Manufacturing
Biofilm buildup on medical devices remains a persistent challenge despite advances in sterilisation methods.
medical devices. Meanwhile, Sheffield Hallam University has researched biofilm prevention through antimicrobial surfaces and ways of controlling biofilm formation on urinary catheters. Technology has also come up with some potential solutions in the form of two innovative devices for decontaminating reusable medical instruments: the BIARmed Safe CleanBox and the Tiny Air automated decontamination system. The BICARmed Safe CleanBox is a closed chamber that uses a ‘bicarbonate spray’ to deep clean reusable medical instruments – effectively pre-cleaning them before sterilisation. This pioneering technology was initially conceived in Italy to clean Formula 1 motor racing components but has now been applied to healthcare. The NHS Northern Care Alliance (NCA) has been the first UK healthcare trust to use the equipment. “The increasing complexity in instrument design and shape has meant that manual cleaning techniques require intense and repetitive application to achieve the desired result,” says David Taylor, NCA decontamination technician. “However, the CleanBox enables us to accomplish this in one swoop, with full confidence, and without the need to don uncomfortable PPE.”
“The CleanBox is a great addition to our facility because it better protects us from the substances on soiled devices. Our impact upon the environment is also reduced because it lessens our dependence upon the harmful chemicals and single-use plastics required by traditional pre-cleaning techniques,” adds Kelly Hulse, NCA decontamination technician. CleanBox is used at the Royal Oldham’s Hospital Sterilisation and Disinfection Unit to re-sterilise medical devices across the NCA footprint. Warburton also praised the Tiny Air automated decontamination system, which is designed for the automated pre-cleaning of surgical instruments. The manufacturers claim this new-to- market “environmentally sustainable innovative technology cleans with cold water and no chemicals in two minutes”. Said to be six times faster than the manual sink process and to increase the production capacity of sterile services departments by 10%.
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Warburton is hopeful that further automation of decontamination processes will raise standards in future. “Decontamination practices need to be repeatable. We’ve got the science and the technology, but it’s not mainstream yet,” he says. “People are nervous about moving away from sinks, but we know that contaminants around drains are a big risk from an infection control point of view.”
Investing in automated decontamination technology offers multiple benefits, believes Warburton, which justifies the initial capital outlay. For example, fewer instruments are rejected at the inspection stage and the number of stages of the process are reduced, as is labour. In the long-term, these amount to savings, he says. “I’ve done a business case for my hospitals and we’re actually going to have a saving by moving away from sinks and cleaning brushes. “Right now, everyone’s playing watch and wait to see what the pitfalls are, but I can see this technology being widely used in future.”
Critical changes to classification In the meantime, Warburton calls for endoscopes to be reclassified from semi-critical to critical, according to the Spaulding Classification system. Originally proposed in 1957, the system remains widely used for defining the disinfection and sterilisation of contaminated reusable medical devices and surgical instruments. “We know there’s a risk of biofilm accumulation, so we need to reclassify these devices as critical. They need to be sterilised as a minimum between patients because they come into contact with the sterile cavity.” He also recommends more widespread use of pre- packed sterile implants. NHS Scotland has completely migrated to them, but not so for NHS England. “The IDSc is encouraging the best practice of going prepack sterile through its membership, but resistance is coming from individual hospitals and the orthopaedic consultants in England,” says Warburton. So, it appears that the technology is on its way and change could be coming – it’s just a question of how long it will take. ●
World Pharmaceutical Frontiers /
www.worldpharmaceuticals.net
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