Study Day Report
This study day took place in the very cosy atmosphere of the "Waerboom" conference centre close to Brussels. The surroundings and the nice autumn day with a lot of pleasant sunshine certainly contributed to the good start of the study day.
In his introduction the chairperson talked mainly about the survey organized by the VSZ in collaboration with Bessemans Consulting which has as its aim to provide an overview of the state of affairs in the Flemish sterilization departments. He said: "Next year the society will celebrate its 20th birthday. During this period we have focused on transferring knowledge and information through the organization of
- study days (2 per year);
- training courses for junior and senior members of staff;
- meetings of working parties;
- training evenings for members of staff.
But the efforts which were and still are made in order to realize our objectives have always had a voluntary nature. The transfer of theory into practice has not always been made. This is mainly due to the fact that hospitals are not forced to make their sterilization departments conform for example to the recommendations of the High Council for Health, the European sterilization norms or the state-of-the-art.
In spite of this, especially during the last years, the quality of the departments has improved, this thanks to the commitment of the members of staff of the sterilization departments.
But good will in itself does not suffice. Today we can only ascertain that the differences between the departments still are too big, with the result that harmonization has not come about. Certain departments apply state-of-the-art techniques while others for example make only use of the ultrason to clean medical devices in the unclean area.
It is estimated that only 10% of the autoclaves have been validated. Validation is an essential requirement in order to deliver a product that meets the definition of being 'sterile'.
It is no longer acceptable that a patient who has to undergo a surgical procedure runs a bigger risk in certain hospitals than in others purely as a result of the poorer quality provided by the sterilization department.
But only the government can, if necessary, impose certain measures and make available the funds to renovate and upgrade the sterilization departments. However, if we want to sensitize the government we can no longer make assumptions but have to provide foolproof facts.
That is why we have to determine the condition of sterilization in Flanders. Hence the survey.
Our aims are:
- to provide a detailed overview of sterilization practice in Flanders;
- to make proposals regarding the architectural and technical norms to which sterilization departments have to be conform;
- put the qualifications of the members of staff on the agenda.
By providing feedback of the results to the participating departments, the latter can determine their position on the Flemish sterilization department ladder.
By providing feedback to the authorities both on a local, Flemish and federal level the appropriate remedial measures can be taken.
Furthermore the chairman informed the audience about the different projects undertaken by the VSZ and he introduced the first speaker: Jan Oort (Interster).
Jan started his paper about the control of sterilization processes by refreshing the knowledge of the audience about some laws of physics. Despite the fact that steam sterilization is the most frequently applied sterilization procedure, one cannot assume that it will therefore also have the best results in all circumstances. Regular checks are a must. With the offer of digital PCD’s it is evident that industry is reacting to the European norms and is providing the necessary means to the hospitals to allow them to guarantee the reliability of the sterilization processes. The evolution of the surgical instruments is taken into account as well because they are becoming more and more complex and very often contain very long lumina. To control the effectiveness of the sterilization process in these hollow spaces a PCD is the most appropriate procedure. The main advantage of a digital PCD is that the interpretation is objectified instead of remaining subjective (interpretation of a colour envelope) with chemical indicators.
Jos Bessemans (Besco bvba) sketched the evolution in the area of surgery and its consequences for the CSA. He gave a detailed account of the financial requirements of the sterilization departments and provided a clear overview of the costs of the CSA. Finally he introduced the survey that the VSZ is organizing in collaboration with Besco bvba.
Filip Sys, Packo Inox, gave a technical description of the composition of the different kinds of steel and the various methods used for the surface treatment of inox. Illustrated with beautiful slides he succeeded extremely well in presenting this specialised topic in such a way that even a layman could understand it.
After lunch Jooost van Doornmalen (KW2, Bureau Veritas) talked in his indomitable style about the essential conditions that have to be met in steam sterilization. He made it clear that by following the European sterilization norms the essential requirements can be met. It is therefore of the utmost importance to start applying these norms.
Laurence Hamza, Omasa, gave a well documented paper on outsourcing with the focus on ophtalmological instruments and the very specific approach one has to adopt.
Dominique Couckuyt, committee member of the VSZ and head of the sterilization department of the AZ Groeninge, Kortrijk, talked about her experience with the harmonization of the sterilization activities in her department. The department is spread across different campuses. As the coordinator of the working party ‘loan sets’ she discussed the state of affairs and the different initiatives undertaken to streamline the supply side, which is always a stumbling block. On the basis of a representative survey she carried out it could be deduced that 3,43% of the borrowed instruments were contaminated on arrival in the hospital.
In his paper Jean-Pierre Willems, Zimmer, provided the perspective from industry. He stated that industry itself also had its problems with deliveries, mainly due to the late orders from hospitals. 35% of the instruments are reserved less than 24 hours before the surgical procedure. As a result the logistical problems and the transport costs are gigantic. From the animated discussion which followed it became evident that more consultation is urgently required between hospitals and industry.
The last speaker was Wilfred Moorer, microbiologist and Acta lecturer. He talked about dental surgeries and the problems experienced by dentists to keep hygiene in check. Remarkable was his statement that when measures are taken the emphasis is put on maximization instead of on optimisation. He clearly favoured the latter approach.
The successful study day ended with a reception. A negative point was the running late of the programme. This point should be given attention to the following times.
The text of the papers and other news items of the VSZ can be found on the EFHSS website under the headings: Member Organisations / VSZ and Conferences / V.S.Z Study Day 27 October 2005 - Lectures