Three years after Joint Commission wrote about the issue, noncompliance with its standard regarding improperly sterilized or high-level disinfected (HLD) equipment is rising, according to the May 2017 issue of Quick Safety. Joint Commission requires that organizations reduce risk of infections associated with medical equipment, devices, and supplies. The most vulnerable locations for lapses in this area are ambulatory care sites and decentralized locations in hospitals, Joint Commission said. Along with loss of accreditation, consequences of noncompliance include placing patients at risk for contamination, risk of potential outbreaks, and exposure to litigation. In 2016, Joint Commission found that 74% of all immediate-threat-to-life declarations were due to sterilization and disinfection equipment breaches. In many cases, Joint Commission said, a long-standing underlying issue was not discovered until after an outbreak occurred. Institutional reasons for this issue include the "mistaken belief" that the risk of passing bloodborne pathogens is low; lack of training on proper sterilization techniques; and lack of leadership oversight. Joint Commission recommends training; asking manufacturers for usage instructions; using evidence-based guidelines for high-level disinfection and sterilizing; increasing quality monitoring; and ensuring that enough space is available to perform sterilization properly.

HRC Recommends: Failures in high-level disinfection and sterilization of medical devices are key concerns for healthcare organizations. For example, inadequate endoscope reprocessing appeared on recent ECRI Institute lists of the top 10 patient safety concerns and health technology hazards. Healthcare organizations should stay alert for additional information and resources that may help reduce the risks of device-associated infections.