Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
KO SM(1)(2),LAW WC(1)(2),WAN CH(1)(2),SHEK YY(1)(2),CHAN CH(1)(2),CHOY WK(1)(2),MAN HM(1)(2),TSANG WY(1)(2)
Affiliation :
(1)(2)Sterile Services Department,Pok Oi Hospital
Introduction :
The Da Vinci Xi system improved surgery precision and patient outcomes through its unique designs in endo-wrist instruments and the specialized endoscope.
These distinctive instrument features presented a new challenge to Sterile Services Department (SSD). To ensure proper decontamination, SSD colleagues require specific knowledge and skills related to credentialed cleaning procedures, designated washer disinfector & program, compatible chemicals and accessory devices. To address this, a systematic learning approach was implemented to introduce these new set of skills and procedures. This approach including theoretical training, practical sessions, "train the trainer" workshops, and a mentorship program. Through the comprehensive training journey, SSD colleagues acquire the expertise necessary to handle robotic instruments professionally, ensuring the highest standards of decontamination, upholding patient safety and maintain the quality of services provided.
Objectives :
The Robotic Instrument Training Program aims to systematically equip staff with the specific skills, knowledge, and competency to handle robotic surgery instruments. Its primary goal is to establish a standard for reprocessing robotic instruments in order to safeguard patient safety.
Methodology :
The Robotic Instrument Training Program was implemented in three phases.
In the first phase, all SSD colleagues attended training provided by manufacturers, covering instrumentals, washer disinfectors, and related devices. Additionally, experienced staff were chosen for an advanced "train the trainer" program conducted by the Da Vinci Xi System company’s training team.
The second phase involved consolidating the training materials into a “Da Vinci Reprocessing Training Handbook,” which encompassed in-house standard procedures, online training video QR codes which allow learning without boundaries, internal audit guidelines and reference materials.
During the third phase, the mentorship program was launched. This involved one-on-one skill-focused training provided by a trainer to a trainee, with no less than 5 practical sessions in handling soiled instruments and 2 practical sessions in inspection, assembly, and packing. An internal audit was performed at the end of the mentorship program to ensure trainees' competency met established standards, and periodic reviews were deemed necessary.
In addition,training videos were broadcasted and reprocessing procedure posters were posted in department in creating the learning culture. By providing visual resources, colleagues could easily access and understand the information.
Result & Outcome :
The Robotic Instrument Training Program was commenced in November 2022. By December 2023, 80% of POH SSD staff demonstrated competence in reprocessing robotic instruments. The adequate credentialed workforces contributed to a reduced turnaround time, with the average time decreasing from 50 hours to 20 hours, and the fast track time was achieved within 6 hours.
During the initial stages, only 2 episodes of non-conformity were encountered out of over a hundred reprocessing episodes. For continuous quality improvement, the specialists of Da Vinci Xi system were sought, resulting in improvements in instrument configuration and lubrication techniques.
Post-disinfection ATP and protein testing consistently yielded insignificant results, which fully complying with international standards. This indicated the dedication of SSD colleagues in maintaining the designated workflow and high quality reprocessed instruments.
Feedback from the Operation Theatre’s counterpart was positive, emphasizing the smooth workflow, reasonable turnaround time, and the quality of reprocessed instruments. Similarly, SSD staff have provided supportive feedback, expressing that the training program effectively equipped them with the relevant knowledge and skills.
