Decontamination
tracking system showing all the manual processes carried out across four sites – which totals around 2000. The CEDU’s track and trace system enabled the unit to look at the number of scopes they were having to reprocess because they had expired. The reason given was that procedures had been cancelled – closer investigation found this was because inpatients were being fed before the procedure, despite being Nil by Mouth. “We identified that we could make a £200,000 pound saving by addressing this,” Sharon Fox commented. “This is the benefit of having a tracking system and a dedicated team, so we can fully review what we are doing,” she continued. Sharon Fox went on to look at the decision- making for implementing innovations; reasons include patient safety, improving productivity, improving staff wellbeing and sustainability. She described some examples of retained contaminants within flexible endoscopy, which included the tip of a brush from the manual cleaning process falling out at the point of use, after the scope had been reprocessed, and an incident in which manual cleaning was not carried out for the duration required. “This is the reason why we need to look at
innovation and take it forward,” commented Sharon Fox. UHB wanted to automate the manual cleaning
process to drive improvement and in 2021, they first introduced the ‘Fizzer automated sink unit’ – now called the Khamsin. The solution was developed by Aston University Birmingham in Partnership with PFE, Innovate UK and Partnership Medical. A research paper was reviewed; then discussions followed with the DIPC, the Director of Corporate Nursing and the AED, and a trial was undertaken for a period of two weeks. The trial proved to be successful. It was decided that the units would be installed at Good Hope Hospital (GHH) in June 2023, as there were concerns that GHH was not compliant – there were no height adjustable sinks, and the environment was very small. There were staffing concerns and increased costs in transport and bank staff during weekends.
In July 2023, a condition audit of all the scopes used within GHH was carried out and a methodology for testing was agreed (weekly testing with HIRL labs). The water quality was checked, and a risk assessment was carried out in relation to the IFU. Then in August 2023, during a bank holiday weekend, the existing sinks were removed and replaced with one height-adjustable sink. A validation regime was agreed and implemented for two machines
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after discussion with the manufacturer, unit management and the AE(D). Staff training was completed, QMS working instructions were introduced, and the Khamsins were added to the tracking system (HealthEdge). Weekly meetings with PFE took place, with the unit manager, to plot progress. “In 2023, we decided that we would develop
the device to take two scopes and that was from the unit manager speaking with PFE,” Sharon Fox continued. She explained that, with the ability to clean two flexible endoscopes simultaneously in just 20 minutes, the unit has helped to improve efficiency. Laboratory testing completed during the trial within GHH suggests that this automated process is far superior than the manual (pre-treatment) brushing of the device. Staff numbers have also reduced within the decontamination unit’s dirty receiving area,
while there have been no further reported sickness and absences associated with musculoskeletal issues. The wellbeing of staff has improved, as they are spending less time at the sink and there has been a reduction in PPE. Full PPE is not required to be worn as the machine is enclosed, while waste is further reduced as the need for brushes and sponges has been eliminated. There has also been a cost improvement, with savings of £1.85 per scope. Ultimately, decontamination of flexible endoscopes is an area where there has been significant progress and technical innovation in recent years. The CSC explored some of the advances that have been taking place, how this could have the potential to shape practice in the future, and gave an insight into how Trusts are implementing a ‘revolution’ in decontamination.
Watch the CSC sessions online! AVM Services
The CSC Annual Scientific Meeting explored a wide range of other topics – too many to cover in this article. Other sessions included: l Ventilation Risk in the era of sustainability demands, Andrew Poplett
l Clinical risk vs theoretical for surgical screws and plates, Ryan Trickett
l Medical Device Revolutions, Jack Walters l H2O2 standards and science, Philippe Destrez on behalf of Advanced Sterilization Products
l The New RMDs’ Pre-Washing system using Sodium Bicarbonate, Stacey Ravenhall (University Hospitals Coventry and Warwickshire) on behalf of MedFirst Supplies
l The use of microbiology in a crisis, Mike Simmons
l Managing microbiology risks without microbiology, Layth Alsaffar
l Adapting Vocational Training to Modern Industry Trends For Decontamination and Sterilisation Personnel, Nick Brown on behalf of Cambridge University Hospitals –
l Steam Quality in Sterile Services, Steve Bishop on behalf of Spirax Sarco
l Risks in Public Health: Cosmetics and Body Art, Karren Staniforth
l Developing Infection Prevention and Control guidelines for special procedures Legislation in Wales (acupuncture, electrolysis, body piercing and tattooing), Amanda Daniel
l Sterilisation risks hidden from view – CH198 Research Labs/Other areas, Brian Kirk
l The Great Debate: “This house believes we need a revolution in periodic testing”. Moderator: Richard Bancroft. For: John Prendergast. Against: Mark Furmage.
Recordings are now available online. Click on the link and select ‘latest’ in the drop down menu, at:
https://centralsterilisingclub.org/c/recordings/
Delegates have free access if they request a coupon code via Becky Hill at: media@
centralsterilisingclub.org
CSJ
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