STERILE SERVICES FACILITIES
“The proof of the pudding is in the eating. In the six months of the temporary facility being on site, the total number of breakdown callouts is just seven. In fact, we once had someone on site while Soby Joseph was on the phone, calling to report the problem.
“With the Trust using a night shift to meet demand, the unit has been operating 24/7. The latest received call to an issue was at 23.40. Our engineer was on site the next morning, handing the machine back at 7.05 am.”
Garth Rowbottom added: “Old-school thinking was applied to the wash cycle too. You can either wash quick or wash well. I told the hospital: ‘I can give you a shorter cycle time, but you may then have to reprocess items which fail’. I adjusted the dwell time, which reduced the amount of kit failing to reprocess. “We could have had a quicker throughput, but not guaranteed that they might not need to reprocess. Given the volume that was being thrown at the department, that would have added to the problem. The mantra is: wash it well, not quick.”
Garth Rowbottom explained: “What we have learnt is that what the Trust team thought couldn’t be done has been possible. In reality, anything can be achieved. You just need to know what you want.
“When you look at the alternatives they were facing, such as taking equipment off site, using a temporary facility is very cost-effective. Taking instruments off site for reprocessing can require the purchase of more instruments to cover for time delays in transportation and reprocessing. It can also lead to the break-up of an established decontamination team. You really don’t want to lose a team of trained decontamination technicians while you do a refurbishment.”
News of the success of the temporary facility at Bath has certainly caused a stir. “We had nine different sites come to have a look; equipment manufacturers too,” said Garth Rowbottom. “They were keen to look at how we had done it, and particularly to know what we charge.”
Reliable equipment
As a mark of their reliability, a number of Envirogen RO machines are already installed across the Bath hospital site, where they ensure the quality of the water supplied for key equipment. They were also chosen for the nearby temporary endoscopy unit, and for both areas of the newly centralised Sterile Services and Endoscope Reprocessing Unit. Two Portakabin buildings, built to SSD’s structural specifications, house the temporary sterile services facility. A 7.28 m2
Portakabin building, with a
reinforced floor, forms the plant room, housing a duplex EndoTherm Duo RO
124 Health Estate Journal October 2019
Soby Joseph, left, Sterile Services and Decontamination manager; David Lockyer, deputy Decontamination manager; Lee Williams, Technical Project manager; Beverley Parmenter, Quality manager - Decontamination, and Garth Rowbottom, junior service engineer, SSD.
system from UK manufacturer, Envirogen, to feed the washer-disinfectors. The EndoTherm Duo model houses two separate RO units within the same cabinet. Having two RO units gives 100% resilience, allowing for scheduled maintenance/service when required without the loss of purified water. The EndoTherm Duo has its own ring main feeding RO water to all three washer-disinfectors. It was also supplied with two duplex water softeners, one to feed the duplex EndoTherm Duo RO system, and one to feed the cold softened process water to the washer-disinfectors. Allan Wigglesworth, Healthcare market manager for Envirogen, said: “We have a long-standing relationship with Bath, and were very pleased that SSD chose our equipment for the scheme. It’s the first EndoTherm Duo duplex installation for a temporary instrument reprocessing facility, but yet again it’s delivered 100% reliability.”
The adjacent production unit is a 10 m by 35.80 m2
Portakabin building with a
reinforced floor and air-conditioning units. The receiving area has twin-bowl sinks for items which require manual washing. Instruments for processing are placed on 18 DIN trays, and loaded into one of the three compact, high-capacity Franke DEKO D32 Excel pass-through washer- disinfector-dryers, supplied by Dekomed. The DEKO D32 Excels are designed and constructed to exceed the standard performance and design requirements stated in ISO/DIS 15883-1 Washer- disinfectors - Parts 1 and 2: and IEC 61010- 2-45. They guarantee process results throughout, with a Class C independent, full process verification recording system. Water pressure for washing is via a high- powered circulation pump. Pipework and
the number of loading shelves fitted with rotating spray arms are calculated to have the maximum soil removal efficacy. Washing spray patterns delivered through five rotating spray arms are purpose- designed racks to guarantee contact with all surfaces and crevices of instruments with the most intricate design. The machines offer a wide selection of disinfection temperatures and cycle times to secure the microbial killing impact. The unit’s touchscreen technology displays a range of information throughout the cycle, together with service actions and routine checks. As is the case at Bath, cycles can be altered to meet almost any special requirement.
Once the cycle is complete, the pass- through machine is unloaded into the Class 8 cleanroom, where the instruments are checked and wrapped ready for despatch to the sterilisers.
Steve Townsend, projects manager at Dekomed, said: “We liaised closely with Garth and the SSD team throughout the installation, commission, and operation of the temporary reprocessing unit to ensure that the machines delivered a first-class service.”
With the new Centralised Sterile Services and Endoscope Reprocessing Department now operational, the temporary sterile services unit has been decommissioned. It delivered over six months of virtually faultless operation, which enabled the Trust to meet the increased demands placed upon it. Indeed, it was so successful that theatre teams hardly realised what was happening.
What initially looked like ‘mission impossible’ for Royal United Hospitals Bath NHS Foundation Trust proved to be ‘mission achievable’.
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