Supplyline Online Magazine June 2023

Editor’s Message

June 2023

Hello, and welcome to the June Edition of Supplyline. In this edition we continue with the regular updates relating to Industry Standards, Sterilising Technology Course Sponsorships and this year’s NZSSA Annual Conference. Registration to the NZSSA Conference is now open, check the flyer in this edition for further information or on the NZSSA website.

So far this year our involvement with Manatū Hauora / Ministry of Health has been a very busy one. I’ve had the pleasure of attending a meeting on behalf of the NZSSA relating to self-regulation and a workshop on Career Frameworks for Allied Health, Scientific and Technical staff. Both were informative and it will be interesting to work through the process to achieve both.

In this edition of Supplyline, there is an article from Pharmac outlining their role in managing reusable medical devices here in NZ. The NZSSA Executive Body has met with Pharmac this year to begin the conversation around what part the NZSSA can play in the introduction of new RMDs into the NZ market.

Thank you to Whiteleys for providing an article on Cathy Rackley who retires after 47 years working in the Sterilising Unit at Dunedin Hospital. I have known Cathy for many of those years and I wish her all the best for her retirement. I thank Cathy for all her efforts and hardwork as an executive member of the NZSSA. Cathy, you will be missed.

Take care everyone and stay safe,

Ngā mihi

Aileen Derby Editor NZSSA Supplyline

MANAAKITANGA - Respect

We

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.

care for each other, showing kindness and empathy in all that we do.

President’s Message

Hello to all our sterile Technicians

Welcome to our mid-year edition of “The Supplyline”

Who would believe we are in the middle of June already.

I have just returned from my first visit home to Scotland in 6 years. It was so nice to tour around my home country and visit with family and friends. It is summer in Scotland and I actually managed to get myself sunburnt, who would have thought it. Now it is back to work and reality and the holiday already feels like it was a lifetime away. Have added a couple of photos for you.

Planning for our conference at Te Papa in September is well ahead and the programme will be out soon. This is an important conference. We have as our keynote speaker Dr Martin Chadwick our professions Chief Allied Professions Officer from the Ministry of Health. If you are having difficulty in getting approval to attend conference, please remind your CSSD manager and your Director of Allied Health at work who is the keynote speaker.

Recently the NZSSA have had a few meetings with Ministry of Health. The first was regarding Sterile Technicians being added to the Green list of employees who can be fast tracked into the country to work. It is important to understand that this can only occur if the person is a qualified technician and that there qualifications are assessed as being equal to those of a NZ training qualified technician. There are specific criteria that are required to be met and these were developed by the NZSSA in conjunction with the Ministry of Health and now sit with Immigration NZ. This is a process that was undertaken by several professions. Details of the requirements are available on the NZSSA website.

Our second meeting with the Ministry of Health was attended in my absence by members of our executive committee. It was advised that as a profession we complete the work required to become a self-regulated profession. The MOH believes we are well advanced in this and that is why we were able to persuade MBIE and Immigration NZ to add our profession to the green list. This will be our focus going forward.

I have to admit to being remiss. I have several qualification badges to send out to members, however work commitments have prevented me from doing so. It is my intention to do this over the next few weeks. It will of course cost me as I am enrolling my granddaughter an impoverished University student to assist me in the process. As always I am happy to receive correspondence from our members about what they are doing and have achieved or just for general enquiries and or just to let off steam.See you all at Conference 2023.

Shelagh Thomas President NZSSA

Brought Ferry

Isle of Harris-outer Hebrides

Outlander stones - Tursachan Chalanais Seann Larach De Chumhachd Calanais standing stones. An ancient centre of power.

Portree, Isle of Skye

North of Ullapool

Cathy Rackley - Recognising 47 years of dedication and commitment to NZ Sterilising

In June 2023, Cathy Rackley is retiring after a remarkable achievement of 47 years of work and contributions to NZ Sterilising.

Cathy commenced work at the Dunedin Public Hospital in 1976, her career ending as the unit manager of Sterile Services Te Whatu Ora Southern. Cathy was a member of the executive of New Zealand Sterile Services Association for 21 years where she served as Secretary for 12 years. Working with the New Zealand Sterile Services Association for 21 years Cathy added “I was privileged to work with a group of passionate and dedicated colleagues.”

Cathy is most proud of combining CSSD and TSSU into one service, integrating staff and practices into one team, and credits the staff at Southern District Health with their willingness to embrace change and teamwork. Looking back on her career Cathy acknowledges how the industry has evolved “Technology advancements in the equipment we use to process medical devices, instrument design has become more complex, compliance requirements and educational resources have increased dramatically resulting in positive changes to the industry and further development of the qualification for SSU technicians have benefited the industry significantly.”

On reflection of Cathy’s 47 years in CSSD, Cathy highlighted:

• Always have back up plans for every situation,

• Working in Sterile Services is not just a ‘job’ it is a healthcare profession,

• ‘We’ are part of a multi-profession team providing healthcare to patients,

• There is no I in team, we all work together for a shared outcome,

• Your workday is fluid, it can change from one minute to the next.

On behalf of the hundreds of thousands of patients that have benefitted from Cathy’s dedication, from all her friends and colleagues and from all of the team at Whiteley, we thank Cathy for her hard work and dedication to Healthcare.

Cathy is recognised for her leadership, adaptable nature, wry smile and passion for teamwork. We wish Cathy every happiness for the future; we hope retirement involves less email and more time to enjoy life outside of Sterilising!!

A wonderful career that should be celebrated!!

It is time to have your say! The second public comment period is open for Draft AS 5369

other devices in health and non-health related facilities

Comment Start Date: 29/05/23

Comment End Date: 10/07/23

You can view the draft with latest comments and provide your feedback here: https://comment.standards.org.au/Drafts/69fd77f8-6ef8-4ed58d27-9952f07c5403

Note: Only comments relating to sections presented within boxes will be addressed by the HE -023 committee.

47th New Zealand Sterile Sciences

Association Annual Conference.

6th – 8th September 2023

To be held at Te Papa, Wellington.

Theme: Changing Landscape

Registration and welcome function: Te Papa

Dinner: The Public Trust Hall

Dinner Theme: Movie night, come as your favourite movie character

For more information go to the NZSSA registration portal

DON’T DELAY, REGISTER NOW!

Hospital medical devices and Te Pātaka

Whaioranga – Pharmac

Megan Nagel

Medical Devices Strategy and Development Engagement Lead Pharmac

Members from the Sterile Sciences executive and staff from Pharmac’s devices team have been meeting recently. Pharmac have pulled together some information about their role in the health and disability system. As well as an update on their hospital medical devices work programme and what this means for staff working in sterile services.

Te Pātaka Whaioranga – Pharmac’s role in the health system

We are a crown entity that was created in 1993, in response to rising prices of medicines through the 1980s.

Our job is to get the best health outcomes from pharmaceuticals (defined by Pae Ora, as “a medicine, therapeutic medical devices, or related products”) for New Zealanders, while staying within the fixed budget set out by the government.

We do not approve pharmaceuticals – that is Medsafe’s role to make sure pharmaceuticals are safe and work as they’re supposed to.

Our Board is accountable to the Minister of Health, who on behalf of the Crown, is accountable to Parliament for our performance.

Manatū Hauora – the Ministry of Health monitors how we are performing on the Minister’s behalf.

Each year the Minister outlines their priorities for Te Pātaka Whaioranga – Pharmac in a Letter of Expectation and we agree on our annual Statement of Performance Expectations. We also report to the Minister quarterly on actions and changes that we need to make, and we table an annual report in Parliament each year.

Managing the pharmaceutical budget

The Pae Ora (Healthy Futures) Act 2022 says Pharmac must decide which pharmaceuticals to fund for the best health outcomes for New Zealanders, while staying within our budget.

In 2022/23, we managed $2.4 billion in spending on pharmaceuticals.

We currently fund approximately 1,000 different pharmaceuticals (in over 2,000 different forms). These are the pharmaceuticals available in hospitals and from your local pharmacies.

Our budget has increased over time to enable us to fund new pharmaceuticals, widen access to pharmaceuticals already funded, and meet other costs related to inflation and population growth.

Our decisions are informed by evidence, internationally recognised assessment methods, and expert advice. We also use commercial tools (such as competitive procurement) to get as much value from the budget as possible so that we can fund more pharmaceuticals for more New Zealanders.

This graph shows our impact on New Zealand’s spending over the past decade, using 2012 prices as a baseline.

The gap between estimated expenditure (dotted line) and actual expenditure (solid line) highlights the $2.4 billion the health and disability system would have had to spend on treatments this year without Pharmac’s pharmaceutical management.

Our role in hospital medical devices

Our work in hospital medical devices covers a broad range of medical devices. These devices could be:

• used in a public health setting or part of a clinically driven pathway,

• used to diagnose, monitor, treat, modify, prevent, or support health requirements,

• used to maintain or improve health and/or safety for all people in the context of the NZ healthcare environment,

• part of an integrated system that supports the clinical environment.

This includes a vast range of products from tongue depressors and bandages to implantable devices (such as pacemakers), diagnostic software, and robotic surgery machines, through to rehabilitation equipment and continence support products. With the health and disability sector reforms, Pharmac is working closely with Te Whatu Ora as we continue to build a comprehensive national list of medical devices that are used in Te Whatu Ora hospitals and their community services.

We are building this list by negotiating national contracts. Currently our medical device contracts cover over $530 million of Te Whatu Ora’s annual expenditure on medical devices.

As of May 2023, about 75% of medical devices (~163,000 items) have been contracted and available for Te Whatu Ora to use, saving the health and disability system over $100 million since the work began.

This graph shows our impact on medical devices spending and savings over the past decade. The total annual expenditure under agreement (solid line) shows how much has been spent on devices we have under contract each year. The dotted line shows the estimated savings that have accumulated through Pharmac’s national contracting.

Sterilisation and Decontamination Equipment and Associated Consumables (SDEAC)

Sterilisation and decontamination equipment and associated consumables are included within the scope of this work includes and covers the following products:

Decontamination and sanitation equipment

• Dirty utility sanitisers/macerators

• Medical device washers and disinfectors

Sterilisation equipment

• Low temperature sterilisers

• High temperature sterilisers

• UV light sterilisers

• Pre/post-sterilisation dryers

• Post-sterilisation storage cabinets

Trolleys for sterilisers/washers etc

• Containers for use in sterilisers/washers

• Trays

• Crates

• Baskets

• Tamper proof locks

Process tests/indicators, including but not limited to:

• Indicator tapes

• Air removal and steam penetration tests e.g. Bowie Dick

• Single parameter tests

• Multi-parameter tests

• Critical parameter/Cycle specific indicators

• Process challenge devices

• Artificial test soil products (when testing equipment such as cleaners/disinfectors and sterilisers)

Packaging

• Sterilisation wraps

• Sterilisation pouches/rolls

• Multipurpose towels/tray liners used in association with clinical decontamination and sterilisation processes

The products that have been contracted so far are on the hospital medical devices list which is published in Part III of Section H of the Pharmaceutical Schedule. This is available on our website (pharmac.govt.nz/devices-list).

The future of Hospital Medical Devices

To date, our focus has been on building a comprehensive national list of devices that are used in public hospitals through negotiating national contracts to build a strong foundation for strategic management of hospital medical devices.

The next step is to implement an integrated approach to hospital medical devices with our sector partners, which drives better value and more consistent and equitable access.

We continue to collaborate with Te Whatu Ora on this to ensure that our devices work is aligned and is supporting the broader organisations goals.

We expect that by 2024 this comprehensive list of devices will be finalised, and:

• Te Whatu Ora hospitals will purchase devices only from the national medical devices list,

• Pharmac will use new assessment and decision-making systems and processes to add new devices to the list.

There will be a new process to request changes to the list which will include adding new technologies, upgrading existing technologies, and delisting devices.

We will need feedback from a range of people to make sure we understand the clinical, technical, and operational requirements for a device. We will also need feedback from consumers and others who bring other important perspectives including Māori, Pacific and disabled people to inform decision-making.

The work we’re doing will mean that people, regardless of where they live, will have the same access to medical devices. Hospital staff will all be buying devices from the same list, with the same pricing and terms for supply.

We are supporting Te Whatu Ora to manage New Zealand’s increasing spending on medical devices sustainably and transparently. And by doing so, we will free up funding in hospitals for reinvestment in services and new technologies that will benefit more people.

We are also taking a longer-term view and aligning how we manage devices with the wider goals of the health and disability system.

To find out more

For more information go to www.pharmac.govt.nz/devices. If you have any questions, please email us at enquiry@ pharmac.govt.nz or keep up to date with our progress by signing up online to receive our bi-monthly newsletter Device Advice (www.pharmac.govt.nz/device-advice).

We look forward to continuing getting input from the Sterile Sciences Association and providing ongoing updates as our work continues.

Belimed WD 750

The Belimed WD 750 is a large scale washer disinfector, setting new standards in safety, quality and economic efficiency.

Key features include:

ƒ EN ISO 15883-1 and EN ISO 15883-2 compliant (complete automatic drainage of piping, pump, tank, valves and fittings; all surfaces coming into contact with the product are inclined).

ƒ Most compact large-scale washer disinfector in its class. Easy-to-service, integrated equipment and service compartment offering space for accommodating media connections and detergent containers.

ƒ Glass horizontal sliding doors and cabin illumination provides clear visual control of the washing process, as well as the patented process status display and double-door push-through model with interlocking doors for separating contaminated/clean area.

ƒ Available in three chamber size options, pre-heating and storage tanks for water reuse and faster cycle times.

PLEASE SPEAK TO YOUR HEALTHCARE MANAGER FOR FURTHER INFORMATION

ECOLAB HEALTHCARE ANZ

7A Pacific Rise, Mount Wellington, Auckland 1060, New Zealand

NZ: 0800 425 529 www.healthcare-nz.ecolab.com

Toi Ohomai Institute of Technology Ltd NZ Certificate in Sterilising Technology (Level 4)

June Alegres

Colleen Archer

Dorothy Armer

Louise Auckram

Sharon Babu Thomas

Damian Balle

Louise Banadera

Jan Bevan

Marebe Capa

Ivan De Guzman

Melanie Dixon

Justine Enriquez

Diane Marie Farr

Joshua Fenn

Sam Fletcher

Kadee Gardiner

Melissa Hounsell

Maike Janisch

John Jeruta

Vinu Johnson

Jijo Joy

Upashna Kamal

Sunkyung Kim

Kathy King

Natalie Manley

Marian Mansing

Briar McClelland

Jacob Pallithottathil Oommen

Jayesh Patel

Karol Prater

Ula Rademeyer

Samantha Spooner

Casey Te Rauna

Melania Vargas

Ngatamaine Wainiqolo

Andrea Wells

Richard Williams

Rachel Leilani Williamson

Lindsay from Multigate did a presentation on Surgical Flow Online education Modules. This required all attendees to participate in answering questions which everyone got involved in.

Kevin from Obex spoke about how important our roles are within the theatre, and showed us a rigid container and how by using these can benefit the department by saving time and money in regards to wet packs and of course if using wrap then holes in wraps.

Lucas from J & J Depuy Synthes showed a presentation around the Velys robotic and navigation instruments. This system is currently used for Total Knee surgery.

We had three workshops as unfortunately Stryker needed to pull out on the day due to illness. We split the attendees into groups which worked well for a while then we seemed to get a bit confused as the workshops went on, we did learn a lesson from this for the next education day.

Lucas did a hands on presentation how they use the Velys Robotic system along with the Attune instruments and we were able to see exactly how this is used and dismantled.

Kevin held a workshop on the hipot, with a reminder that we must always use the blue wrist strap unless you want a shock. He also explained what damage we should be looking out for on the insulated items. Kevin also spoke about rigid containers which was interesting for those of us that don’t have these in our hospitals

Dave also from Obex spoke about Ronguers and showed us a new system. This was very interesting. Apparently you can now buy just the tips which are replaced when they are blunt. This saves the hospital money and also these are easier to clean as they are dismantled in the decontam area before placing in the batch washers.

At the end of the day we did some feedback asking what the attendees would like to have in the next education day. This was interesting and some of the feedback received was around manual cleaning, infection control and Flexi scope content. This has given us an idea on what technicians are needing to ensure that they are processing equipment correctly and we are all going in the same direction.

The day concluded for some with a tour of the department at Waikato which they found very interesting.

On the 1st of April we held our regional education morning at Te Whatu Ora Waikato. We had around 5560 attendees from Auckland Hospital, Counties Manukau, Grace Hospital, Tauranga Hospital, SX Rotorua, Greenlane, Thames, Waikato and also Auckland Eye surgery.

2023 HSPA Conference Recap

In May of 2023, I was able to attend the Healthcare Sterile Processing Association (HSPA) conference in Nashville, Tennessee. The HSPA is one of the largest certifying bodies for sterile processing technicians in the United States and offers four different certifications. I was lucky enough to be one of eleven recipients of HSPA’s conference scholarships to attend the conference and one of only two international recipients, the other being from Canada. Attending a large international conference was a fantastic opportunity to jump on the front line of new education and developments within the industry. The chance to network with people from all over the world and be able to bring those connections and things that I learned home to Aotearoa was amazing. There were 1200 attendees and ten different countries represented, including Brazil! The conference took place over four days with an array of hands-on labs Saturday afternoon and a wide variety of speaker sessions from Sunday to Wednesday. There were also trivia games in the evenings as well as a social on Sunday night and a full day to explore the large expo hall.

I currently work as a sterile processing technician at the University of Otago’s Faculty of Dentistry and I have been in the field on and off for the last ten years. In my time as a sterile processing technician, I have worked at a Magnetdesignated hospital, an ophthalmology clinic, and now large-scale dentistry. One of the things I was most looking forward to in attending such a large conference was the ability to network with people who work in similar teaching clinics, whether in hospitals or dental care.

I’m very interested in learning how staff in other sterile processing departments manage the unique challenges we face as teaching facilities. To this end, I attended a very interesting session by Jill Holdsworth, the Infection Prevention Manager at Emory Hospital Midtown a teaching hospital in Atlanta, Georgia. Her discussion, “Sterile Processing Beyond the Operating Room” was about the leaders of the Infection Prevention and Sterile Processing teams working together to create a continuum of care across all care settings. I found this particularly helpful as she really drove the point home about interdisciplinary cooperation and how we as a sterile processing unit bear responsibility to reach out and get to know the teams we work with (as do they!) whether that is OR staff or dental students and assistants. She discussed how they worked out interdisciplinary education sessions for OR/Clinic and SPD staff on the MIFUs for instruments that they were both handling, especially in cases for things like endoscopes which have quite specific MIFUs for point-of-use cleaning. From this I was able to start building ideas for things we could look at implementing within our own department, and how we could start looking into educational outreach.

This year, HSPA introduced a mentorship programme to the conference for the very first time. First-time attendees were able to sign up to be paired with a mentor who had attended before and who would be available to help them network as well as discuss their conference and career goals and recommend which sessions would be most beneficial for them to attend. I was paired with

Casey Czarnowski, a Sterile Processing Consultant from Minnesota. Casey is on the Board of Directors of the Minnesota HSPA chapter and also writes the educator’s update column in HSPA’s Process Magazine. Being a part of the mentorship program was such a benefit to the conference. Casey was able to introduce me to people who could answer my questions, point me in the right direction for which sessions would help me the most, and gave me a built-in conference buddy. I feel very lucky to have experienced my first conference this way.

Many of the sessions at the conference were about the reprocessing of flexible endoscopes as the standards in America (ANSI/AAMI as well as AORN guidelines) have just been updated. While the reprocessing of flexible endoscopes isn’t currently relevant under my purview, I still found that there was good information and advice I could take away about best practices in decontamination areas and handover communication with clinic staff. One of my favourite sessions was from Cori Ofstead, the President and CEO of Ofstead & Associates, Inc. in conjunction with Frank Daniels and Marie Brewer the Director of High-Level Disinfection and Sterilisation at VCU Health and the Regional Manager of Sterile Processing at Unity Point Health respectively. They presented a series of studies they did on splashes in decontam generated by manual cleaning and how the studies led them to adjust

References

their environments and practices, as well as run follow-up assessments on PPE.

Overall I’m very glad I attended the conference. I was worried I would feel out of place having shifted in recent years from hospital-based sterilising to dentistry, but what I found was the ability to create a niche for myself in the information even when it wasn’t one-to-one relevant to my current practice. From this experience, I have been able to bring home evidence-based practice to help back points that our SPD has been trying to make and ideas on how to action them. I also made friends and connections with people working in sterile processing departments all across America who I continue to share ideas with as we look forward to creating the future of our profession.

Ofstead CL, Hopkins KM, Daniels FE, Smart AG, Wetzler HP. Splash generation and droplet dispersal in a well-designed, centralized high-level disinfection unit. Am J Infect Control. 2022 Sep 15:S0196-6553(22)00629-0. doi: 10.1016/j. ajic.2022.08.016. Epub ahead of print. PMID: 36244924.

Ofstead CL, Hopkins KM, Smart AG, Brewer MK. Droplet dispersal in decontamination areas of instrument reprocessing suites. Am J Infect Control. 2022 Feb;50(2):126-132. doi: 10.1016/j.ajic.2021.10.023. Epub 2021 Dec 2. PMID: 34865859.

Noelani Grandona, CRSCT

NZSSA Executive 2021-2024

President: Shelagh Thomas

CSSD

Hutt Valley

Capital, Coast and Hutt Valley

Phone: 04 566 6999 ext 2745

Mobile: 027 589 6473

Email: shelagh.thomas@huttvalleydhb.org.nz

Maureen Scott

Sterile Services

Hamilton Waikato District Health Board

Email: Maureen.Scott@waikatodhb.health.nz

Karen McCormick

CSSD Manager

Wellington

Capital, Coast and Hutt Valley

Email: Karen.mccormick@ccdhb.org.nz

Sharon Moss

National Sterile Services Manager

Southern Cross Health

Christchurch

Email: sharon.moss@southerncrosshospitals.co.nz

Jenny Carston

CSSD Manager

Tauranga

Hauora a Toi Bay of Plenty

Email: Jenny.Carston@bopdhb.govt.nz

Treasurer: Alison Stewart

NZSSA Treasurer

28 Brighton Street

Island Bay

Wellington 6023

Mobile: 021 209 8127

Email: nzsterilescienceassoc@gmail.com

Secretary: Paul Moody

Senior Product Development Manager

Fisher & Paykel

Auckland

Email: paul.moody@fphcare.co.nz

Anthony Valvoi

Sterile Services

New Plymouth

Taranaki

Email: anthony.valvoi@tdhb.org.nz

Martin Bird

Sterile Services

Dunedin

Southern

Email: martin.bird@southerndhb.govt.nz

Aileen Derby

CSSD Manager

Manukau

Counties Manukau

Email: Aileen.Derby@middlemore.co.nz

Kelly Swale

Sterile Services Manager

Faculty of Dentistry, University of Otago

Dunedin

Email: kelly.swale@otago.ac.nz