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Ronald Wassenburg
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At the end of this presentation you should be able to: - explore how manual pre-cleaning procedures developed over the years - recognize responsibilities regarding manual pre-cleaning - debate future developments in manual pre-cleaning
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INTRODUCTION
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1. Air channel
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1. Air channel 2. Water channel 3. Biopsy channel 4. Suction channel 5. Water jet channel
Channels interfering each other Difficult accessible nozzles Different channel diameters Different soiling levels
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EVOLUTION
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2. Leakage test
3. Manual pre-cleaning
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4. Cleaning
preferred
5. Disinfection
preferred
6. Rinses
preferred
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1990
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NATIONAL GUIDELINES Like the SFERD PROFESSIONAL STANDARD HANDBOOK http://www.infectiepreventieopleidingen.nl/do wnloads/SFERD_handbook_2011.pdf
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Responsibilities!
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!!!
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After the procedure the endoscope is transported in a special transport tray to the central endoscope reprocessing department and with the usage of a pass through door placed into the reprocessing area.
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State-of-the-art pre-cleaning: the basin can be filled handsfree and the detergent is dosed automatically. Of course after the manual leakage test is performed.
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Using ISO 15883 compliant (pass through) systems for automatic endoscope reprocessing. The reprocessing room is separated by the machines into a contaminated and clean area.
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The processes in the endoscope washer disinfector can be remotely monitored with traceability and registration software.
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The pass through principle: after the cycle in the pass through EWD is finished successfully, the endoscope can be unloaded on the other side of the machine (clean area).
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On the clean side the hospital applied a strict hygienic regime, to ensure that once the endoscope has its reprocessed and disinfected status, it will keep it!
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After unloading from the EWD, the endoscope is placed for drying in one of the drying cabinets.
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or the endoscopes is directly needed within another procedure and with the use of the transport system through anothor pass through door safely transported to the treatment rooms.
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CONCLUSION
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Pre-cleaning, manual cleaning procedures for flexible endoscopes: more and more automated.
Critical factors success: - Perfect controlled endoscope logistics - Implementing quality assurance systems
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Ronald Wassenburg
Managing Director of Wassenburg Medical Devices B.V., The Netherlands Representative of the Dutch normalization committee, in the ISO TC198 working group 13 Active member of the Dutch Sterilisation and Sterility (NEN) normalization committee
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NEN-EN-ISO 15883-1 (en): Washer-disinfectors - Part 1: General requirements, terms and definitions and tests (ISO 15883-1:2006,IDT) (EUROPEAN COMMITTEE FOR STANDARDIZATION) NEN-EN-ISO 15883-4 (en): Washer-disinfectors - Part 4: Requirements and tests for washer-disinfectors employing chemical disinfection for thermolabile endoscopes (ISO 15883-4:2008,IDT) (EUROPEAN COMMITTEE FOR STANDARDIZATION) Technical Specification ISO/TS 15883-5 : Washer-disinfectors Part 5: Test soils and methods for demonstrating cleaning efficacy (EUROPEAN COMMITTEE FOR STANDARDIZATION) Health Technical Memorandum 2030: Washer-disinfectors, Design considerations (London: The Stationery Office) Health Technical Memorandum 2030: Washer-disinfectors, Operational management (London: The Stationery Office) Health Technical Memorandum 2030: Washer-disinfectors, Validation and verification (London: The Stationery Office) PROFESSIONAL STANDARD HANDBOOK FLEXIBELE ENDOSCOPES - Cleaning and Disinfection: Dutch Advisory Board Cleaning and Disinfection Flexible Endoscopes (SFERD) Leitlinie zur Validierung maschineller Reinigungs- Desinfektions- prozesse zur Aufbereitung thermolabiler Endoskope (German working group under the supervision of: Schmidt V. (AKI), Beilenhoff U. (DEGEA), Jones A. (DGSV), Krger S. (DGKH)) Cleaning and disinfection endoscopes (Infection Prevention Working Party (WIP)) Proper Maintenance of Instruments - Red Brochure (Arbeitskreis Instrumenten-Aufbereitung [Instrument Preparation Working Group]) ISO (International Organization for Standardization) http://www.iso.org/iso/home.html FDA (U.S. Food and Drug Administration) http://www.fda.gov/ User manual of the endoscope
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