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 forcep2. Ronguer3. Power tools/drill4. 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 dirtybefore cleaning

More Dirty

Probability Plot and I-MR Chart

The data is from Handpiece, Manual wash processWe will study Handpiece in round 2

160012008004000-400

16

14

12

10

8

6

4

2

0

C1

Fre

qu

en

cy

Mean 244.2StDev 427.1N 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 cleanTotal 120 Data, Without Handpiece.

ATP Test Protein Residual Visual Inspection Magnify GlassInspection

Pass 92% 96% 100% 100%

92% 96% 100% 100%

0%10%20%30%40%50%60%70%80%90%

100%

Axi

s Ti

tle

Passuse 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)