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Based on observation, staff interview and document review, it was determined that the facility failed to provide a sanitary environment to avoid sources and transmission of infections and communicable diseases.
Findings include:

Reference #1: AAMI ST 79 section 7.2.2 on 'Manufacturer's instructions' states, "The written recommendations of the device manufacturer should always be followed."

Reference #2: Manufacturer instructions of 'Cardinal Health Scrubcare Exidine 4%' states, "Uses: Surgical hand scrub significantly reduces the number of microorganisms on the hands and forearms prior to surgery or patient care. Healthcare personnel handwash helps reduce bacteria that potentially can cause disease. Patient preoperative skin preparation skin wound and general skin cleaning."

Reference #3: Manufacturer instructions of 'Cidex OPA solution' states, "The first step in the high level disinfection process is through cleaning. Contaminated instruments must be thoroughly cleaned prior to disinfection. To remove debris, thoroughly clean all instrument surfaces with mild protein dissolving detergent such as ENZOL Enzymatic Detergent."

Reference #4: Manufacturer instructions of 'Rusch Laryngoscopes' states, "Immediately after use, blades should be rinsed in clean tap water to remove any residue. The blade should then be gently scrubbed in soapy water with a soft brush to provide a through physical cleaning."

Reference #5: AAMI ST 79 section 3.3.6.8 on 'Handwashing facilities' states, "Handwashing facilities should be located in or near all area in which instruments and other devices are decontaminated."

1. On 9/12/12, Staff #8 stated that laryngoscope blades are pre cleaned with surgical hand scrub 'Cardinal Health Scrubcare Exidine 4%' and then soaked in the Cidex OPA solution for high level disinfection. The facility failed to follow the manufacturer recommendations for the cleaning of the Rusch Laryngoscopes as indicated in Reference #4.

2. A designated handwashing sink is not available in the Endoscopy Suite reprocessing room. Staff #7 stated that he/she routinely utilizes wall mounted hand sanitizer and washes his/her hands at the reprocessing sinks where soiled scopes are cleaned.



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