David Robinson - NHS Manchester

Washer Disinfectors –
specifications, uses, maintenance and
David Robinson
Selection of Equipment
Washer Disinfector
Instrument Cleaning
• Washer disinfector is the preferred method
• Two key reasons
– Instruments must be clean prior to sterilization
– Prevention of sharps injuries to nurses
Instrument Cleaning
• Whitworth et al
– Burrs study
Manual Cleaning 35%
Ultrasonic 55%
Domestic dishwasher 70%
Medical washer disinfector 95%
Manual cleaning is inconsistent and less
Hands Free Instrument Transfer
Clip trays (cassettes) offer hands free instrument
Instrument Cleaning
Cycles of a washer disinfector
1. Pre-wash
2. Drain
3. Wash
4. Drain & Rinse
5. Thermal Disinfect
6. Drain & Rinse
7. Forced Air Dry
8. Water Drain
Washer Disinfector Cycles
Cycles on a washer disinfector can be varied to
suit the size and type of load
Heavily Soiled Load – The washer disinfector
will wash the instruments twice to reduce
bacterial load.
Half Load – The washer disinfector is able to
reduce the cycle time due to the reduced load
Important – Choose the correct cycle for your load!
Compliant Cycles
• You must refer to the manufacturer’s
guidelines when choosing a cycle.
• You must not alter the cycle in any way.
• You must put the correct instrument load on
the correct cycle in order for that cycle to be
Washer Disinfector Maintenance
• The Washer Disinfector must be installed by an
approved engineer.
• Training must be provided on installation and all
practice staff should be present.
• Filters should be changed according to
manufacturers instructions.
• Machines should be cleaned weekly using a rinse aid
Logging Data
Cycle data must be logged
• Data Logger – Information is stored on
memory card and then downloaded onto
• Printer – Data is sent to printer then paper
copy is produced which is then kept.
• Direct Data Download – Machine is attached
to PC and data directly downloaded
Bench Top v Under Bench
Under Bench
Bench Top
• Capacity
• Capacity
– Under utilized
• Cycle time
– 1.5-2.5 hours
• Possible electrical work
– 30 amp
• Cost of cycle
– Expensive
• Servicing
– Less access
– Appropriate
• Cycle time
– 45-60 mins
• Plug and play
– 13 amp mains socket
• Cost of cycle
– Inexpensive
• Servicing
– Easy access
Bench Top v Under Bench
• Bench Top takes up valuable counter space
• Bench Top WD that fits under bench?
• Drainage!
– Most Bench Tops use gravity fed drainage so
cannot be mounted under bench
• Solution?
– Find a Bench Top that uses pumped drainage!
Choosing a Washer Disinfector
• What do I get for my money?
– accessories, delivery, installation, training etc
RO connection as standard?
Cycle times - beware!
Are all cycles compliant?
Forced air drying?
Hand Pieces?
Autoclaves (Sterilizers) –
specifications, uses, maintenance and
David Robinson
Equipment Selection
Equipment Selection
Vacuum or Non Vacuum .....?
Choosing an Autoclave
• Mentioned in HTM 01-05
• Non Vacuum (downward displacement)
– Can be used for solid and unwrapped, unpouched
instruments only
• Vacuum
– Can be used for wrapped, pouched, or air
retentive instruments
• An autoclave that can do both types of cycle will give
you more flexibility
Processing Power!
Decontamination bottle neck
Capacity to process instruments
11 litre - 22 litre? How do I decide?
Tray capacity is the important point
– 6 clip trays v 12 clip trays
– 60 instruments v 120 instruments
Two Potential Scenarios
BenchTop WD
Vacuum Autoclave
Underbench WD
Vacuum Autoclave
Autoclave Installation & Maintenance
Training must be provided at installation
Door seal should be cleaned after every cycle
Autoclave cleaner should be used weekly
Water must be drained at the end of day
Filters should be changed annually or
according to the manufacturer’s guidelines
• Maximum weight limit must not be exceeded,
so check before adding other trays
Cycle Checks
• Use Data Logger or Printer to record every
• Use Bowie Dick test daily to check steam
• Use TST strips on every cycle to check
(If Data Logger or Printer is not available, you will need to watch
the machine go through the first cycle of the day; check that
correct bar pressure and sterilization temperature is reached
and then log data in book)

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