During WFHSS 2026 (World Federation for Hospital Sterilisation Sciences), Antonio Scavelli delivered a presentation focused on a topic of growing importance in healthcare: the role of washer-disinfectors as a critical barrier for patient safety and infection prevention.
Entitled “Beyond Cleaning: Washer-Disinfectors as a Critical Barrier for Patient Safety and Infection Prevention”, the presentation offered a broader perspective on medical device reprocessing, emphasizing that cleaning and disinfection are much more than technical tasks performed within the Central Sterile Services Department (CSSD).
When discussing patient safety, attention is often directed toward surgeons, operating rooms, clinical protocols and sterilizers. However, as highlighted during the presentation, every surgical instrument must pass through a complex reprocessing pathway long before sterilization takes place.
Decontamination, cleaning, disinfection, inspection, packaging and sterilization are all essential steps within a single integrated system designed to ensure that medical devices can be safely reused.
According to this view, the final clinical outcome depends on the reliability of the entire reconditioning process, rather than on any single, isolated step.
The presentation referenced data from international organizations such as the WHO and ECDC, highlighting the ongoing burden of Surgical Site Infections (SSIs), which continue to rank among the most common healthcare-associated infections worldwide.
In some surgical specialties, infection rates remain significant, resulting in increased patient morbidity, extended hospital stays and higher healthcare costs.
Every improvement made within the reprocessing chain therefore contributes directly to reducing infection risks and improving patient safety.
One of the key themes of the presentation was the application of James Reason’s Swiss Cheese Model to healthcare reprocessing
According to this approach, safety is not achieved through a single perfect barrier but through multiple layers of protection working together:
Each barrier contains potential vulnerabilities. Risk increases when multiple weaknesses align, allowing adverse events to occur.
The underlying message is simple: infection prevention is the result of a coordinated system of defenses.
One of the strongest messages delivered during the presentation was that sterilization cannot compensate for inadequate cleaning.
Blood, tissue, proteins, organic residues and biofilm can shield microorganisms and compromise the effectiveness of subsequent processing stages.
For this reason, international guidelines and the EN ISO 15883 standard identify cleaning and disinfection as essential prerequisites for successful sterilization.
Removing contamination is therefore not simply an operational activity but a critical microbiological risk-control measure.
A particularly important concept discussed during the session was the evolving role of the washer-disinfector itself.
Traditionally viewed as equipment designed solely to clean instruments, it should now be considered a risk-management technology.
Among all reprocessing steps, automated cleaning and disinfection constitute the first barrier that is truly:
As a result, the washer-disinfector becomes the first stage in the reprocessing chain where performance can be objectively measured and verified.
Technology alone cannot guarantee safe outcomes.
Common challenges observed in CSSDs include:
As highlighted by several international studies, many failures are not caused by equipment malfunction but by the interaction between people, processes and systems.
Modern technologies must therefore be designed to support users through improved ergonomics, simplified operation, traceability and decision-support features.
Looking ahead, increasing instrument complexity, the rise of robotic surgery, workforce shortages and sustainability requirements are making CSSD operations more challenging than ever.
According to the model presented at WFHSS 2026, safety depends on the integration of three key elements:
Only when these three pillars work together can healthcare facilities build resilient systems capable of reducing risk and delivering consistent outcomes.
The concluding message of Antonio Scavelli’s presentation was that the role of the washer-disinfector is rapidly evolving.
Today, it is no longer simply about washing surgical instruments. It is about actively contributing to infection prevention, risk reduction, healthcare worker support and patient protection.
In this context, cleaning can no longer be regarded as merely a technical procedure.
Cleaning is a clinical intervention and one of the most important safety barriers between contamination and the patient.
