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Instrument Cleaning and Cleaning Verification Study 3M Singapore with Singapore Hospital Visual Inspection Magnifying Glass Inspection ATP Test Protein Residue Test User Verification Study in Singapore Hospital To evaluate surgical instruments cleaning and cleaning verification method in hospital. To compare methods of inspection - visual inspection, inspection with magnify glass, use of Clean-Trace ATP test, Protein residue test - in monitoring the manual cleaning process/ automatic wash disinfector with enzymatic detergent Instruments and method of testing • Instruments that are used in high risk procedures and known to be difficult to clean will be tested in the study. Four types of surgical instruments will be chosen for inclusion in this study: 1. Long forcep 2. Ronguer 3. Power tools/drill 4. Hollow suction tube 1 2 3 4 Instruments and method of testing procedure • Choose thirty (30) used instruments belonging to the above 4 category types. Total 120 instrument • Do the ATP test is done for each instrument and record RLU reading • Clean instruments using 3M Biofilm Removal Multi enzymatic cleaner • Process instruments through the manual wash and washer-disinfector. • Do the ATP/Protein Residue test/Visual Inspection/Magnify glass check after removal from washer-disinfector and record RLU reading. • Clean-Trace ATP test and Protein Residue test – these are done by inserting swabs into lumen of laparoscope and hollow suction tubes; joints of long forceps and drill attachments of the power tools. Comparison, different type of instruments before cleaning Study: Ronguer, Handpiece/drill before cleaning • Paired T for Ronguer - Handpiece • N Mean StDev SE Mean • Ronguer 29 24502 36650 6806 • Handpiece 29 124748 134399 24957 • Difference 29 -100246 137102 25459 • 95% CI for mean difference: (-152397, -48096) • T-Test of mean difference = 0 (vs not = 0): T-Value = -3.94 P-Value = 0.000 • Handpiece is more dirty than Ronguer before cleaning! Ronguer Scissors Tube Suctions Handpieces Handpieces and Tubes suctions are most dirty before cleaning More Dirty Probability Plot and I-MR Chart The data is from Handpiece, Manual wash process We will study Handpiece in round 2 1600 1200 800 400 0 -400 16 14 12 10 8 6 4 2 0 C1 Frequency Mean 244.2 StDev 427.1 N 30 Histogram (with Normal Curve) of C1 ATP/ Protein Residual/ Visual Inspection/ Magnify Glass Inspection Result 3M BMEC Cleaner only, Mechanical Wash, RLU ≤150, Protein Residual ≤ 5 ug is clean Total 120 Data, Without Handpiece. ATP Test Protein Residual Visual Inspection Magnify Glass Inspection Pass 92% 96% 100% 100% 92% 96% 100% 100% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Axis Title Pass use 3M BMEC Cleaner Summaries ATP test is more objective and sensitive method than visual inspection. ATP tests measure the levels of organic soil and microbial contamination on the cleaned device. ATP Test: Cleaning Result Pass: RLU< 150 3M BMEC cleaner shows better cleaning efficacy Thank you Welcome to Singapore ATP Result After Cleaning (Mechanical Wash) Data including Long forcep, Ronguer, Hollow suction tube (All with mechanical wash) Without Power tools/drill (As it is manual wash)
