Decontamination
in decontamination science. This needs to be addressed internally within Trusts, as well as outside of the hospital setting, she asserted. Chris Hill, national sales manager at Getinge,
believes the sector has come a long way, but agreed with Zoe that there is a need to drive awareness of decontamination and bring the discipline to the forefront. Decontamination has been ‘a Cinderella’ service in the basement, historically, but it is “the heart of the hospital”. It needs to be taken more seriously and it needs investment, Chris asserted. Chris has been in the sector for around 17 years and originally came from a military background. Having started his own career as an apprentice, he has seen their value first hand, in developing the next generation of skilled individuals in STEM professions – including decontamination science. There is a recognition among AEDs that there is a need to attract “fresh blood” into the industry. Chris commented that he was optimistic that the situation is improving and observed there are some “really good people coming though”. Rakesh Javer, managing director, Wassenburg UK, said that reprocessing of endoscopes has also come a long way since the early 2000s, when scopes were often cleaned manually. In the past, he had witnessed scopes receiving ‘a quick wipe’ and then being immersed in “a bucket full of other scopes”. There were concerns around ventilation and space – reprocessing was often carried out in very small, ‘satellite’ reprocessing units. “Today, endoscope reprocessing has moved
to dedicated, centralised units, and is now managed by decontamination leads who have the expertise. Most hospitals have moved away from manual reprocessing and automation has significantly improved safety and efficiency. “However, there still needs to be a
better understanding of why we do things. Apprenticeships and accreditation are important steps forward, but there needs to be more investment in ongoing education and training in hospitals – as a supplier, we are helping to support this with study days. “However, there needs to be greater
recognition for the individuals performing the vital role of decontamination, in general,” he commented.
Calls to improve decontamination of ultrasound probes Judith Pilling, a qualified sonographer, was among the experts asked for their views, by CSJ, on how patient safety can be improved. Judith qualified in ultrasound at Leeds St James’s University Hospital in the early 90s and obtained her Masters in 1998. She highlighted the risks associated with inadequate decontamination of ultrasound probes. In the past, there has been wide variation in the methods used to clean ultrasound probes. In some instances, they may be given a ‘quick wipe’ between patients and a variety of different materials may be used. Unfortunately, a combination of non-standardised methods and human factors has led to outbreaks of infections and even patient deaths. Keys et al (2015) tested ultrasound equipment used in five EDs and five ICUs for blood and microbial contamination. They found that 61% of samples tested positive for blood contamination and 48% tested positive for microbiological contamination. Transducer leads and transducers had high blood contamination (88% and 57%, respectively) and microbiological contamination (62% and 46%, respectively).6 Other studies have also highlighted the increased risks associated with undergoing
An apprenticeship is a real job; it is about learning new skills, new knowledge and new behaviours, while earning money.…They go from Level 2 entry level apprenticeships, right the way up to degree level – so they provide a really good, professional
route and life-long learning opportunities. Claire Sides, STERIS IMS
20
www.clinicalservicesjournal.com I February 2023
Endocavity ultrasound.7-9 In the UK, the MHRA issued a Medical Device
Alert warning of the risks associated with reusable transoesophageal echocardiography, transvaginal and transrectal ultrasound probes, following the death of a patient from hepatitis B – which was thought to have been transmitted by an improperly disinfected endocavity ultrasound probe.10 “Endocavity probes for transvaginal and anal scanning, and even line insertion, should go through high level disinfection,” Judith commented. This minimises the risk of cross contamination between patients and reduces the risk of infection, she advised. Automated systems are now available which
eliminate some of the human error and variation associated with manual wiping systems. The waste associated with wipes disposal is also reduced, Judith points out. However, she added that some automated systems are more environmentally friendly/sustainable than others. Workflow of the department also needs careful consideration when implementing a decontamination system for both manual and automated systems.
Decontaminating robotic instruments As with past IDSc conferences, the decontamination of robotic instruments was also a key topic of discussion. In the early days of adoption of robotic technologies, there were some well-publicised challenges, but the sector has progressed and there is now better awareness of the importance of involving sterile services – at the design stage and during procurement.
Getinge’s Chris Hill highlighted the importance of communicating early on with the manufacturers of pioneering medical device technologies, such as robotics, to ensure decontamination is always at the forefront. SSDs, manufacturers of decontamination solutions and the device manufacturers need to ensure they
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