The adherence to guidelines for infection control regarding the use and decontamination of surgical and medical instruments and equipment is vital in reducing the possibility of transmission of infectious agents. In the absence of this, it could expose patients to cross-infections, healthcare professionals in danger of litigation, and practitioners at the risk of being referred to their professional regulators for disciplinary actions. This could result in professionals being taken off their registers and not being able to practice at a later date.
An audit of local practices conducted in some GP practices showed that many did not adhere to national guidelines for the decontamination process for minor or general instruments for surgery and other devices, such as the Disposable Vaginal Speculum in UK. This was due to the reuse of tools designed for one purpose only, as well as inadequate decontamination for reused instruments. Most of these infractions could be prevented by investing in more efficient reprocessing methods, for example, contracting out reprocessing or using disposable tools. Costs can be reduced by utilizing disposable instruments in a proper manner and, in this instance, vaginal speculation.
Review of Disposable Vaginal Speculum in UK:
In 2000, the vice director of the Surgical Material Testing Laboratory (SMTL) created a report on behalf of the world’s leading maker of disposable vaginal speculum in UK concerning the issue of disposable and vaginal speculations that are reusable (Phillips, 2000). Although many reports from companies could contain biases, this report focused on the problems associated with the lack of practices within GP practices. It also found that certain GP practices will need to invest a significant amount in training, testing, equipment, and maintenance to align with the guidelines for best practices. There was a suggestion that some doctors would be willing to bear the cost of buying only one-use specula to bring reprocessing by best practice guidelines.
Clark (2004) looked at the patterns of health care delivery in primary care. He analyzed the extent to which guidance like Controls Assurance in Infection Control and Decontamination of Medical Devices were recognized, understood, and implemented in four primary health trusts. The results revealed a need for more knowledge and practice. The researcher suggested that these could be indicative of practice in other PCTs.
Decontamination:
Decontamination is a process through which reusable medical devices can be made secure for continued use by reducing the risk of transmitting infectious agents. It is a process that involves disinfection, cleaning, and sterilization. However, research suggests that primary care doctors often need help properly cleaning their medical devices with the proper method, citing financial reasons behind this oversight. According to MHRA (2000), Reprocessing medical devices that are only used once, typically due to economic considerations, is standard practice even though it poses a risk of infection to patients. However, Phillips (2000) found that a few GPs were willing to set aside costs to benefit the overall good in adhering to safe and secure practices and proved that purchasing disposable vaginal speculum in UK for single use is more cost-effective than reprocessing the reusable versions.
Benchtop steam sterilisers:
The healthcare system in the last decade has shifted from a hospital-centric approach to a more community-based system. It has led to the availability of GPs with a broader variety of services (Health Service Guidance 1993), including cervical cytology and minor surgical procedures.
To provide the services required, the increasing number of GPs require benchtop steam sterilizers (BTSS) to remove contamination from equipment. Fuller (1992) investigated the sterilization procedures within GP practices and outlined the best practices for reprocessing medical devices. This included periodic servicing, regular checks, and meticulous documentation. However, the study revealed that only one-third of surgeries complied with the most effective practices.
Single-use devices:
The MHRA (2000) insists that devices intended for one-time use should not be used again under any circumstance. The devices are not made to be reprocessed because this could cause various issues, including changes in substance and material and mechanical malfunction. There is also the possibility that processing them will not remove the contaminants properly. All of these factors can increase the risk of cross-infection. However, a lack of knowledge of the implications of reusing instruments designed for single use only results in many devices being reused and reprocessed, even though there are explicit labels on the packaging and, sometimes, on the instruments themselves.
Local audit
An audit conducted in local practices found unsafe infection control procedures and decontamination protocols. Sure, doctors appeared, inadvertently performing dangerous decontamination procedures and not following the current guidelines for national practice.
Many GPs are independent suppliers of healthcare. This could be problematic because they are not under direct supervision from the NHS and thus are not as easily controlled as NHS services. However, GPs and their practice nurses are held accountable professionally and must continually improve the quality of their services (Gillam & Bradley, 2001). Suppose they want to conform to the guidelines on infection control and guidelines. In that case, it is prudent for practices to look into using vaginal specula for single use, especially when considering the cost of using BTSSs safely and efficiently. Salford PCT, therefore, recommended that GPs, sexual health services, and nurses in practice make the standard purchase of a single-use disposable vaginal speculum in UK.
