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STERILE SERVICES
Installing an automatic dosing machine
An opportunity arose to trial a new dosing systemat the RoyalVictoriaHospital (RVI) Sterile Services department. TheClinicalServices Journal finds out how the dosing technologies and chemistries were implemented.
For more than 100 years, Dr Weigert has been supplying cleaning and disinfection, and dosing systems into the pharmaceutical, medical, laboratory and professional kitchen industries. Employees based at Dr Weigert are constantly tasked to investigate and research detergents and cleaning agents in a bid to provide the best results using the smallest possible dose.
Concentrated cleaning technologies are advantageous as they require less space and manual handling, while reducing the plastic and detergent requirement – and the burden on the environment. In addition, logistics and product shipping becomes more efficient and economical.
Detergents and cleaning chemicals
As well as the automated reprocessing machine, there are many issues to be considered when selecting appropriate detergents and cleaning chemicals for use in the machine. Cleaning agents for use in washer-disinfectors should be in a liquid format to allow for accurate dispensing and be dosed in an appropriate volume to decontaminate the bioburden present on instruments entering the machine. In addition the chemicals ideally should be low foaming, free-rinsing, non-abrasive and, where possible, biodegradable. Material compatibility is a crucial
concern. Chemicals should be compatible not only with the instruments being reprocessed but also with other areas touched by the chemicals including the inside of the reprocessing machines itself. In addition, other additives used during the
wash cycle have to be considered together with the quality of the water used in the sterile services department. Suppliers of chemical additives should provide product data sheets and material safety data sheets for the chemicals and detergents supplied. These should include details of biocompatibility studies.
Batch management of supply chemical
is very important to ensure that solutions are within the recommended ‘use-by’ period Reference should be made to local COSHH provisions.
A dosing system should be in place to ensure the required concentration of chemicals can be accurately dispensed into the reprocessing machine on each wash cycle. Regular validation testing
If you don’t experiment with different technologies on the market then you run the risk of never making any
improvements in the way you work. Neil Christie, Newcastle Upon Tyne Hospitals NHS Foundation Trust
NOVEMBER 2018
should confirm the required dosing system is within tolerances expected and calibration of the dosing system should be carried out where anomalies are found.
Neil Christie, operations manager for the
Sterile Services department at The Newcastle Upon Tyne Hospitals NHS Foundation Trust was keen to identify new and different technologies to maximise efficiencies for reprocessing surgical instruments. Neil said: “I think it’s always good to
try new things, some work, some don’t. I just like to opportunity to try. If you don’t experiment with different technologies on the market then you run the risk of never making any improvements in the way you work. “There are so many different types of chemistries out there, different types of machinery and you hear and read different things about them. I always try to have one eye on what Europe is doing as well and any new technologies that are available.” In 2017, the Royal Victoria Infirmary Sterile
Services department in Newcastle-upon-Tyne reprocessed more than 177,000 instrument sets and over 47,000 additional single items from a range of different specialities including: trauma, cancer, women’s health and orthopaedics among others. With three Sterile Services departments across the Trust based at the Royal Victoria Hospital, Freeman Hospital and Dental Hospital, the departments are under continual pressure to deliver exacting results, ensuring that all instruments are reprocessed to high standards on a daily basis. In the past, the department had used cleaning systems where the detergent was not only costly, but was supplied in bulk 1000 litre containers which were unwieldy to handle and presented storage challenges. Pod detergent dispensing systems had also been used which can be affected by variations in the quality of the mains water supply; affecting concentration levels and alkalinity. An opportunity arose to trial a new dosing system when two new single chamber washers were installed at the Royal Victoria Hospital (RVI) Sterile Services
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