Clean Steam

Healthcare surgical instrument infection control is dependent on the ability to destroy or reduce the growth of organisms that cause disease and sometime death.

However we find ourselves lagging behind a number of healthcare industries with regards to quality utilities to support steam sterilization.

 

Steam quality in hospitals is an area that lacks attention and is completely misunderstood. Standards for both the operations and construction for steam sterilizers in hospitals do not address steam quality or even the installation of steam filters as a mandatory requirement, they are optional.

They quality of hospital steam is managed solely by boiler room staff who have limited knowledge regarding sterilizers and sterile processing. Black iron pipes with steam traps and shutoff valves rarely receive preventative maintenance in today’s hospitals occurring only after a problem arises.

If not routinely cleaned, the inside chambers of steam sterilizers turn green over time due to minerals/contaminates in the steam lines. Poor quality steam associated to black iron pipes is the primary reason for this unnecessary residual build-up.

One must ask the question, how do properly cleaned instrument sets placed in a sterilizer turn the chamber green or cause discoloration at all? Terminal chamber cleaning must be completed quarterly even monthly when the quality of steam is out of control.

 

Additionally pharmaceutical and biotechnology industry uses clean steam generators designed to provide clean or pure steam at the point of use or in a central location; not piped in from an aging boiler room hundreds of feet away.

They are often used to generator clean steam for a steam sterilizer producing pyrogen-free quality pure steam. Surgical instruments deserve no less.

Brown and white spots on outer wraps are directly related to the quality of steam entering the chamber. Sterilizer manufacturers routinely receive blame for this even though the recommended the installation of steam filters in the first place.

The acquisition of steam filters is often removed from the original purchase quote in order to reduce capital expense by misinformed materials managers. From the get-go, the purchase and installation of steam sterilizes can be hampered by poor decision making and a lack of understanding for the sterilization process.

Steam quality is not measured or monitored for purity; our main focus lies with indicators and biologicals that pass the test so we can quickly push instruments through the system. More recently, instrument washer tests are getting long over due attention addressing washer failure. Once again we put the cart before the horse testing the cycle but not the quality of water or steam used to process surgical instruments.

Table-top sterilizers used in dental clinics and some physicians offices recommend sterile or purified water in the steam reservoir; however, hospitals use black-iron piped delivery systems. Hospital boiler rooms can be hundreds of feet from the sterilizer with no ability to ensure steam quality.

When looking at the pharmaceutical and biotechnology industries you find that they require quality controls not seen in hospitals. Once again we need to ask why it is that they have higher quality controls with regards to water quality and steam purity.

The quality of steam in these industries is no more or less important then healthcare. All healthcare related industries should follow the same standard when it comes to quality measures related to water conditions and steam quality.

There are a number of companies producing clean steam generators for the pharmaceutical and biotechnology industries.

It is time for the sterilizer manufacturers to get on board and support hospital sterilization departments need for quality water and steam generators that solely support surgical instrument processing.

Facilities and materials mangers need to be educated to the importance of steam quality and its affect on surgical instrument processing.

We need the FDA and AAMI to support strict requirements not guidelines for the installation and upgrading needed for steam sterilization.

Clean functioning sterilizers produce sterile products that will be used on patients. Hospital acquired infections at this time cannot be tracked back to poor sterilization processes, or can it?

This is the question that is starting to get attention.

Pharmaceutical and biotechnology industries along with even the computer and food industry take extra measures to insure the quality of water and steam is pure. Their standards do not allow contaminants with great attention to testing and quality control. Hospitals cast blame, stick their heads in the sand or simply look the other way.   

The older the hospital the bigger the problem is. Hampering the ability to change this is the lack of space needed to expand allowing for additional equipment to support the current sterilizers and washers in a typical sterilization department.

The pharmaceutical and biotechnology industries utilize pure and clean steam generators that exceed the requirements of the US Pharmacopoeia. Each unit is produced to comply with the US FDA’s current Good Manufacturing Practices and is manufactured according to ISO 9001 quality standards.

Their steam generators are constructed of stainless steel eliminating rusting often seen in hospitals due to the use of black iron pipes and rusty steam traps.