The COVID-19 pandemic has changed hospital processes and made people more aware of the need to thoroughly sterilize medical instruments between patients. This article discusses some of the changes that may occur due to lessons learned throughout the global health emergency.

Post-COVID medical instrument sterilization could include an increase in hospitals using single-use items when possible. That approach eliminates the potential cross-contamination risks associated with insufficient reprocessing between patients.

For example, the FDA recently approved a single-use bronchoscope for procedures such as airway intubation, secretion management and taking biopsies. U.S. bedside procedures involving bronchoscopes total more than 1.2 million annually. Occasional reports of patient infection due to inadequate reprocessing of those instruments have occurred, even when sterilization professionals follow the correct procedures.

It’s not feasible for hospitals to trade all current sterilization efforts for single-use instruments. However, some administrators may wish to examine which tools have the highest contamination risks at a given facility and explore whether disposable options are on the market.

The COVID-19 pandemic caused a shift in the kinds of care given at hospitals. Many non-urgent procedures were delayed while hospital staff tried to manage the influx of patients who needed emergency attention. “Some equipment that previously stayed on the nursing floors is coming to sterile processing for cleaning and disinfecting. Technicians are also handling code carts and intubation equipment in a much higher demand than ever before.” Marcy Konja, a sterile processing expert, explained on SpecialtyCare’s website. “One hospital that normally used or exchanged five to eight code carts a day is now using 35 to 50 due to the increased need with [the] pandemic. Cleaning and restocking these carts is a high priority, and we are beginning to see shortages in these supplies also.”

Even after the COVID-19 threat passes, medical facilities will continue to experience demand surges, such as during the flu season. Penn State’s medical department recently opened a dedicated off-site sterilization facility called the Interventional Support Center (ISC). It can handle the instruments from up to 200 surgical cases per day while catering to two hospitals and three outpatient locations. Chris Pastore, the facility’s managing director, stated in a Penn Medicine news release, “The opening of the ISC sets a new standard for sterile instrument processing. It also marks a new approach from Penn Medicine. By moving our processing operations from the traditional hospital setting to an off-site, dedicated facility, we’re able to increase efficiency in a high-quality, cost-effective way—all while keeping up with increasing demand.”

The ISC is the largest such facility in the country, and plans to develop it began long before COVID-19 became a problem. However, the center could serve as a template for other hospitals to follow, especially if decision-makers there are interested in off-site sterilization options.

Strict processes must be followed in cleaning medical equipment, and requirements are based on the type of machine and instrument. For example, a professional using a gravity displacement autoclave to sterilize wrapped tools should ensure they get at least a half-hour of exposure at 121° F, according to the CDC.

However, as new findings become apparent, the agency could change the recommended procedures for certain types of disinfection and sterilization. Recent research finds that detergents and ultraviolet light are insufficient to kill clustered noroviruses, for example. Another study looked at transvaginal ultrasound probes used in the Scottish Health Service. It found that gynecological patients exposed to those instruments had a 41% greater infection risk and 25% higher likelihood of needing prescription antibiotics than those that did not have these devices used on them.

Although the above-mentioned studies did not relate to COVID-19, they were published when the pandemic remained a threat. Both of them emphasize the potential need to revisit measures such as employee training and disinfection. Researchers continually learn new things about how well existing sterilization works and what other methods could improve outcomes. Staying abreast of those developments helps instrument sterilization professionals play vital roles in infection prevention.

Innovations used during COVID-19 may inspire future procedures. For example, one disinfection robot took only 30 minutes to clean 4,000 square feet. Increased automation might help achieve medical instrument sterilization goals, too.

One current use case involves a hospital in Denmark using a robot to transport reprocessed medical instruments from the facility’s sterilization center to the locations where providers will use them. The robot handles daily deliveries for five hospital departments and cuts down on the number of people working with the sterile goods. That benefit also plays a role in better disinfection measures.

Hospital representatives say the robot reduces instrument waiting times by enabling targeted deliveries. Plus, it relieves humans of the repetitive bending and lifting the task required. They can now spend time in different roles that are easier on the body.

The COVID-19 pandemic caused many providers to think differently about how they treated patients and the importance of safety. The worldwide health crisis will likely bring about lasting changes in medical instrument sterilization. The four points discussed in this article are only some of the trends that may result. When healthcare facilities adopt new procedures, they’ll collectively play a role in improved patient safety.

The utilization of reprocessed medical devices can help cut down the increasing cost of healthcare for consumers while also tackling device shortages.

It’s time to embrace new technology and promote standardization to raise best practice protocols.

The medical device reports describe both patient infections and other possible contamination issues.

As medical device costs continue to be a growing area of hospital expenditures, many hospitals control the savings through device reprocessing programs. The shift toward planned obsolescence is especially troubling given the financial challenges many hospitals face.

Devin Partida is a MedTech and HealthIT writer based in San Francisco, California. She is also the Editor-in-Chief of the tech website ReHack.com.

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