It wasn’t that long ago that most facilities cleaned their instruments by hand before sterilisation.  However, these days in order to comply with Australian standards, in particular AS 4187; a facility needs to ensure efficient preparation of medical instruments. Where the accuracy of hand-washing was dependent on the individual personnel’s assessment, automated washing now leaves very little room for error during re-processing. Still, not all washer disinfectors are created equal and there are many variables to consider when selecting a new washer disinfector for your facility.

Effective drying capability

Perhaps the most important factor to consider when selecting a washer disinfector for your facility is the units drying capability. While most washer disinfectors are equipped with a heated drying cycle and a forced air drying system, selecting a unit with additional drying capabilities results in a more thorough drying process.

Finding a unit with customisable drying cycles is a valuable feature for a washer disinfector. Being able to modify cycle times and parameters means being able to meet the individual requirements of your facility, your load and the RMD’s that you are processing.

Additionally, if you can source washer disinfectors with in-chamber fans this can also greatly accelerate the drying process, with air-flow able to reach all rack levels evenly.

Dosing pumps

Confirm your washer disinfector has a minimum of two dosing pumps. This ensures the chemical agent is dispensed quickly to reduce the cycle time. Additionally, this feature gives the facility the freedom to purchase any brand of chemicals they prefer dependent on their budget and current supplier contracts.

Future proofing

Purchasing a new washer disinfector is a huge investment, so it’s critical to future proof by sourcing a unit that not only meets the needs of your facility now, but in the years to come. It’s important to consider the following:

  • Electronic traceability – AS 4187 states that HSO’s should be working towards an electronic tracking/process record system. Ensuring your washer disinfector has electronic capability to tray or instrument level is extremely imperative as facilities move towards completely paperless systems.
  • Robotics – With Australia poised for a boom in robotic surgery over the next few years, selecting a unit that is compatible with robotic instrument preparation (in particular the Da Vinci Surgical System) would be a strategic move for larger hospitals.

Remote maintenance

Another important factor to consider is the serviceability of your washer disinfector. Access to remote maintenance can greatly reduce time and service costs, with a facility’s service provider able to identify errors and diagnose problems from off-site.

Automatic loading and unloading

For larger CSSD’s the opportunity to reduce handling can save a considerable amount of time. Finding a washer disinfector that has automatic loading and unloading of carts results in less reliance on staff and significantly lower operational costs.

Ergonomics

While this seems obvious to consider, quality construction can significantly improve the usability of your washer disinfector.

For example, quiet operation can signal a well-constructed door and chamber.  Sound-proof and insulated doors can greatly reduce noise in the CSSD and make for a more comfortable workspace. Some washer disinfectors also use inflatable door seals which properly seal the chamber during cycles, eliminating any residual noise.

Another important question to be asked in regards to ergonomics is whether the unit offers easy access to the electronics and chemical drawer for serviceability. Access through the front of the unit means washers can be placed side-by-side within the CSSD for more efficient use of space, and your service provider or biomedical team can perform maintenance easily.

In regards to the chamber and racks, make note of your washer’s capacity and the versatility of your racks. Some modern units use identical rack connections on all sides, meaning racks can be inserted from any side and therefore eliminating human error.

Even small differences in features can also make a huge difference to everyday operations. For example, some washers use coloured lighting to indicate cycle phases or large fonts are used to display cycle information on the user interface. Both of these features allow CSSD staff to easily identify cycles and monitor work-flow from a distance.

Economical options

Most modern washer disinfectors come with the option of a pre-heat tank and recovery tank.

A pre-heat tank means water can be pre-heated before entering the chamber, saving anywhere from 10 to 20 minutes where the water would typically heat once in the chamber. Having this option allows more cycles to be performed over the day for increased efficiency.

A recovery tank offers an intermediate storage of process water and recycles the rinse water. This ensures a faster cycle time and reduces water and energy consumption.

References

The Financial Review, Australia poised for a boom in robotic surgery, https://www.afr.com/business/health/australia-poised-for-a-boom-in-robotic-surgery-20180618-h11jrk

Queensland Health Guideline, Decision making guideline for the cleaning, disinfection and sterilisation of non-lumen flexible nasendoscopes, https://www.health.qld.gov.au/__data/assets/pdf_file/0032/682367/qh-gdl-454.pdf

MMM Group, Cleaning and Disinfection, https://www.mmmgroup.com/en/products/healthcare/cleaning-disinfection

Australian/New Zealand Standard, Reprocessing of reusable medical devices in health service organisations: Fourth ed. SAI Global Limited.