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INSTRUMENT DECONTAMINATION


Selecting the right water treatment solution


An integral part of any hospital disinfection system is having a reliable source of purified water in line with the relevant Health Technical Memoranda (HTMs). Here, Kalpesh Shah, head of Sales – Process Water, at Veolia Water Technologies UK (VWT UK), looks at the guidance within the HTMs, and provides an overview of the crucial practical issues to consider when it comes to implementation on site.


Disinfection systems are crucial to the running of hospitals and healthcare facilities in order for them to maintain an adequate level of infection control. As such, the installation and maintenance of a reliable and consistent source of purified water to these disinfection systems is key. The Health Technical Memoranda (HTMs) provide detailed guidance on a variety of areas relating to the design, installation, and operation of hospitals and healthcare facilities. The HTM portfolio includes documents discussing the design and required standards for the


decontamination of surgical instruments (HTM 01-01), and the management and decontamination of flexible endoscopes (HTM 01-06).


In the majority of healthcare facilities, endoscopes and other instruments that cannot be thermally sterilised at temperatures above 60 °C are chemically disinfected and rinsed in purified water. In most cases this is done through the use


of automated endoscope reprocessors (AERs) or washer-disinfectors (WDs) for sterile surfaces. The HTM guidance, along with ISO 15883, specify the general performance requirements for AERs and WDs, and the minimum water quality that should be supplied to them.


Strict guidelines on final rinse water quality


For final rinse water quality in particular, HTM 01-06 and HTM 01-01 provide strict guidelines on the appearance, acidity (pH), electrical conductivity, hardness, and total viable count (TVC) of microorganisms in a sample. With regard to final rinse water used for disinfecting endoscopes, HTM 01-06 also specifies a maximum total organic carbon (TOC) level, while HTM 01-01 specifies maximum chloride, iron, lead, phosphate, and silicate levels in the final rinse water used for washer-disinfectors.


With a wide range of specifications,


The Thermapure range of compact, heat- sanitisable reverse osmosis (RO) systems ‘provides cost-effective water treatment to the latest decontamination guidelines’.


selecting the right water treatment solution to supply healthcare disinfection systems is crucial, and there are a range of factors to consider to ensure that the specification is correct. At present, in most cases the solution selected will be a reverse osmosis (RO) system, as such systems harness one of the most cost- effective water purification technologies currently on the market. RO systems use a semi-permeable membrane to separate and remove 99% or more of the dissolved solids, particles, colloids, organics, bacteria, and pyrogens, from a water supply. The feedwater enters the membrane under pressure, and the water molecules pass through, while the contaminants are captured and discharged. One of the main benefits of RO systems is that that they do not require the addition of hazardous or expensive chemicals that could add additional particulates to a water supply. Furthermore, as the only ongoing expense is electricity, the cost to run an RO system and produce the required water is low.


Disinfection systems, and a reliable and consistent source of purified water, are crucial to the running of hospitals and healthcare facilities, in order for them to maintain an adequate level of infection control.


50 Health Estate Journal February 2021


Establishing the requirements Once a type of water purification system has been selected, the next step is to establish the requirements for the system to make sure that an optimum level of purified water is always available to suit


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