Supplyline Online Magazine October 2023

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OCTOBER 2023

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NZSSA New Zealand the journal of NEW ZEALAND STERILE SCIENCES ASSOCIATION Sterile Sciences Association

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Business Card Directory A QUICK AND HANDY DIRECTORY OF OUR STERILE SERVICES SUPPLIERS

Neil Maclennan

Garry Gorham

Medical Products Manager

Business and Operations Manager

P: +64 9 276 3271 M: +64 21 499 101 E: nmaclennan @ crknz.co.nz

M: +64 21 554 789 P: +64 9 276 3271 E: ggorham@crknz.co.nz

3 Hotunui Drive Mount Wellington, Auckland P: +64 9 276 3271 F: +64 9 276 9645 www.crkennedy.co.nz

3 Hotunui Drive Mount Wellington, Auckland P: +64 9 276 3271 www.crkennedy.co.nz

Annette Moffatt Aidan Kersley

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m 021 0221 4984 | p 0800 224 224 e aidan@sterilesolutions.co.nz e office@sterilesolutions.co.nz

m 027 543 2266 | p 0800 224 224 e james@sterilesolutions.co.nz e office@sterilesolutions.co.nz

Director

Director

Account Manager 021 587 031 annette.moffatt@opritech.co.nz Customer Care 0800 32 40 32 opritech.co.nz

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Richard Murray buscard.indd 2

7A PACIFIC RISE MT WELLINGTON AUCKLAND 1060

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NZ RegioNal MaNageR dustin.habeck@ecolab.com T 0800 425 529 M +64 21 280 6869 W ecolab.com

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Michele Fuller Territory Manager Infection Control

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Damian Draper

+64 274 972 454

+64 274 972 445

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steven@surgicalsystems.co.nz P 0508 SURMED (0508 787 633) F +64 3 376 4046 A PO Box 1336, Christchurch 8140, New Zealand www.surgicalsystems.co.nz

Operations Manager

damian@surgicalsystems.co.nz P 0508 SURMED (0508 787 633) F +64 3 376 4046 A PO Box 1336, Christchurch 8140, New Zealand www.surgicalsystems.co.nz

INTERMED MEDICAL LIMITED

Claire Smith

Product Specialist - CSSD

021 760 265 71 Apollo Drive, Albany 0632 PO Box 33268 , Takapuna 0740 , Auckland T 09 415 4800 F 09 415 9045 FREE 0800 333 444 E claire@intermed.co.nz W www.intermed.co.nz

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Editor’s Message October 2023 Hello, and welcome to the October Edition of Supplyline. This is the last edition before Christmas, where has 2023 gone to! In this edition we continue with the regular updates relating to Industry Standards, Sterilising Technology Course information and the information from this year’s NZSSA Annual General Meeting. I’ve also included the dates for when Supplyline is to be published during 2024 in this edition. The NZSSA Conference this year was held in Wellington at Te Papa. While the weather wasn’t always kind, the conference itself was very good. A variety of speakers and topics made it a very interesting conference. There are photos of the conference as well as photos from the conference dinner included in Supplyline. The conference organisers did an amazing job.

NZSSA’s 50th year as the national sterilising body for sterilising personnel here in NZ. The conference is going to be held in Auckland which I believe is where the first ever NZSSA conference was held in 1974. Information will be included in each edition of Supplyline as well as on the NZSSA website. We have three articles from NZSSA members and a big thank you them for being brave and sharing their work with their colleagues around the country. If there is anyone who has completed Level 5 Diploma in Sterilising Technology and would like their article published, please let me know. Congratulations to Whiteleys on achieving 90 years in business. Not an easy thing to achieve, so well done. See the information on their achievement in this copy of Supplyline. Take care everyone and stay safe, Ngā mihi Aileen Derby Editor NZSSA Supplyline

Next year’s conference is very special, celebrating the

President’s Message Hello all

updated Scope of Practice and competencies of practice document. We hope to have a first draft completed by the end of the year. We will also be looking to update the website and make it more user friendly.

For those of you who are PSA members, pay equity has been a long time in the works, but has finally been agreed upon by Te Whatu Ora and the PSA and accepted by you all. The sad part, it may be after Xmas before we see the payouts.

In September we held the conference at Te Papa and had a fantastic turnout from our members. Our speakers were phenomenal. I would like to thank our trade partners especially our principal, gold, silver and bronze sponsors for making this all possible. We had a fantastic movie themed dinner where everyone turned out in costume. The photos will be on the website and some in Supplyline.

Now we need to wait and see what the MECA bargaining will bring about.

Next year is the big 50th celebration of the NZSSA and will be held in Auckland.

I need to reiterate for you all, especially for team leaders and managers, that there are strict requirements for employing overseas trained technicians. If these requirements are not adhered to, we can just as quickly lose the ability to do this. Please see details on our NZSSA website, https://nzssa.org/career-opportunities/ and please ask if you have questions. If you have vacancies and can employ a trainee who is a New Zealand resident, please do so. There is a push coming from the Ministry of Health and Te Aka Whai Ora for an ‘earn as you learn’ scheme. More details yet to be published on this.

2024 is also election time where we will be voting for an executive for the next three years. Please, if you are interested, contact me and I can give you advice on what is required.

Welcome to this spring edition of supplyline.

As you know the Ministry of Health recognises us as a self-regulated profession. This requires the NZSSA to bring documents and requirements that technicians need to meet up to date. Aileen Derby and myself are working our way through an

the journal of NEW ZEALAND STERILE SCIENCES ASSOCIATION

Finally thank you to Sharon, Aileen, Alison and Anthony who were the organisers of this year’s conference, along with Britta from MTANZ. You did a fantastic job, well done! Enjoy this edition of Supplyline. I am off to the WFHSS Congress in Brussels with scholarship winner Donna Dador and we will write about it in next Supplyline.

Shelagh Thomas NZSSA President

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MANAAKITANGA - Respect We care for each other, showing kindness and empathy in all that we do.

AUAHA - Innovation We are committed to finding future focused solutions and take personal responsibility to be better every day.

KOTAHITANGA - Relationships Our diversity is our strength, we back each other and work together in partnership.

EKE TAUMATA - Equity We are committed to doing the right thing by ensuring equity and hauora are at the heart of everything we do. 4

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SUPPLYLINE – JUNE 2023


An Effective and Reliable Method to supply clean steam for Sterilization of Medical Devices.

An Effective and Reliable Method to By Velluppillaifor Jeyarajah supply clean steam Sterilization of Medical Devices. Abstract Sterile Services Unit, Waikato Hospital, Hamilton.

By Velluppillai boiler-generated Jeyarajah A centralized steam system often results in wet packs, inadequately Sterile Services Unit, Waikato Hospital, Hamilton. Packs [RMD] due to presence of Air, Nonsterilized Reusable Medical Instruments Abstract Condensable Gases [NCGs], superheated steam, contaminated RMD packs with harmful Dissolved Solids [TDS] andsystem Endotoxins. On in thewet other a steamto-steam ATotal centralized boiler-generated steam often results packs,hand, inadequately sterilized Reusable Medical Instruments Packs [RMD] due to presence of Air, Non-Condensable Gases [NCGs], superheated steam, contaminated generator improves the quality of the steam and supplies clean steam that will eliminate all RMD packs with harmful Total Dissolved Solids [TDS] and Endotoxins. On the other hand, a steam- to-steam generator these nonconforming RMDs. Moreover, the costs involved monitoring and maintaining is improves the quality of the steam and supplies clean steam that will eliminatefor all these nonconforming RMDs. Moreover, the costshigher involvedfor foramonitoring and boiler-generated maintaining is much higher a centralized boiler-generated than for a much centralized steamforthan for a dedicated steam-steam to-steam dedicated steamto-steam generator. Therefore, this literature review finds that a dedicated steam generator generator. Therefore, this literature review finds that a dedicated steam generator is the is the most suitable method to supply clean steam. most suitable method to supply clean steam. Introduction

Introduction The evolution of sterilization began with probing for the causes of infections. The milestone

The evolution of sterilization began with probing for the causes of infections. The milestone discoveries are the following.

discoveries are the following.

Discoveries 1846 Discovery of anaesthesia. 1876 World’s first autoclave. 1920s Mathematical discovery of temperature and pressure ratio required to kill bacteria. 1934 The world’s first book on sterilization. 1960 Commercially producing disposable sterile items. 1970s Rectangular and larger steam sterilizers.

World’s first autoclave Pressure and safety valves.

Instruments kept in a basket. Little water

The era of modern sterilization began with the introduction of rectangular and larger steam

The era of modern sterilization began with the introduction of rectangular and larger steam sterilizers (Menna, sterilizers During the lasthas 50 evolved years, considerably. steam sterilization has evolved 2017). During(Menna, the last 502017). years, steam sterilization The nonconformity factors for today’s steam sterilization are wet packs, inadequate steam penetration, contamination by chemical impurities, and bacterial considerably. The nonconformity factors for today’s steam sterilization are wet packs, endotoxins. inadequate steam penetration, contamination by chemical impurities, and bacterial Wet packs will allow the migration of the microbes from outside to inside the RMD packs. As the result, the sterilized endotoxins. RMDs become contaminated, and they possess a significant infection risk to patients (Basu, 2017). Elimination of wet packs requires process improvement (DeSilva et al., 2018). A study involving 67 specialists across 5 continents suggests Wet packs will allow the migration of the microbes from outside to inside the RMD packs. that the factors that cause wet packs can be categorized mainly into three categories. They are 60% steam quality, 30% As the performance, result, the sterilized RMDs become(Rodrigues contaminated, and they possess a significant sterilizer and 10% loading techniques et al., 2022).

infection risk to patients (Basu, 2017). oftemperature wet packsmust requires process The steam has to penetrate the RMD packs rapidly Elimination and the required be achieved. Even a small amount ofimprovement air and NCGs {carbon dioxide(gas), and hydrogen(gas)} form an insulation around the RMD (DeSilva et al., nitrogen 2018). (gas), A study involving 67can specialists acrossbarrier 5 continents packs and invalidate this process. The experiments conducted by Shen et al. (2019) confirm that the concentration of suggests that the factors that cause wet packs can be categorized mainly into three NCGs and the steam penetration into RMD packs are indirectly proportional. In addition, the process is invalid if NCGs categories.were They 60% steam 30%propose sterilizer and 10% loading concentration to are exceed 0.15%. Dasquality, et al. (2020) thatperformance, performing a bowie-dick test once a day is not sufficient to ensure continuous of the sterilization process. In addition, a Process Control Device [PCD] and techniques (Rodrigues etmonitoring al., 2022). type 2 chemical indicator need to be used. The steam has to the RMD packs rapidly and theendotoxins requiredand temperature must be Sterile RMD packs canpenetrate become contaminated with TDS and bacterial the sterilizers can become achieved. Even a small amount of air and NCGs {carbon dioxide(gas), nitrogen (gas), and

the journal of NEW ZEALAND STERILE SCIENCES ASSOCIATION

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contaminated with TDS due to poor steam quality. The sources of TDS are contaminants of feed water and chemicals added for boiler water conditioning. They are mainly the ions of calcium, magnesium, potassium, sodium, hydrogen carbonate, chlorine, and sulphate (DeSilva et al., 2018). The concentration of contaminants in steam is directly proportional to the amount of contaminant that will be present on the materials of RMDs and sterilizers at the end of the process. These contaminants are harmful to patients, sterilizers, and RMDs. Bacterial endotoxins cannot be destroyed by steam sterilization and are a health risk to patients if injected intravenously by contaminated RMDs (HTM01-01. 2016). The reasons for the nonconformity factors include poor sterilizing techniques by the Sterile Services Unit [SSU] technicians, defects in the sterilizer functions, and poor steam quality. The contaminants of steam and the two most effective methods to supply clean and saturated steam [95% dry] are discussed in this literature review. Discussion Steam contaminants The steam which coexists with water at 100◦C is saturated. In practice, saturated steam is 95% dry, or the dryness fraction is 0.95. The steam can be contaminated by feed water, chemicals used for the treatment of boiler water, and distribution systems (HTM 01-01, 2016). The feed water is mainly contaminated by the following. • Chemical impurities. I. Toxic metals [Cadmium, Mercury, and Lead] II. Particulates adverse to patients. III. Impurities causing limescale in the boiler, distribution system, sterilizer chamber, and load items [Calcium. Magnesium, and Strontium]. IV. Impurities contribute to corrosion in stainless steel [Ion, Chlorine, Phosphates, and Silicates]. • Bacterial endotoxins • NCGs (kremer & McDonnell, 2020).

In a boiler-generated centralized steam system, most of the condensate is returned to the boiler. The condensate can carry corrosion from the pipelines. Filming amines must not be added to feed water to treat these corrosions (HTM 01-01, 2016). The other factor that causes poor steam quality is a poorly maintained and ineffective steam distribution system and the boiler. The minimum quality requirements for steam are correct quantity, correct pressure, correct temperature, free from contaminants and water droplets, and Non-Condensable Gases [NCGs] (Spirax Sarco, 2022).

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Firstly, steam must be provided by the correct size pipes at the correct flow rate and correct quantity for the steam to transfer the required heat energy to the load (HTM 01-01, 2016). Secondly, the steam temperature must not exceed ≥ 25 ◦C (AS/NZS 4187, 2014). A poorly maintained distribution system can deliver steam with higher pressure and dry steam to the sterilizer. Upon entry, to the chamber, the high-pressured dry steam will expand, and so will become superheated. Superheated steam can impair the sterilization process as it cannot transfer the required heat energy to the load. It can also damage combustible materials such as linen, paper, and rubber (HTM 01-01, 2016). Thirdly steam must be clean. It must be supplied by layers of scales-free pipes and a boiler and fragments of dirt, welding slag, and jointing materials that were improperly applied. If corrosion were to be present in the long pipelines, it will liberate magnetite [Fe3O4] particles that can’t be stopped by strainers (HTM 01-01, 2016). Fourthly, the dryness value of the steam must be ≥ 0.95 (AS/NZS 4187, 2014). Dry steam will become superheated upon entry into the sterilizer. Excess moisture can cause ineffective sterilization and wet loads. Wet steam can arise from the boiler and / or distribution systems. High TDS levels in boiler water contribute to stable bubbles and foaming. The stable bubbles, foaming, and high and/ or agitating water levels can enable water droplets to be carried over by steam (DeSilva et al., 2018). In addition, large quantities of water can be carried over due to priming when there is a high demand for plant steam. On the other hand, although the distribution system pipes are stainless steel and insulated, continuous heat loss to the environment cannot be prevented. The heat loss will form moisture outside and inside the pipes. Outside moisture will cause corrosion whereas inside moisture will form water droplets. Accumulated water droplets can form a slug of water down the distribution system. The consequences of these are the following. Wet steam creates wet loads and reduces the heat transfer of condensation during sterilization. In addition, droplets of water can cause corrosion and promote rapid bacterial growth in places such as steam traps, dead-legs, and gauges of the distribution system. The bacterial growth will promote contamination of the steam by endotoxins. If a slug of water accumulates it will cause water hammers. Water hammer can damage pipeline ancillaries and cause loss of steam (Spirax Sarco, 2022). Finally, the NCGs must be ≤ 3.5% v/v (AS/NZS 4187, 2014). The major contributors of NCGs have poorly maintained boiler water and distribution system. Firstly, turbulence in the surface boiler water can happen due to high concentrations of TDS and forming. Air will mix with water during turbulence. The Dissolved and feed water air {[ carbon dioxide(gas),

SUPPLYLINE – JUNE 2023


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The steam generator supplies clean saturated steam [95% dry] free from TDS, NCGS, and water droplets, Hot well removes air and other NCGs RO water removes Particulates, organic molecules and endotoxins endotoxins are Distribution system Stainless steel pipes fitted with air vents, steam traps, separators, Base exchange softener removes contaminants that forms scales and strainers as required.

Figure: 1 Generating clean saturated steam for SSU(HTM 01-01, 2016) & (Spirax Sarco, 2022) “

(Spirax Sarco, 2022)

Figure: 2 A clean steam generator system housed in SSU. Future research needs to find answers to questions such as what are the statistical shreds of

formed, nosocomial installing strainers, steamdue traps, separators, air Oxigen(gas), and to nitrogen and other will who be acquired evidence prove(gas)] the number ofNCGs} patients infections to TDS, vents, and gauges adequately and appropriately, analyzing carried over by steam. Secondly, the magnetite particles endotoxins, and inadequate sterile instruments used on patients due to undetected wet for steam quality and purity at key contamination areas produced by the corrosion can liberate hydrogen(gas) packs, inadequate steam penetration [NCGs], and superheating? of the pipelines and continuously monitoring [DeSilva and the leaks that may be present in the long pipelines can et al., 2018]. The boiler and distribution system can be leak air into the distribution system. In addition, carbon Preparing for tomorrow, today continuously monitored by an automated system such dioxide(gas), and Oxigen(gas), will promote corrosion in Supervisory Control and Data Acquisition System the boiler and distribution system (HTM 01-01, 2016). The article summarises the known contaminants as of steam to date, and the two most [SCADA] (Suryadarma & Ai, 2020). Methods to supply saturated effective methods tosteam supply clean saturated steam for steam sterilization. However, it is Supplying clean steam by a steam-to-steam generator from thesteam above the most effective and economic method to supply A goodclear quality plant candiscussion, be suppliedthat to sterilizers has several advantages. They are the following. by improving the feed water qualitysteam by lowering the steam by a dedicated steam generator. clean, lasting, and saturated is supplying • Can be housed in SSU and maintained by SSU. The TDS levels ≤ 2000 ppm, analyzing, and maintaining the 5 requirements for maintaining the steam supply by the boiler water quality for TDS levels, installing an insulated user are listed under Clause 3.39 and 3.40 of HTM 01stainless steel effective distribution system that is free 01(2016). from dead-legs, and other areas where moisture could be the journal of NEW ZEALAND STERILE SCIENCES ASSOCIATION

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• Automatically controlled and monitored TDS levels by the steam generator. • Automatic removal of air and NCGs by the steam generator. • Water droplets formed by condensation in pipelines are much less. • No water carryover or priming – Guaranteed clean steam. • Endotoxin contamination is negligible. • Continuous monitoring of the conductivity of the feed water. • No risk of corrosion contamination by the sterilizer condensate. • Continuous loss of heat by the distribution system is much less.

DeSilva, J., Filippone, C., & Martinez, L.M. (2018). The secrets in the steam. Journal of Health Science, Vol6, 178-182. doi: 10.17265/2328-7136/2018.03.007 HTM01-01. (2016). Health Technical Memorandum - Management and decontamination of surgical instruments (medical devices) used in acute care. h t t p s : // w w w. g ov. u k /g ove r n m e n t /p u b l i c a t i o n s / management-and-decontamination-of-flexibleendoscopes

• Easy and low cost to maintain a small distribution system (Spirax Sarco, 2022).

Kremer, T.A., (2020). Water Quality in Medical Device Processing: The Power of Prevention. Biomedical Instrumentation and Technology, Vol54(Issue4), 304309. Doi: 10.2345/0899-8205-54.4.304.

The disadvantage of this system is the capital cost is high. However, if upgrading the plant steam is high, a steam-tosteam generator method must be chosen (HTM 01-01, 2016) & (Spirax Sarco, 2022).

Menna, D. (2017). Unwrapping the history of sterilization. The Journal of Perioperative Nursing in Australia, Vol30(Issue4), 41-46. https://search.informit.org/ doi/10.3316/informit.317349524505125

Future research needs to find answers to questions such as what are the statistical shreds of evidence to prove the number of patients who acquired nosocomial infections due to TDS, endotoxins, and inadequate sterile instruments used on patients due to undetected wet packs, inadequate steam penetration [NCGs], and superheating?

Rodrigues, S.B., Souza, R.Q., Graziano, K.U., Erzinger, G.S. (2022) Specialists’ opinion regarding factors related to wet loads after steam sterilization. Journal of Hospital Infection, Vol120, 117-122. https://doi.org/10.1016/j. jhin.2021.12.003

Preparing for tomorrow, today The article summarises the known contaminants of steam to date, and the two most effective methods to supply clean saturated steam for steam sterilization. However, it is clear from the above discussion, that the most effective and economic method to supply clean, lasting, and saturated steam is supplying steam by a dedicated steam generator. Bibliography Basu, D. (2017). Reason behind wet pack after steam sterilization and its consequences: An overview from central sterile supply department of a cancer center in eastern India. Journal of Infection and Public Health, Vol10, 235-239. http://dx.doi.org/10.1016/j. jiph.2016.06.009

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Das, T.K., Laha, S.K., & Basu, D. (2020). Potential problems of inadequate air removal and presence of noncondensable gases in steam sterilization process: A brief discussion. Infection Control and Hospital Epidemiology [Infect Control Hosp Epidemiol], Vol41(Issue6), 739-740. https://doi.org/10.1017/ice.2020.68

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Shen, Y., Wang, X., Yao, Z., & Li, X. (2019). Effect of noncondensable gas on heat conduction in steam sterilization process. Thermal Science, Vol23(Issue4), 2489-2494. doi.org/10.2298/TSCI1904489S Spirax Sarco. (n/d). First for steam solutions. https:// www.spiraxsarco.com/ Standards Australia & Standards New Zealand. (2014). Reprocessing of reusable medical devices in health service organizations (AS/NZS 4187:2014). https:// www.standards.govt.nz Suryadarma, E.H.E., & Ai, T.J. (2020). Mapping Predictive Maintenance in SCADA-Based Industries: A literature review. International Journal of Industrial Engineering and Engineering Management, Vol2Issue(1), 57-70. doI: https://doi.org/10.24002/ijieem.v2i1.4368

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President’s Report The NZSSA are so pleased to welcome you all to the AGM for 2023. We are now living in a new normal, where, what we always did prior to 2019 no longer appears valid. Yes, our practice is the same however on a daily basis there is no certainty that the lists we thought we would be doing are the ones we will do. Staff sickness and stress levels are at an all-time high and no one other than ourselves and our profession seems to care. My observations are that each subspecialty within our working environment are only concerned about their own needs and not the needs of the perioperative group as a whole. The NZSSA executive has continued to hold regular meetings throughout the year. With the advent of Microsoft Teams, we have in fact been able to increase the number of meetings held to every six weeks. We successfully ran Leaders meetings via zoom and had attendees from both Australia and NZ. A Regional meeting was held in Tauranga and a meeting is being planned for the Christchurch post this conference. The NZSSA are grateful for the support of our trade partners in getting these meetings up and running and we are always keen to explore other avenues around this to ensure that our members get access to additional training and education. Education, as ever, is major focus of the NZSSA. The courses continue to attract new students from the workforce and some from overseas. We continue to offer scholarships for members to undertake the Level 5 Diploma. For 2023 we offered scholarships for members to attend the NZSSA conference in Wellington, The FRSECA conference in Melbourne, Australia, and the WFHSS conference in Brussels, Belgium. Sadly, there was not a lot of interest in the scholarships for conferences, however I am pleased to say that we have now awarded a scholarship for a member to attend the WFHSS in Belgium. I look forward to their report. This year, I and several executive members were involved in an official review of the qualification which then went to NZQA for approval. There have been some very minor changes requested by the NZQA. The updated qualifications can be viewed on the NZQA website. At the 2022 AGM I made mention of the paths that we as a profession need to follow going forward. I mentioned the need to amend our registration portfolios submissions to every 3 years in line with other similar professions and also what type of profession we intend to be. This has partially been decided for us by the Chief Allied Professions Officer at the Ministry of Health/ Manatu Hauora. The NZSSA have been advised that we are to develop ourselves fully into a self-regulated profession. We are 60% there with work already undertaken, but still have work to do. This will be a priority over the next year. For you the members it will mean that to be

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a sterile sciences technician in NZ you will have to be a member of the NZSSA. You will also have to submit your portfolios/PDRP for assessment and you will have to hold a minimum of a Level 4 certificate in sterilising technology. (L3 pre-2019) This year also saw, for the first time after many attempts, Sterilisation Technicians added to the Immigration Green List. We managed to be accepted as we are well on the road to self-regulation. The Green List offers successful applicants either an immediate residency visa or residency within two years. To be successful applicants need to have an offer of employment and have had their qualifications assessed and validated by the NZSSA as equivalent to the minimum of the level 4 certificate of sterilising technology. As per last year, the standard AS/NZS4187:2014 is still the current standard for best practice that we are required to work to. The draft standard AS 5369 is going through the final public comment phase and I hope that we shall have some news on that very soon. When this occurs, we shall announce it on the website and all facilities shall be expected to obtain a copy of this document and implement it, in the workplace. 2024 will be an association election year, where you the members vote for the executive team for the next three years. I personally would like to remain on the NZSSA Executive however, I would like to stand down from the role of president. If you are passionate about our profession, and taking it into the future, then please consider putting your name forward for the executive elections. We have been considering venues for the 2024 50th Anniversary conference and Rotorua is looking like a front runner at this stage. I would especially like to thank MTANZ team members Mel and Britta for helping us to make this conference a success and introduce us to some new conference technologies. I would also like to thank Sharon Moss, Alison Stewart, and Anthony Valvoi for their excellent work on the conference committee. I would like to thank all of our trades who continue to support us and the NZSSA and the members appreciate you all. I would like to thank the executive for the dedication and the free time they give due to their passion for the profession, and I would like to thank you the members for supporting your profession. Shelagh Thomas

President NZSSA

SUPPLYLINE – JUNE 2023


Secretary’s Report Statement of Financial Position Tena koutou katoa,

Given the increasing demand on our time with jobs, families, and friends it is important we start reorganising and defining all the background processes that are required to make an association like ours run smoothly so we can focus on growing the profession and advocating for you, our members. To that end much of this past year has been occupied with revamping our association systems and putting some of the foundation blocks in place that will allow us to move towards self-regulation and greater recognition for the industry. New software has been purchased to assist with executive operations and facilitate better collaboration amongst the various sub committees. It will also provide better security for our data and will be most noticeable as our new @nzssa.org email addresses are rolled out for association business. Work has also started on creating role based operational procedures to ensure future committee members can come up to speed with various functions quickly and efficiently. Additionally, the executive has released a new complaints procedure to enable members an avenue for resolution of any potential grievances within the association.

The Association remains in a strong financial position. The Executive have managed expenses well during this period of disruption where natural building of equity has been stalled. The accounts operate on an accrual system in line with the Association reporting as a Tier 3 registered charity. Total accumulated funds Assets Liabilities

$207,236 $215,159 $ 7,923

Statement of Comprehensive Income (Profits and Losses) Revenue Expenses Profit for the year

$ 127,927 $ 118,548 $ 9,379

Statement of Cash Flows Net cash flow from operating activities Net cash flow from investing activities Cash at end of the year (bank balance)

$ (2,721) $ (2,226) $ 45,031

Deliverables Education

2 x Executive Leadership meetings in person

Congratulations to all those achieving their level 4 and 5 diplomas this year – and thank you to all those who have taken the time to complete their association registrations. Finally, if you have any thoughts or queries regarding the association, please feel free to contact myself or any of the executive team. And for anyone interested in helping out with the association’s 50th celebrations next year please get in touch – new ideas are always welcome. Nga mihi. Paul Moody

2 x Leaders’ meetings hosted by zoom

3 x Supplyline journal publication 1 x Conference scholarship to WFHSS

NOTES TO FINANCIAL STATEMENTS

Secretary, NZSSA

Accounts

Treasurer’s Report

The audited performance report demonstrates an overall profit of $ 9,379 which is directly associated with being able to resume conferences following the pandemic.

The figures presented in this report are as at 31 March 2023 for the financial year 2022 – 2023. The accounts were prepared by McIntyre Dick & Partners and audited by Accounting for Charities Trust.

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Financial Trend

The difference in financial growth through being able to host conferences to the financial bottom line can be seen in the difference between the two Covid years and this last financial year.

Independent Auditor’s Report Auditor’s Report

Qualified Opinion Report Financial year 2020 – 2021

Deficit $ 4,641

Financial year 2021 – 2022

Deficit $ 3,894

Financial year 2022 – 2023

Profit $ 9,379

With resumption of the conference and other activities the trend into profit was achieved. The Executive approved provision of two (2) education scholarships for which no applicants were received. Approval was given for an international congress scholarship to Alison Stewart. This enabled her attendance of the Barcelona WFHSS Congress. You can read her report in the February 2023 Supplyline.

Commitments

The association strategic plan for the financial year 2023 – 2024 is included after the financial summary. Scholarships Each year the Executive, as the management arm of the Association, allocate funds to scholarships and activities to registered members to promote educational opportunities and advocate for the profession.

It is the opinion of the auditor that the performance report gives a true and fair view, in accordance with Public Benefit Entity Simple Format Reporting – Accrual (Not-For-Profit). Basis for Opinion This opinion is based on the belief that the audit evidence obtained was sufficient and appropriate. The audit was conducted in accordance with International Standards on Auditing (ISAs). Key Audit Matters Key audit matters are those of most significance in the audit of the performance report for the current period (1/4/2022 – 31/03/2023). Those matters were addressed in the context of the audit as a whole and informing the auditors opinion and a separate opinion is not provided on these matters. Going Concern In the opinion of the Executive Committee the Association is a going concern for the foreseeable future.

Congratulations to the following for being awarded scholarships for 2023: WFHSS Conference Scholarship – Donna Dador Education Scholarship – Sophia Twinkle Samuel As with previous years there has been a low take up of scholarships and the executive are looking at alternate ways to promote these in the future.

“The Strength of the NZSSA comes through its membership.”

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Financial Summary

Strategic Plan 2023-2024

Subscriptions

The strategic direction for the current financial year was discussed at Executive meetings and has resulted in the plan presented in this document.

This summary presents comments on key areas within the financial statement. The membership continues to rest around 600 financial members. Reminders are sent out electronically, via email, where practical. Some members do not provide emails. Members are held on the books for 12 months after expiry to allow for capture via employer or individual renewal. Where the employer bulk invoices this does mean this income stream is more robust and consistent. The focus continues to be to get all members renewed within 3 months of their expiry month. This requires a stronger follow up process once renewal notification is sent out. Supplyline Advertising The companies continue to support the Association through advertising in the journal. Advertising takes the form of regular entry of business cards and full or part page advertising throughout the journal. The new editor for the journal has been proactive in increasing the advertising as this supports the activities of the Association and provides exposure of companies to the membership. The result has been to see an increase in advertising income and exposure to companies. Scholarships The budget for education scholarships is approximately $13,000 per annum. The actual spend varies per year depending on whether the recipient enrolls in all six courses at one time or in each course individually. This means the $6,500 per recipient may be spread across more than one financial year. The spend in 2022-2023 was $6,543. This expenditure represents recipients from the previous financial year. There were no applicants in the reporting financial year.

Education is the focus for the coming year. With COVID-19 now in the background the Association can move forward with a return to face-to-face education events, hosting the annual conference and providing scholarships for conference attendance both nationally and internationally. These activities are in addition to scholarships for education and providing knowledge through the quarterly association journal, Supplyline.

The Plan Education Events

Budget

Leaders Meeting – via Zoom

$ 100.00

Face to Face education session – $ 3,000.00 North Island x3 Midcentral x2, Wellington x1 Face to Face education session – $ 2,000.00 South Island x2 Christchurch x1, Dunedin x1 Scholarships Education – up to 2

$12,000.00

NZSSA Conference 2023 - up to 4

$10,000.00

WFHSS Conference 2023 x1

$ 6,000.00

One conference scholarship to the WFHSS congress was approved and utilized. The strategic plan presents the allocation for scholarships for the coming financial year. It is hoped there is more interest demonstrated in these opportunities.

FSRACA Conference 2023 x2

$ 7,000.00

All scholarships and NZSSA activities are promoted through the NZSSA website.

Executive flights and accommoda- $ 6,000.00 tion 2023-2024 financial Budget Total $52,100.00

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Executive Expenses President attendance of WFHSS

$ 6,000.00

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Executive Plan of work

The executive plan of work focuses on putting processes in place to become formally self-regulated and build the Association’s reputation as the national membership body for people involved in reprocessing reusable medical devices. This plan of work is intended to create a robust framework for the Association to; • measure overseas qualifications against NZ qualifications to enable immigrating technicians and employers to have clarity for positive and safe employment practices, • advocate on the behalf of members on appropriate reprocessing practices, • build relationships with the Ministry of Health (MoH), Ministry of Business, Innovation and Employment (MBIE), and other key entities, and • ensure members are receiving value as a member of the NZSSA. The following table presents the plan initiated in 2022 and continuing through to 2024.

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The NZSSA would like to take this opportunity to acknowledge and thank our Conference Sponsors for their sponsorship at the NZSSA 49th Annual Conference 2023.

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Manual cleaning of endoscopes, is it necessary when using an AER that is capable of pre cleaning?? In 2021 GESA released a document titled Infection Prevention and Control in Endoscopy 2021.The recommendations in this document represent the best available evidence at the time of compilation and are intended to be used as a guide only. In NZ and Australia this is the guiding document for Endoscopy reprocessing and other associated endoscopy activities. I want to focus on Chapter 8 of this document in specific chapter 8, 8.1 Effectiveness of recommended reprocessing protocols. In this section the document states “Endoscope reprocessing machines that perform mechanised cleaning are now in common use and provide an equivalent level of efficacy for removal of biological material and microorganisms as optimal manual cleaning. Such machines should ultimately replace manual cleaning to provide standardisation of the cleaning process and remove the human factors that can adversely affect the quality of manual cleaning”. Also in 8.4 Cleaning Equipment. It states “Some AFERs remove the need for manual cleaning as an essential prerequisite to HLD. Mechanising the cleaning step of reprocessing offers clear advantages in terms of reproducibility and standardisation”. After reading this document and thinking about the removal of manual cleaning and the advantages this would have for the department which include less damage to scopes caused in the manual cleaning process, Less aerosols in the air which reduces cross contamination and less risk to staff, as well as staff time factors, I decided to investigate this process as each automatic flexible endoscope reprocessors (AFER) will be different to a degree and could produce varying results, as well I was unable to locate the original study that was done and what AFER was used in the trial. In our endoscopy unit we have 2 x Medivator Advantage plus AFERs which can have a pre clean cycle ADDED. The first step was contacting the service agent and getting a pre clean cycle programmed in to the Medivator. This was achieved and I decided to use the pre clean chemistry Matrix from Whiteley which has a lot of independent research to show that it is currently

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the best bio-film remover on the market and is approved for use in the Medivator advantage plus. Next step was to speak to all stakeholders. When making changes, especially if those changes could have an effect on the patient, it is important to involve all stakeholders in the process. After all stake holders were made aware of what I wanted to do and had agreed, I then contacted the IPC team and set up a meeting. In this meeting I discussed the Genca 2021 infection prevention and control document as well as outlined the process I wanted to undertake to ensure that our AFERs are able to achieve the desired result and give consistent results. This process consisted of selecting our most used scopes and preforming daily then weekly then monthly microbiological testing to see if any cultures remained in the scope’s channels after cleaning and disinfection through the AFER. Once this process was approved, I then began the process. first, I choose 2 endoscopes 1 x Gastroscope and 1 x Colonoscope, our most used scopes that are used multiple times per day due to doctors preferences. After patient use, I then started loading these scopes into the Medivator directly with no manual cleaning beforehand, the next morning when the channels were dry from sitting overnight in the aeration cabinets, I collected Microbiological testing samples on both scopes and then processed the scopes so they could be used for lists that day, I did this every day for the first week. After 7 days of incubation all samples returned a no cultures detected result. I then spaced my testing out to a week. After one week I again collected microbiological samples from both scopes and after 7 days incubation these again returned no culture detected results. I then moved to monthly testing, again after 1 month I collected microbiological samples from both scopes which again returned a no cultures detected result. Now with these results I expanded the trial to all scopes with and exception of the Duodenoscopes as these scopes are more complex in desig. I then continued taking samples from multiple scopes over the next 3 months which all returned negative culture results. Below are some of the results. SUPPLYLINE – JUNE 2023


In conclusion the results have shown that the pre clean cycle on the Medivator Advantage Plus AFER is sufficient to clean the channels of the Colonoscopes, Gastroscopes & Bronchoscopes. Given the complexity in design and location of where a Duodenoscope is used I have decided that regardless of these results the Duodenoscopes will continue to have a manual clean before reprocessing in the AFER. I have however added the pre clean cycle on to the Duodenoscope cycle so ensure the duodenoscopes is getting the best clean available. These results have helped to create new processes in the Endoscopy reprocessing room which have allowed us to give faster reprocessing times as well as minimizing cross contamination In the room. Following on from this trial I have continued to do microbiological testing on all scopes over the last 6 months which has confirmed the process is sufficient, no microbial growth nor any foreign bodies discovered in the journal of NEW ZEALAND STERILE SCIENCES ASSOCIATION

the channels like seeds or tips. Although this trial has shown that manual cleaning is no longer needed, we have kept the manual cleaning process for some circumstances, as iv stated previously for all Duodenoscopes, but also for all Colonoscopes that are used in acutes or un-prepped patients and are heavily soiled will undergo a manual pre clean before being placed into the AFER. Although the results have showed this to be unnecessary for the Colonoscopes, I believe that a manual pre clean in these circumstances is best practice. Anthony Valvoi Te Whatu Ora Taranaki Central Sterile Sciences Manager References: Infection Prevention and Control in Endoscopy 2021

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NZSSA Supplyline Dates for 2023 / 2024 Date

Advertising / Articles required by:

Published:

October 2024

9th October 2023

30th October 2023

February 2024

5th February 2024

26th February 2024

3rd June 2024

24th June 2024

7th October 2024

28th October 2024

June 2024 Oct 2024

Overseas Qualified Technicians Green List Immigration Applicants From 29 May 2023 Anyone seeking to come into NZ under the immigration Green List must follow the process established by the New Zealand Sterile Science Association (NZSSA) in collaboration with Ministry of Health and Ministry of Business Innovation and Enterprise, to have their overseas qualification assessed as equivalent the NZ Certificate in Sterilising Technology (Level 4). Instructions and application form for qualification equivalency: https://nzssa.org/career-opportunities/ If the qualification is not approved as equivalent the applicant will have to enter NZ via the accredited employer avenue and complete the NZ Certificate in Sterilising Technology (Level 4) to become qualified.

Current Visa Holders Working and Living in NZ Current Visa holders wanting to change to immigration Green List criteria (pre and post 29 May 2023): Must follow the process established by the New Zealand Sterile Science Association (NZSSA) in collaboration with Ministry of Health and Ministry of Business Innovation and Enterprise, to have their overseas qualification assessed as equivalent the NZ Certificate in Sterilising Technology (Level 4). Instructions and application form for qualification equivalency: https://nzssa.org/career-opportunities/ If the qualification is not approved as equivalent, the visa holder will have to remain on the accredited employer visa and complete the NZ Certificate in Sterilising Technology Level 4

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NZSSA Registration – Work Visa Holders Work visa holders (post 29 May 2023) applying for NZSSA registration: Must hold the HSPA Certificate or an approved overseas qualification, and at least 3 years experience in sterilising technology. Have worked in NZ to meet the ongoing education requirements. For full details of NZSSA Registration: https://nzssa.org/ application-for-nzssa-registration/

Permanent Resident Visa Holders Permanent residence Visa Holders (pre 29 May 2023) wanting NZSSA registration: Must hold the HSPA Certificate and at least 3 years experience. Have worked in NZ to meet the ongoing education requirements. If they wish to do the Diploma they will need to meet the requirements for language etc. although their IAHCSMM /HSPA qualification will be recognised as the entry sterilising qualification. For full details of NZSSA Registration: https://nzssa.org/ application-for-nzssa-registration/

NZ Diploma in Sterilising Technology Overseas qualified technicians who wish to do the NZ Diploma in Sterilising Technology (Level 5), will need to meet the enrolment requirements for language etc. Their IAHCSMM /HSPA qualification or visa approved overseas qualification will be recognised as the entry sterilising qualification required to study in the Diploma.

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Celebrating 90 years of business with Export Customers 22nd September 2023 Whiteley held its 5th Biannual Export Conference in Sydney on 13th September 2023. The 3-day meeting saw delegates in attendance from Korea, Taiwan, Thailand, Indonesia, New Zealand, Japan, Switzerland, and Malaysia attend the conference to discuss business opportunities and prospects for Whiteley products in the international marketplace. The export conference allowed delegates to tour key Sydney facilities in conjunction with the conference. The Export meeting was led by Whiteley’s Vice President of International Sales, Greg Pobjoy Greg focused on building and strengthening export customer relationships, product training, education and team building were all focus areas that helped to create a successful export meeting in Sydney. The export meeting was held alongside the Whiteley 90-year celebration dinner. The gala dinner was held at Curzon Hall in Marsfield on Thursday 14th September. More than 100 guests were in attendance from key industry bodies, export customers, researchers, academics, and customers.

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Associate Professor Greg Whiteley said: “The 90th gala dinner was fabulous for us and our family, I wanted to express my personal gratitude to everyone who joined us to celebrate 90 years of Whiteley. Not many companies get to 90 years of age, but we are one of that rare breed and we look forward to the next 90 years from here.” “On the night we did not have time to canvas all of the on-going work in which our team are engaged but there is much more to follow over the next couple of years.” As Australia’s largest manufacturer of sterilants, disinfectants and professional cleaning technologies, Whiteley have been protecting lives and livelihoods since 1933. With its manufacturing facility located at Tomago, Whiteley Corporation is a proud advocate for conducting business in the Hunter Region. Moving forward, Whiteley Corporation will continue to be a proud export ambassador for the Hunter Region. The company will look to explore new export markets and strengthen the export relationships that currently exist.

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AS 5369 Reprocessing of reusable medical devices and other devices in health and non-health related facilities The new standard has moved into a new stage of its development and an is nearing the final steps prior to release. The committee is now voting on the document. When this is complete the new standard will be published.

When the standard comes into publication it will be announced on the NZSSA website and leaders of services will be emailed with the notification.

The Effects of Reprocessing Single-Use Screw Implants & using Manufactures Instructions for Use Introduction

Organization, 2016).

With the advancement in technology of medical devices, reusable medical devices (RMDs) become more intricate with delicate working mechanisms causing RMDs to not being able to be cleaned and processed properly, resulting in a higher rate of pathogenic cross-contamination (Dunn, 2002). This led to the introduction of single-use medical devices (SUMDs). When first introduced they were welcomed, as they allowed hospitals the convenience, they “no longer had to be concerned with product age, overuse, breakage and malfunction” (Dunn, 2002, p. 991). Furthermore, advanced technology and single-use RMDs allowed for treatment on patients to be less invasive.

Single-use screw implants (SUSI) have become a popular topic of conversation, with the practice of reprocessing by placing screws in trays alongside medical devices that are reusable and are kept in either a metal or plastic holder, and cannot always be removed from the tray to allow effective cleaning (Alfa, 2012). “Screws are often contaminated with overlooked debris during procedures and are frequently subjected to multiple reprocessing until used” (Costa et al, 2018, p. 2006).

The increase of sophistication in SUMDs drove the cost up bringing about health care organizations to explore options. One being the reprocessing of SUMDs within the health care facilities themselves or a third-party reprocessing company (Kwakye et al, 2010). With the increase over the past 4 decades and worldwide concerns which have come from this practice, regulations and standards have evolved. This has brought about a change in the way we now define and reprocess SUMDs. Standards AS/NZS 4187 (2014) states that “a single use medical device that is past it’s expiry day, or that has been opened but unused shall only be reprocessed, if this is permitted by the medical device manufacturer. Reprocessing of the medical device shall be performed in accordance with the validated sterilisation instructions provided by the manufacturer of the medical device. Medical devices labelled as or intended for single use and that have been used, shall not be reprocessed or used” (Standards NZ, 2014, p. 39). Likewise, The World Health Organization (WHO) memorandum for processing SUMDs recommends the same approach (World Health

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The understanding is manufacturer’s instructions for use (IFU) are essential to be able to determine if reprocessing of a SUSI can be achieved whether used, or unused. Consequently, there have been studies conducted on the effects of reprocessing SUSI and IFUs. The aim of this literature review to is to investigate their findings and the impacts of reprocessing on SUSUs. Types of Effects

The Testing The scope of studies for the types of effects of reprocessing SUSI initially began with weakness testing, Colella et al (2008). McAuley (2016), focused on the effects of using metal screw caddies to reprocess SUSI. Pereira et al (2023), also included high and low usage screws (n=126) in a study to “access the surface integrity and microbiological conditions of patient ready screws in orthopaedic trays that had had multiple reprocesses” (Pereira et al, 2023, p. 1).

The Findings Colella et al (2008) established weakness testing that brand specific differences exist, however, “statistical SUPPLYLINE – JUNE 2023


variability in maximum insertion torque and lateral displacement force” (Colella et al, 2008, p. 678) indicated sterilization had no relevance to stability.

5) and if used have potential to cause harm to the end user (Vickery et al, 2013). It may have been beneficial to provide data on the

McAuley’s (2016) study generated “visual proof that screws in screw caddies show signs of contamination and corrosion, and evidence that exposure to an increase number of all reprocessing cycles leads to increased rates of contamination, corrosion, deterioration and/or damage” (McAuley, 2016, p. 55). Pereira’s et al (2023) study further supports McAuley’s findings. Grooves were detected, predominantly in the least used group. “Residual protein was detected on 96.3% and there was no statistically significant difference in the amount of protein between the groups (P=0.07)” (Pereira et al, 2023, p. 4). Surface damage and soil was visual on screws subjected to SEM and biofilms were detected on 8 screws, 3 in the most used group and 5 in the least used (Pereira et al, 2023).

state of screws before testing began. To include this in the studies, could have contributed to the variables in the testing, one study did test one new screw after the first process and grooves where detected. It was suggested the damage may have occurred during the manufacturing process, transport, and general handling (Pereira et al, 2023). Costa’s et al (2018) study included the condition of loan sets on arrival and after reprocessing, although the randomized sample was small (n=3), bacterial contamination was detected on arrival.

Instructions for Use (IFU) Pereira’s et al (2023) study reported most IFUs in North America do not state how screw implants should be processed. Abdalla’s (2020) pointed out reprocessing included numerous steps which took fifteen times longer than real-time processing does than was required to be performed according to legal and manufactures requirements. Likewise, Agarwal et al (2019) had similar findings when they reviewed 4 major manufacturers IFUs for reprocessing pedicle screws. The guidelines had at least nineteen disjointed steps, which took a minimum of nineteen hours required to reprocess a tray of 164 pedicle screws. However, real time observation “revealed a substantial lower turnaround time for each set, as it only included the processes of mechanical washing” (Agarwal et al, 2019, p. 174), skipping 8 of the guideline steps (Agarwal et al, 2019, p. 178). Alfa’s (2012) assessment of IFUs for seven different manufacturers found: - Only 2 clearly indicated that screws are implantable and they had been validated for the cleaning process. - 2 instructs the rack of screws remain in the tray for automatic cleaning. - The term single-use in all 7 was used and clearly state they should not be reprocessed if they encounter patient material. - 5 were unclear if screws are single use. - None state if screws can be indefinitely reprocessed multiple times.

Summary In brief the evidence indicates the reprocessing of SUSIs has an adverse effect on the screws. “Surface damage favours the accumulation of organic matter, increasing the difficulty of reprocessing” (Pereira et al, 2023, p. the journal of NEW ZEALAND STERILE SCIENCES ASSOCIATION

Although companies were aware of the research being conducted, overall views of end user suggested IFUs were not adequate for the reprocessing of SUSIs. There appears to be a lack of regulatory for manufacturers IFUs. Costa et al (2018) concluded findings “underpin the inconsistency between the terms single-use and multiple reprocessing when applied to implants, such as screws” (Costa et al, 2018, p. 2011). Furthermore, Agarwal et al (2019) concluded results indicated impracticality of cleaning prescribed in the IFU.

Conclusion Overall, there is a substantial amount of research been conducted over the past couple of decades to conclude there are adverse effects to reprocessing SUSIs. Studies suggest IFUs neither support single-use and/or multiple use to support best practice. There is not enough current research into IFUs to support if they are in line with standards and/or recommendations. It would be beneficial for further research to be conducted on IFUs, to improve and/or eliminate the adverse effects on reprocessing SUSIs in line with best practice standards.

References Abdalla, Y. (2020). Valve based healthcare: maximizing efficacy and managing risk with spinal implant techology. Interdiscoplinary Neurosurgery. doi:https://doi. org/10.1016/j.inat.2020.100810 Agarwal et al, A. S. (2019). Harbouring contaminants in repeatedly reprocessed pedicle screws. Global Spine Journal, 9(2), 173-178. doi:10.1177/2192568218784298 Alfa, M. J. (2012). The pandora’s box dilemma: reprocessing of implantable screws and plates in orthopedic tray sets. Biomedical instrumentation & technology, 46(sp 12), 5559. Colella et al, G. T. (2008). Effects of repeated cycles of sterilizations on the mechanical characteristics of titanium miniplates for osteosynthesis. British Journal of Oral and Maxillofacial Surgery, 46(6), 449-545. Costa et al, D. L. (2018). Reprocessing safety issues associated with complex-design orthopaedic loaned

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surgical instruments and implants. Injury, 19(11), 20052012. doi:https://doi.org/10.1016/j.injury.2018.09.006 Costa et al, D. V. (2022). Providing sterile orthopedic implants: Challenges associated with multiple reprocessing of orthopedic surgical trays. Hygiene(2), 63-71. Retrieved from https://www.mdpi.com/2673947X/2/1/5 Dunn, D. (2002). Reprocessing single use devices - The ethical dilemma. AORN Journal, 75(5), 898-999. Hennessy et al, O. D. (2021). Screwing our enviroment: an analysis of orthopedic implant related waste. Irish Medical Journal, 114(2), 266-269. Kwakye et al, G. P. (2010). Commentary: a call to go green in health care by reprocessing medical equipment. Academic medicine, 3(85), 398-400. McAuley, T. (2016). Reprocessing of single use screws: A study on the effects of repeated reprocessing on single use screws in screw caddies. In Australasian College for Infection Prevention and Control 2016 Conference. Retrieved from http://www.acipcconference.com.au/wpcontent/uploads/2016/02/Reprocessing-of-single-useorthopaedic-implants.pdf Pereira et al, L. L.-V. (2023). Biofilm on patient-ready orthopaedic screws acquired through the loaner system.

Acta Paul Enferm, 36. Retrieved from https://www. researchgate.net/publication/368956576_Biofilm_on_ patient-ready_orthopaedic_screws_acquired_through_ the_loaner_system Riley, R. &. (2009). Screw banks vs pre-sterilised individually packaged screws and plates. ACORN, 22(2), 10-13. Standards NZ, A. S. (2014). AS/NZS 4187:2014+A2 Reprocessing of reusable medical devises in health services organizations. Suchowerske el at, A. M. (2020). A comparison of risk profile for orthopedic operations when utilizing individaully wrapped screws (IWS) when compard with sterile screw caddies (screw racks). Journal of Orthopedic Surgery, 28(3). doi:10.1177/2309499020944086 Vickery et al, K. H. (2013). A review of bacterial biofilms and their role in device associated infections. Healthcare Infection, 18(2), 61-66. World Health Organization. (2016). Decontamination and reprocessing of medical devices for health-care facilities. Retrieved from World Health Organization: https://www.who.int/publications/i/item/WHO-UHLIHS-IPC-2022.4

NZSSA Executive Elections 2024 The new executive to manage the NZSSA affairs from September 2024 – September 2027 will be ratified at the 2024 Annual General Meeting. Before this, nominations are received, any voting required carried out and then the Executive proposed in the Annual Report ready for ratification at the annual general meeting. Voting is only required where more than one person stands for President or secretary, or there are more than eight members nominated for the executive.

• Nominations open: 1 February 2024 • Nominations close: 30 March 2024 • Collate nominations: April 2024 • Candidate Photo and Bio published in June 2024 Supplyline • Voting (if required): completed in July • Final proposed executive notified August 2024

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Toi Ohomai Institute of Technology Ltd NZ Certificate in Sterilising Technology (Level 4) Edmund Susan Rachel Edgar Jerald Nathan Aryelle Carley Pablita Alyssa Kenneth Zenaida Maddison Heidi Chantelle Madison Melanie Karishma Shine Sijo Sanoj

Arellano Bodle Cawkill Condino Duyor Edwards Fidow-Kele Field Gabisan Gallo Garingalao Gelvosa Graham Gutierrez Harper Hemara Hooper Immanuel John Jose Kachappilly Jose

Sanjay Jerinte Mark Roli Ryan Lorenzo Allen Brisa Sajeev Maricel Noah Nelson Joe Rolly Jr Pamela Jonathan Ruth Glenda Vipin Christine Emma Jane Cody

Kinattukara John Knol Landero Macauling Macdonald Malbog Mandecote Marino NEDUMATTATHIL Padie Papali'i Perez Redosendo Rivera Rollinson Smith Townsend Tuano Varghese Walker Wendt-Smith Young

Toi Ohomai Institute of Technology Ltd NZ Diploma in Sterilising Technology (Level 5) Sashi

Prakash

Theresa

Luke

Luke

Rabjohns

Sharon

Concepcion

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Toi Ohomai Institute of Technology Ltd.

Sterilising Technology programmes • Trimester 3 starts Monday 16 October 2023

• Students have enrolled for their courses or advised if they are taking a break. • This trimester is a busy time for work and holidays. Students - plan your study and keep to the plan! • Keep in touch with your tutor • Share your course outline with your service leader / educator / anyone helping you with your study

• Trimester 1 starts Monday 19 February 2024

• Now is the time to get students enrolled for 2024! • Courses available for Trimester 1 are being confirmed. • For all inquiries email: SterilisationApps@toiohomai.ac.nz

• Enquiries regarding your application:

• If you have a study plan in place or have already enrolled send all inquiries to: SterilisationApps@toiohomai.ac.nz

• Prepare for study:

• Devices for study – smart phones and tablets are alright for the learning, a computer or laptop is needed for the portfolio assessment tasks. • Study plan - to fit study around work and family – this study is at distance and you will have to do it in your own time. Allow 12 – 16 hours per week • Check your internet connection – you will need this to access the online learning modules, library and upload portfolio assessment tasks.

Throughout your study you will have full support from Toi Ohomai in the same way a student coming onto campus does. Your tutor can connect you with the student support services.

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50th Anniversary of the New Zealand Sterile Sciences Association Join us in celebrating this significant milestone at the Aotea Centre, Auckland.

25th – 27th September 2024.

Conference Dinner: Thursday 26th September 2024 Dinner theme: Fashion, Style, Music, History, and Events of 1974.

Midland CSSD Regional Meeting 25th November 2023 8.30 am to 1 pm

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NZSSA Executive 2021-2024 President: Shelagh Thomas CSSD Hutt Valley Capital, Coast and Hutt Valley

Secretary: Paul Moody Senior Product Development Manager Fisher & Paykel Auckland

Phone: 04 566 6999 ext 2745 Mobile: 027 589 6473 Email: shelagh.thomas@huttvalleydhb.org.nz

Email: paul.moody@fphcare.co.nz

Maureen Scott Sterile Services Hamilton Waikato District Health Board

Anthony Valvoi Sterile Services New Plymouth Taranaki

Email: Maureen.Scott@waikatodhb.health.nz

Email: anthony.valvoi@tdhb.org.nz

Karen McCormick CSSD Manager Wellington Capital, Coast and Hutt Valley

Martin Bird Sterile Services Dunedin Southern

Email: Karen.mccormick@ccdhb.org.nz

Email: martin.bird@southerndhb.govt.nz

Sharon Moss National Sterile Services Manager Southern Cross Health Christchurch

Aileen Derby CSSD Manager Manukau Counties Manukau

Email: sharon.moss@southerncrosshospitals.co.nz

Email: Aileen.Derby@middlemore.co.nz

Jenny Carston CSSD Manager Tauranga Hauora a Toi Bay of Plenty

Kelly Swale Sterile Services Manager Faculty of Dentistry, University of Otago Dunedin

Email: Jenny.Carston@bopdhb.govt.nz

Email: kelly.swale@otago.ac.nz

Treasurer: Alison Stewart NZSSA Treasurer 28 Brighton Street Island Bay Wellington 6023 Mobile: 021 209 8127 Email: nzsterilescienceassoc@gmail.com

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S U P P LY L I N E

SUPPLYLINE – JUNE 2023


the journal of NEW ZEALAND STERILE SCIENCES ASSOCIATION

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