete cleaning process.

The right ultrasonic washer-disinfector depends on your facility’s needs. A high-volume surgical center with orthopedic and robotic procedures will have different requirements than an outpatient surgery center with lighter caseloads.

1. Understanding Your Asset-to-Need Ratio

 
Determining the best ultrasonic washer for your department means assessing your current and future needs. A few factors to consider:

• Surgical Volume and Case Types: How many cases do you handle daily? A facility with ten or more ORs and 50+ daily cases may need a larger unit with higher load capacities. Conversely, lower-volume facilities might find a compact model sufficient.

A term often used in our industry is throughput, which is defined as ” the amount of material or items passing through a system or process.” Larger units with higher throughput need more room. Some are wider to accommodate more or longer instruments, while others extend further from the wall. Height is also crucial for lid openings, elevators, and any vertical attachments like sprayers or backsplashes.

A compact tabletop model may be ideal for smaller SPDs with lighter reprocessing loads.

• Instrumentation: Facilities that reprocess complex or delicate instruments (like da Vinci robotic arms) will benefit from an ultrasonic unit that can handle mixed loads (cannulated, non-cannulated, orthopedic, and general surgery instruments) without causing damage or delays.
• Cycle Specifications and Water Standards: Does the ultrasonic provide thermal disinfection and use critical water in the final rinse? Meeting standards like AAMI TIR34 (5.2.1.3 on rinsing) ensures patient safety and minimizes contamination risks. Some units allow tap water rinsing, but final rinsing with critical water is crucial for instruments contacting sterile body areas to avoid endotoxins and microbial contaminants. To learn more about water quality standards, visit our recent blog: Water Safety in Device Reprocessing-Understanding ANSI/AAMI ST108:2023

2. Building a Case for Approval: Justifying Your Ultrasonic Washer-Disinfector

Once you’ve identified the right ultrasonic washer-disinfector, it’s time to build a compelling case for approval. Remember, leadership is focused on outcomes, so your proposal should highlight how the new equipment addresses their priorities.

1. Identify Patient Safety Risks: Describe the potential risks associated with using your current outdated equipment. For instance, bioburden could remain on instruments without a high-quality washer, posing a safety hazard and increasing liability. If you’re requesting a borescope (a video scope for inspecting lumened devices), explain how it will verify cleanliness, reduce risks, and meet manufacturers’ instructions for use (IFUs).
2. Outline the Benefits: Detail how a new ultrasonic washer-disinfector will improve department efficiency, elevate patient safety, and reduce regulatory citations. Mention specifics like reduced reprocessing times, enhanced load capacity, and improved cleaning for complex devices. These benefits align with the facility’s patient safety goals and contribute to operational efficiency.
3. Connect to Organizational Mission and Values: Frame your request within your mission. For instance, if your facility values quality patient care and innovation, explain how this upgrade supports those principles. It demonstrates that SP is dedicated to upholding these values through improved equipment that ensures sterile instruments are consistently available and compliant.

3. Partnering with Vendors to Build Your Financial Case

 
Your vendors are valuable allies in this process. They understand the technical details and can provide data, case studies, and success stories to support your proposal. Here’s how you can partner effectively with them:

• Safety and Differentiation: Ask vendors how their products enhance patient safety. Look for features that set their ultrasonic washers apart, such as shorter cycles, energy efficiency, or enhanced water filtration systems.
• Financial Case Support: Vendors often have experience in crafting financial arguments that appeal to decision-makers. Request specific metrics or cost-benefit analyses. A well-presented financial case, grounded in data, can turn the tide in your favor when justifying capital expenses.
• Supporting Documentation: Collect photos, IFUs, and case studies that illustrate the effectiveness of the washer-disinfector. These materials offer tangible evidence to stakeholders, showing the real-world impact on similar facilities.

Key Questions to Guide Your Proposal

As you gather information, consider questions like:

• How does this washer-disinfector align with our patient safety goals?
• Can the washer handle our specific instrument types and case volumes without delays?
• What are the maintenance and operational costs, and how do these compare to our current unit?

Selecting and justifying an ultrasonic washer-disinfector upgrade can be complex, but approaching it methodically helps. By understanding the types of equipment, assessing your needs, and building a detailed, evidence-backed proposal, you increase the likelihood of securing approval.

The right ultrasonic washer-disinfector ultimately improves operational efficiency, supports regulatory compliance, and elevates patient safety. With a carefully crafted proposal and the right support from vendors, you’re well on your way to retiring that “dinosaur” and bringing in a unit that meets today’s demands.

Resources
1. https://www.merriam-webster.com/dictionary/throughput
2. All AAMI Standards & Guidelines should be readily available in your facility, and if you do not have a copy, the direct regulations can be found/purchased here