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Innovation


to manual wrapping of cleaned medical instruments.


In 2019, 20.2% of EU residents were 65 years or older. By 2100, the figure is expected to be 31.3%.8 A similar trend applies to the UK. Hospitals in Western countries are already struggling to find new employees for the CSSD.9


With an


ageing population, the professionally qualified population is shrinking and labour market tightness is expected to increase further. Increasing labour market tightness can lead to more employee attrition and a higher number of errors in the CSSD due to a higher workload. A shortage of CSSD staff may also ultimately lead to reduced hospital operating capacity. Robotic wrapping of medical instrument


trays provides an answer to these challenges. In 2018, R-Solution Medical, from the Netherlands, developed a wrapping robot for medical instrument trays. This robot - the R-APPIT - is in use at several Dutch hospitals, including the Jeroen Bosch Ziekenhuis and Radboud UMC. In 2023, the second generation of the robot was introduced at the World Sterilisation Congress (WFHSS 2023) in Brussels.


Method and functionalities of the R-APPIT The R-APPIT is placed in the clean room of the CSSD. This can be either a closed area or an open area where the workstations of CSSD employees are also located. The safety


of employees is thereby ensured using radar detection. When employees come close to the robot, the wrapping process is automatically stopped. After arriving in the clean room, the washed and disinfected instruments are checked and assembled by a CSSD employee. After this, the employee places the instruments in a tray. These trays are placed on a conveyor belt, which runs along the workstation and carries the instrument tray to the wrapping robot. The wrapping robot scans the barcode of the instrument tray. A vision system uses artificial intelligence to determine the optimal wrapping method and the amount of wrapping material needed. The robot is capable of wrapping instrument trays with a width between 120 and 320 mm, a length between 240 and 560 mm and a height between 50 and 150 mm. An optional weighing module determines the


weight of the instrument tray and whether a trayliner is required and/or heavier wrapping material is required to wrap an instrument tray. The robot then wraps the instrument tray using the OneStep or sequential method, as desired by the hospital or commercial CSSD. In the process, the path is validated by the robot and the instrument tray is labelled. The label ultimately links the instrument tray to the wrapping roll LOT number in use, making recalls possible. CSSDs can also choose to equip the robot with an optional control module. This optional module takes a picture of the instrument tray before wrapping. This makes it clear whether the instrument tray was completed at the CSSD and whether the instrument tray was wrapped correctly. The wrapped instrument trays are delivered


to the steriliser by means of a conveyor belt or an automated guided vehicle (AGV), after which the instrument trays are sterilised and stored. The robot has a management system that provides detailed insight into the number of wrapped trays per type, the amount of wrapping material used, non-conformities, missing instruments, and more.


Benefits of robotic wrapping Robotic wrapping of medical instrument trays offers several advantages for hospitals, CSSDs and CSSD staff. First, robotic wrapping provides cost savings for hospitals. On average, a CSSD employee can wrap about 28 instrument trays per hour. On an annual basis, this puts the production capacity of a full-time employee at about 33,500 instrument trays. At maximum deployment, the R-APPIT can


wrap up to 525,000 instrument trays per year. This gives the robot the same production capacity as more than 15 full-time employees. In


76 www.clinicalservicesjournal.com I April 2024


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