WHO is assessing infection safety levels in hospitals in Ukraine and supplying them with new equipment and information materials, as well as training hospital personnel. Throughout the pandemic infection safety has been at the top of the agenda during all stages of equipment reprocessing, which involves the disinfection, cleaning, remanufacturing, testing, packaging, labelling, and sterilization of reusable medical devices. Surgical site infections are the most prevalent type of health-care-associated infections (HAIs) in Ukraine, with an estimated 156 000 cases every year. These infections impact treatment outcomes and prolong a patient’s stay in hospital. According to a survey carried out by WHO and the Public Health Centre of the Ministry of Health of Ukraine, improving the reprocessing of medical devices is one of the key priority measures to prevent surgical site infections and other types of HAIs.
In line with the WHO and EU initiative on health system development in Ukraine, Dr Jarno Habicht, WHO Representative in Ukraine, emphasizes that such steps are vital for increasing the level of infection control on the ground. “We need to ensure that clean devices are used when providing medical care, and WHO is glad to see readiness for change in the local hospitals,” he notes.
Serving those in hospital and beyond
Olena Shymulo has been working at the Odessa public hospital since 1983, heading the Central Sterilization Department (CSD). The hospital was the first in the southern region of Ukraine to be ranked as a Clean Hospital when it was reconstructed and fitted out with modern equipment over ten years ago. Now, however, it requires a major overhaul.
“During the last ten years we haven’t expanded, but shrunk,” Dr Shymulo points out. “Our equipment wore out so I am glad that, with the assistance of WHO, we will be re-equipped.” She believes that creating a CSD in every Ukrainian hospital is the only way to improve infection prevention and control standards. “A CSD is at the heart of every hospital. If our potential is fully realized, we will be able to serve the whole city and beyond,” she assures.
However, not every hospital has a CSD. In the Mykolaiv Regional Hospital, for example, reprocessing takes place in each department individually. Dmytro Bachynskyi, who is a surgeon at the hospital, understands the importance of reprocessing. “If it was centralized here, it would be much easier to monitor the process and ensure the highest standards,” he notes.
Teaching the reprocessing cycle
According to Dr Shymulo, another major issue is the lack of professional preparation among nurses in charge of reprocessing. A majority of CSD personnel are assistant nurses and their level of knowledge about the reprocessing cycle is often very low. “Reprocessing is far more than just cleaning,” Dr Shymulo points out, adding, “One should be trained in a medical college to become a CSD professional, to ensure that patients receive quality care”.
In other European countries reprocessing is done by sterilization technicians, but there is no such profession in Ukraine. “In these circumstances, the solution could be to teach reprocessing from scratch,” says Gennadiy Sergeyev, Head of the Ukrainian Association for Sterilization and Disinfection. To meet this demand for knowledge, WHO has conducted a series of webinars and training sessions for hospital personnel across the country, organized a reprocessing school and translated all relevant WHO recommendations into Ukrainian.
This story has been developed with the financial assistance from the European Union as part of the EU and WHO initiative on health system development in Ukraine.