Instrument Lubricant

[morgan0132]

We have lubricant residue on instruments after sterlization. What document can I use to prove the instruments are sterile.
Morgan

[Harvey Johnson]

I would look for the problem of residual lubricant rather than a sterilization verification.
AAMI ST79 7.5.6 addresses type and use of lubricant.
Check with the manufacturer as to compatability of the lube with your sterilization process as well as the correct use dilution formula, then have your dispenser checked for correct flow rate.

[morgan0132]

I contacted my Bio-Med people and they are going to verify my flow rate. We also use PREMIX-SLIP by Ruhof. I have contacted them and they provided documentation that thier product has been tested nad sterility occurs after use. However it is a "mineral oil lubricant". I have checked MSDS and cannot determine if this is oil based, which according to the reference you gave me AAMI states to not used oil-based instrument lubricant????

[SERC]

There are two main types of lubricant medical parafin, or silicone based (milk). The parafin type has a lower dosage than does the silicone based. Also when checking dosage also verify the water level if used in your washer, if your water level is to low your dosage will be to high.

[morgan0132]

We are using the "milK" type. I am still meeting opposition from this nurse stating she does not feel confident the instrument is sterile if it the oily lubricant is visable, due to steam contact issues. I provided her with the test study from the manuf. of the lubrication and the AAMI standard. Do you know of Any other written examples I can provide? I have advised "if in doubt throw it out" all I can do is advise her that it is sterile....but it's not enough????

[SERC]

I have several questions. 1. Are you using the lubricate in your washer or soaking them? 2. Have you been able to determine if you water level and lubricate flow rate are correct? 3. Are you getting a brownish residue in your containers after sterilization? 4. Is the lubricate visable are being detected by touch? As for other publications we are held to AAMI standard for validation of our procedures. The is another web site by the instrument manufactures working group that may be of help, you can get to them via www.ctechmedical.com on the left side panel choose SERC Home then helpful links and instrumentation help, you will be at the site where you can check their forum or post a question for their response by instrument specilist.

[morgan0132]

We use the lubrication in washer and at assembly table if necessary. I have determined my water level and flow rate are correct. I had one problem, had hole in enzyme hose and it was replaced but lubricant was properly working. I am not getting a brownish residue after sterlization. The lubricant is visable and can be detected by touch on 4 different occasions in past 3 months. All were different instruments two of them require addidtional lubrication at assembly.

[cheapskate]

Try to contact company of washer for suggestions. Or the company of the chemical.

[morgan0132]

I have contacted the lubricant mfg. and provided me with a study verifying sterlization. The nurse questioned the study???

[Harvey Johnson]

Looks like you have expended quite a bit of efffort to relieve one nurse's concerns.
She is right, if instruments are processed correctly, there should not be an oily residue on them. (remember Duke Hospital and the elevator oil?)
With this happening 4 times in the last 3 months and is not a constant problem, beyond mechanical hiccups, it could be a procedure problem. Is someone over milking after the wash process?
Not seeing the situation first hand, I can't point fingers, I am just throwing out suggestions.
Keep looking, there has to be an explanation for the occasional residue.