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Debris on surgical instruments should be rare — perhaps one or two a year, the head of the provincial Patient Safety and Quality Council said Friday.
Dr. Doug Cochrane, who is leading an overall external review into dirty instruments being found at Royal Inland Hospital, said findings from his investigation will go to the Health Services Ministry as well as Interior Health officials.
Surgeries are set to resume Monday after a week shutdown on elective procedures.
RIH has launched two external reviews of the latest discovery that shut down the surgeries and has led to just 10 emergency procedures being conducted at the hospital this week.
Another four patients were sent to the Okanagan to have operations done there. And 250 people scheduled for elective procedures this week have had to be rebooked.
Cochrane said the review will include experts looking at sterilization procedures, training in the department and other information.
“We have a provincial mandate. So we take what we learn and make sure others are aware of it (at other hospitals),” he said.
“Our role is to validate the integrity of the process” as well as to look properly at the causes and report to the ministry, Cochrane said, adding the review will probably take two or three weeks.
A neurosurgeon himself, he said he would see one or two incidents of debris on instruments in a year. Most common was lubricant or what appears to be rust.
At RIH, the complaints have centered around bits of bone, blood, wood and glue being found on sterilized instruments.
Cochrane said it’s reassuring RIH hospital staff were on top of things enough to notice the debris.
Interior Health’s chief executive officer Dr. Robert Halpenny said in a press conference Friday almost all of the 400 or so packs of surgical equipment at RIH have been resterilized.
Dr. David Stewart, acting head of surgery at RIH, said he has been impressed at how quickly IHA has acted to gather information and ensure there haven’t been any increases in infections.
“A discovery like this is not taken lightly,” he said.
Complaints have been made over the past two years about bits of bone, blood or other debris being found on surgical equipment at RIH.
Stewart said it happens at all hospitals.
But the frequency at RIH set off alarm bells.
“It becomes a tipping point where it’s happening more than normal,” he said.
The issue boils down to the volume of surgeries and problems with some of the sterilization equipment, he said.
“The system became overwhelmed.”
Halpenny said the equipment was sterilized at 134 centigrade for four minutes, plus remaining at high heat for 15 minutes as it dries. That’s far beyond the one minute at 100 centigrade that a 2004 study has said would kill potential viruses and bacteria.
“So the risk to patients is minimal,” he said.
“The issue that concerned us was patient safety.”
Much of the problem with the equipment and volume is being looked at in terms of workload and flow, he added.
By Monday, surgeries at RIH are going to start ramping up. Halpenny said the slate will start at 60 per cent of normal.
Budget requests are being made for upgrades for the RIH sterilization unit, Halpenny said. However, even if it’s approved in the 2010/2011 budget year, getting everything done could take a year.
He stressed that the problem isn’t the fault of staff, who have training and certification to do the job.
“We have to commend our staff for the way this has been handled.”
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aged says... 
0How long would a restaurant stay in business if they gave their patrons dirty utensils? Maybe the hospitals should hire those restaurant dishwashers who seem to be experts.
Posted on February 22, 2010 @ 2:30 am PST | Report post to Editor | 3324719