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Elements and Performance Criteria

  1. Identify cleaning requirements of a range of surgical instruments
  2. Prepare for cleaning of a range of surgical instruments
  3. Apply cleaning processes to a range of surgical instruments
  4. Check quality of cleaning of surgical instruments

Required Skills

Essential knowledge

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit manage the task and manage contingencies in the context of the identified work role

This includes knowledge of

Composition and manufacturing process of surgical instruments and how these impact on the correct use and selection of cleaning process eg various grades of stainless steel and properties of martensitic steel

Detergency action and standard precautions procedures

Enterprise code of practice

General categories of instruments and associated cleaning requirements

Impact on client care of defective insulation being used on surgical equipment

Relevant legislation for selection and reprocessing of reusable medical devices

Reporting requirements and mechanisms for faulty medical devices

Standards including ASNZS ASNZS Therapeutic Goods Amendment Medical Devices Bill and the Therapeutic Goods Medical Devices Regulations Relevant stateterritory guidelines for sterilising services NCCTG Reducing Public Health Risks Associated With Reusable Medical Devices

The importance of cleaning and inspection as a contribution to client safety

Essential skills

It is critical that the candidate demonstrate the ability to

Accurately complete all documentation

Address relevant WHS infection control and risk management requirements

Comply with relevant Australian New Zealand standards and associated guidelines

Demonstrate consistency of performance over a number of trials

In addition the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit manage the task and manage contingencies in the context of the identified work role

This includes the ability to

Apply cleaning processes

Apply problem solving skills to use available resources

Follow manufacturers recommendations the Therapeutic Goods Amendment Medical Devices Bill and the Therapeutic Goods Medical Devices Regulations for care of surgical instruments

Follow manufacturers professional and organisation policies and procedures

Identify general and specialist surgical instruments

Identify items requiring insulation testing

Select and use personal protection equipment

Take into account opportunities to address waste minimisation environmental responsibility and sustainable practice issues including appropriate practices to ensure efficient use of resources

Use literacy numeracy and oral communication skills required to fulfil the position in a safe manner as specified by the health care facility

Evidence Required

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria Required Skills and Knowledge the Range Statement and the Assessment Guidelines for this Training Package

Critical aspects for assessment and evidence required to demonstrate this competency unit


The individual being assessed must provide evidence of specified essential knowledge as well as skills

Where for reasons of safety space or access to equipment and resources assessment takes place away from the workplace the assessment environment should represent workplace conditions as closely as possible

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Context of and specific resources for assessment

Assessment should replicate workplace conditions as far as possible

Simulations may be used to represent workplace conditions as closely as possible

Resources essential for assessment include access to

relevant workplace or appropriately simulated environment where assessment can take place

Australian Standards government and organisation policies and procedures

Access and equity considerations

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities workers should be aware of cultural historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues in particular relating to factors impacting on health of Aboriginal andor Torres Strait Islander clients and communities

Range Statement

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Surgical and medical instrumentation and equipment may include:

General instruments

Flexible and rigid endoscopic equipment

Insulated instruments

Laparoscopic instruments

Microscopic instruments

Power tools

Fibre optic equipment

Cleaning may involve:

Disassembly

Solutions including:

soaking

enzymatic

lubrication

stainless steel stain remover

Brushing of lumen/cannulated items

Non-immersible items

Complex specialised instrumentation

Leak testing of flexible endoscope

Mechanical lubrication

Disassembling instruments for cleaning may include:

Opening ratcheted instruments for processing

Opening taps and valves

Disassembling and reassembling multipart instruments and stilettes to check for correct fit and function

Using correct dismantling technique for a variety of endoscopic instruments

Particular requirements for general surgical instruments may include:

Check scissors for correct set, sharpness and barbs

Correctly clean, inspect and check box-jointed forceps for stiffness or wear

Identify and correctly clean and inspect instruments with long shafts for example cup biopsy forceps, punches and rongeurs, checking the shaft for debris

Identify processes required for removal of dyes/ adhesives

Soak instruments used for Bonny's Blue to remove the dye

Identify and process blind-ended instruments such as spackmann's cannula by processes that may include soaking and flushing safely with high pressure water

Identify cannulated drills and process to remove impacted bone and other debris, inspecting for cleanliness prior to packaging

Identify very fine suckers and process to remove wax blood and other organic debris using a variety of stillettes and brushes that touch the sides of the cannulation

Identify difficult designs, follow manufacturer's instructions, dismantle for cleaning by brushing and flushing, and reassemble to check function for instruments such as Filshie clip applicators and Tonsil snares

Instruments with textured surfaces may include:

Acetabula graters

Reamers

ENT files

Requirements of instruments with tightly coiled structures include:

Soak appropriate enzymatic detergents

Rinse off gross debris

Follow the manufacturer's instructions for effective and safe use of enzymatic detergents

Importance of soaking as soon as possible as part of pre-cleaning in the operating theatre

Value of keeping the instrument moist prior to dispatch for cleaning

Selection and use of enzymatic detergents includes:

To soak instruments with soil impacted in textured surfaces

To soak instruments with tightly coiled structures

Follow manufacturer's instructions for effective and safe use

Instruments with specific processing requirements include:

Flexible illuminated instruments, for example:

cystoscopes

choledochoscope

brochoscope with channels

Power tools

Screw and implant caddies

Items requiring manual cleaning

Safe and correct processing of flexible endoscopes may include:

Wipe and suction with a solution immediately after the procedure, following the manufacturer's instructions

Follow instructions for leak testing, and soaking in enzymatic detergent solution

Follow instructions for disassembling, brushing, wiping and checking for cleanliness

Follow instructions for drying (eg. using alcohol to flush channels or dry under low pressure forced air)

Safe and correct processing of power tools may include:

Follow manufacturer's instructions to prevent water entering the motor

Identify and brush cannulation in power-tools

Remove debris between movable, close-fitting parts

Safe and correct processing of screw and implant caddies may include:

Identify instruments likely to contain organic soil, such as drill bits

Follow manufacturer's and organisation instructions to:

soak in mild detergent solution

rinse with flushing water

assist drying with low-pressure forced air
(eg. leave lid on to prevent dislodging fine items)

Safe practices for manual cleaning include:

Safe and effective brushing:

selecting a suitable brush

reducing the creation of aerosols

removing debris off brush before retracting it up into a cannula.

Follow standards such as AS/NZS 4187 for safe and effective methods of manual cleaning.

Select agents and equipment for manual cleaning following AS/NZS 4187

Safe work practices to conduct insulation testing includes:

Follow safety requirements when operating insulation porosity testers

Follow appliance manufacturer instructions in applying devices such as the brush to identify defects

Follow organisation processes for the removal and replacement of defective items

Instruments on loan may include:

Complex instruments with instructions from a loan set company

Borrowed instruments from other hospitals