Monitoring the Cleanliness of Reusable Surgical Instruments in Central Sterile Supply Department by Adenosine Triphosphate Method

Li, Ye; Lu, Ye; Cai, Ran; Hu, Guoqing; Lu, Longxi

doi:10.1093/jaoacint/qsab102

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…It is impossible to observe the cleaning effect on the shaft cavity of the robotic arm, the gap at the working end, and other complex structural locations. In recent years, the cleaning efficacy of these devices has been monitored by experts using successively more scientific methods, including ATP detection and residual protein detection, among others ( 11 , 12 ). However, the shaft cavity of the da Vinci system has its own unique lumen structure.…”

Section: Discussionmentioning

confidence: 99%

Investigation into the current status of cleaning, disinfection, and sterilization of da Vinci surgical instruments—a cross-sectional survey

Chen¹,

Yuan²,

Chen³

et al. 2023

Gland Surg

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Background: In recent years, the use of robotic-assisted surgery has developed rapidly in China and is now widely used in many clinical fields. However, da Vinci robotic surgical instruments are more precise, expensive, and complex than ordinary laparoscopes, have less instrument configuration, involve restrictions on the duration of use, and have cleanliness requirements for supporting instruments. The purpose of this study was to analyze and summarize the current status of cleaning, disinfection, and maintenance of da Vinci robotic surgical instruments in China to improve the management of these devices.Methods: A questionnaire survey on the use of da Vinci robotic-assisted surgery at medical institutions in China was designed, distributed, and analyzed. The survey included items regarding general information, management of instrument handling personnel, instrument handling techniques, guidelines, and references for instrument handling. The results and conclusions were formed from the data generated by the analysis system and the answers of respondents to the open-ended questions.Results: (I) All surgical instruments used in domestic surgery practice were imported. There were 25 hospitals that conduct more than 500 da Vinci robotic-assisted surgeries every year. (II) In a relatively high proportion of medical institutions, nurses continued to be responsible for the processes of cleaning (46%), disinfection (66%), and low-temperature sterilization (50%). (III) A total of 62% of the surveyed institutions used fully manual methods for cleaning instruments, and 30% of the ultrasonic cleaning equipment in surveyed institutions did not comply with the standard. (IV) A total of 28% of surveyed institutions used only visual inspection to evaluate cleaning efficacy. Only 16-32% of surveyed institutions regularly used adenosine triphosphate (ATP), residual protein, and other methods to detect sterilization of cavities in instruments. (V)In 60% of the surveyed institutions, robotic surgical instruments have been damaged.Conclusions: Cleaning efficacy detection methods of robotic surgical instruments were not uniform and standardized. The management of device protection operations should be further regulated. In addition, further study of relevant guidelines and specifications as well as the training of operators is warranted.

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Section: Discussionmentioning

confidence: 99%

Investigation into the current status of cleaning, disinfection, and sterilization of da Vinci surgical instruments—a cross-sectional survey

Chen¹,

Yuan²,

Chen³

et al. 2023

Gland Surg

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show abstract

“…If the cleaning is not thorough, any organic matter remaining on the instruments will form a protective film on the surface of microorganisms, affecting the disinfection and sterilization effect, 20 proper cleaning can remove up to 99% of microorganisms, and may extend device life and save medical costs. 12 , 21 Using the proper cleaning method to sanitize surgical instruments and strictly monitor their quality. Therefore, it is suggested that the standardized cleaning process: for special and complicated medical equipment, should be classified by a special person, cleaning separately, reasonable selection of cleaning agent, while the cleaning personnel are required to strictly regulate the operating procedures to prevent cross-infection.…”

Section: Discussionmentioning

confidence: 99%

“…Studies showed that the defect rate of packaging inspection was 1.43 ‰ ~1.67 ‰. 7 Ye et al 12 found that the qualified rate of manual cleaning and mechanical cleaning were 70.59% and 84.97%, respectively. Costa et al 13 still found biofilm and bone fragments by scanning electron microscope after sterilization, which is not surprising given the number of surgical instruments processed.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Adverse Events in Central Sterile Supply Department: A Single-Center Retrospective Study

Chen,

Liu,

Zhang

2023

RMHP

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Purpose Adverse events bring pain to patients, prolong hospitalization, and may even endanger life, it is necessary to effectively identify and manage adverse events. However, in Chinese mainland, there are few studies on adverse events in Central Sterile Supply Department. The purpose of this study was to investigate the prevalence of adverse events in Central Sterile Supply Department and offer suggestions for enhanced quality management. Materials and Methods A retrospective study was conducted to assess the prevalence of adverse events in a tertiary hospital from January 2020 to December 2022, employing a convenient sampling approach. The occurrence of adverse events of CSSD shall be collected for the basic information of the principal person of adverse events and the information of the adverse event. Descriptive statistics are described by frequency (percentage) and are analyzed by using X 2 test. Results A total of 101 adverse events were reported, with the majority being attributed to substandard cleaning quality (34, 33.66%), followed by faulty instrument assembly (25, 24.75%) and defective marking (7, 6.93%). Additionally, incorrectly sterilized items (6, 5.94%), occupational exposures (3, 2.97%) and late distribution (5, 4.95%) were also observed, accidents (8, 7.92%) and other types of adverse events (13, 12.87%). The highest risk chain for adverse events was identified as inspection and packaging (49, 48.51%) and device cleaning (32, 31.68%), with the majority of adverse events occurring on a scale of three (30, 29.7%) and four (70, 69.31%), respectively. Furthermore, it was determined that the type of person responsible, education, years of work and the structure of the device, the number of instruments in the operating kit, and the size of the kit may be factors in the occurrence of adverse events (P < 0.05). Conclusion Adverse events occur frequently in central sterile supply department, thus necessitating strict supervision during cleaning and inspection of packaging. Managers should pay special attention to staff with low working life and education. Furthermore, a grading system, in line with the central sterile supply department, should be implemented to ensure the management of adverse events and the quality of services provided is harmonized.

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Checking the Cleanliness of Surgical Instruments Using the Adenosine Triphosphate-Bioluminescence Assay

Park,

Lee,

Kim

2024

J Korean Acad Fundam Nurs

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Purpose: Cleaning is crucial for reprocessing reusable surgical instruments (RSIs). In this study, we used the adenosine triphosphate (ATP) bioluminescence method to assess the cleanliness of RSIs according to the cleaning method used.Methods: From April 3 to June 2, 2023, surgical sets, including hemostatic forceps, needle holders, operating scissors, dressing forceps, and suction tubes, that arrived at the decontamination room in the central sterile supply department of one general hospital were selected through convenience sampling. For each of the three cleaning processes, 30 cleaned RSIs were sampled with test swabs for inspection, and the relative light unit value was measured using ATP test equipment.Results: Suction tubes, hemostatic forceps, and needle holders ranked low in cleanliness (x2=11.69, p=.020), and the contamination rate after mechanical cleaning was significantly lower than that after manual cleaning (x2=31.34, p<.001).Conclusion: Surgical instruments treated by manual processing and those containing tubes were associated with the low cleanliness. Therefore, it is necessary to check whether surgical instruments, including tubes, are manually washed at an appropriate level, and regular monitoring will be required.

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Monitoring the Cleanliness of Reusable Surgical Instruments in Central Sterile Supply Department by Adenosine Triphosphate Method

Cited by 3 publications

References 12 publications

Investigation into the current status of cleaning, disinfection, and sterilization of da Vinci surgical instruments—a cross-sectional survey

Investigation into the current status of cleaning, disinfection, and sterilization of da Vinci surgical instruments—a cross-sectional survey

Incidence of Adverse Events in Central Sterile Supply Department: A Single-Center Retrospective Study

Checking the Cleanliness of Surgical Instruments Using the Adenosine Triphosphate-Bioluminescence Assay

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