Decontamination
are “all on the same page”, he commented. This is a stance that CMR Surgical – a robot manufacturer – also reaffirmed in a discussion on decontamination of robotic instruments, during the conference programme. Stuart White, decontamination manager, CMR Surgical, highlighted the benefits of laparoscopic minimally invasive surgery (MAS) – it reduces complications, requires fewer resources, and ensures faster recovery times, shorter hospital stays and lower infection rates. However, it is physically demanding and difficult to perform. Robot-assisted surgery helps to overcome the limitations of conventional laparoscopic MAS. It reduces physical strain; reduces training time; offers higher precision, flexibility and control; improves vision, increases dexterity and enables the ability to perform complex procedures. Stuart explained that reprocessing challenges occur when instruments cannot be dismantled and have a complex design. He emphasised that reusable robotic instruments must be developed so that they can be reprocessed using standard practices. This means reducing inaccessible areas and including features to prevent retention of cleaning fluids, e.g. flush ports. Material selection is also important, and manufacturers need to consider the effects of detergent use, ultrasonic energy and steam sterilisation. Key factors for success include: early
customer engagement with the manufacturer, professional education, unambiguous Instructions For Use (IFUs), as well as ongoing support. He concluded that robotic instruments, endoscopes and associated ES cables are not hard to reprocess, but they do require special care and attention. “It is when people deviate from the IFUs that problem occur,” he asserted.
Technology
Within the exhibition halls, IDSc provided a showcase for an array of exciting innovations that show promise in advancing the decontamination sector. As hospitals strive to tackle the backlog,
ensuring uptime and efficiency will be high priorities in 2023. Innovative digital technologies, automation, artificial intelligence and machine learning will all be key. “Going forward the sector will see greater
automation,” Getinge’s Chris Hill commented. He pointed out that there is increasing
interest in automated loading systems and automated flushing systems. Manual cleaning elements, in particular, will become more automated in the future, which will help to remove human factors. However, digital technologies are also bringing increasing intelligence – enabling teams to connect their equipment to gain valuable insights, troubleshoot issues remotely, maximise uptime, improve efficiency through automatic replenishment of consumables, optimise equipment utilisation, and monitor multiple sites from one location. Decontamination services require the funding to support the adoption of these new technologies, but also to upgrade and replace out-dated equipment, however. Rakesh Javer called for increased investment in the sector: “The Government is planning to invest in building new hospitals, but what about the existing hospitals? We are seeing departments having to really ‘sweat their assets’ – washer disinfectors are being used far beyond their life expectancy and the level of investment is slow. There is a backlog of patients – the numbers are increasing every day, and this requires significant investment in equipment and resources,” he asserted.
Sustainability During the conference, sustainability also emerged as a high priority area and there were some thought-provoking discussions on how the NHS must tackle its environmental impact – including sessions by Professor Mahmood Bhutta, the inaugural chair in ENT Surgery at Brighton and Sussex Medical School,
and honorary consultant and green lead for University Hospitals Sussex; Dr. Chantelle Rizan, an ENT research fellow at University Hospitals Sussex NHS Trust and honorary clinical lecturer at Brighton and Sussex Medical School (BSMS); and Anthony Heard, sterile services manager at the Princess Alexandra Hospital NHS Trust. The NHS in England has a staggering carbon
footprint of nearly 25 million tonnes and all four nations in the UK have committed to Net Zero by 2045. The key principle underpinning sustainable healthcare includes: “reduce, reuse, recycle”. Reflecting on some of the key issues raised during the conference sessions, Wassenburg’s Rakesh Javer commented that sustainability in endoscope reprocessing is a significant challenge. “The mandate has been set. To achieve this, decontamination leads need to evaluate a number of factors around endoscope washer disinfection. Units need to consider how much water and power is consumed by their washer disinfectors, while lots of units have moved to RO, which comes at a premium,” he commented. He pointed out that suppliers are also having
to focus on their sustainability credentials. “As a manufacturer, we are being asked more and more about plastic content and what type of vehicles we use to deliver on to site,” he revealed. “Suppliers to the decontamination sector will have a key role to play in supporting the NHS to achieve its goals, going forward.” Chris Hill revealed that Getinge has implemented a variety of initiatives to support SSDs in achieving their sustainability goals. This includes the launch of a Sustainability Handbook which offers guidance for decontamination managers on how they can improve sustainability in their department. By bringing together the best practices of CSSD managers worldwide, Getinge has created ‘10 ways to make sterile reprocessing more sustainable’. These include: 1. How to focus on sustainability in your daily work.
2. How to set and lead your team sustainably. 3. How to create awareness of your utility consumption.
4. How to optimise the workflow. 5. How to reduce the consumption of water and to reuse the water in your facility.
6. How to reduce the electricity consumption of washer-disinfectors and sterilisers.
7. Improving the lifetime of your instruments is a sustainability goal.
8. How to optimise the planning process to ensure instrument availability.
9. How to optimise inventory management and reduce the risk of re-sterilisation.
10. How to optimise the ordering/investment of instruments for surgery.
February 2023 I
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