Central Service - Issue 3/07

EDITORIAL

WFHSS Congress

NEWS UPDATE

What’s New in Standardisation: Instrument Disinfectants
Joint OEGSV/WFHSS Congress. Baden/Vienna, 3 - 5 May 2007
The Latest on Low-Temperature Sterilisation. Johnson & Johnson Satellite Symposium, 3 May 2007, Baden/Vienna
Sparkling Egg Award 2007. Awarded at the WFHSS Conference in Baden near Vienna
The 29th French National Sterilisation Meeting - Just Short of the Jubilee Mark. 25 - 26 April 2007, Lyon
Performance Requalification of Validated Cleaning and Disinfection Processes on Changing Process Chemicals. Supplementary Memorandum by the AKI on the Guideline for Validation and Routine Monitoring of Cleaning and Disinfection Processes for Heat-Resistant Medical Devices
Patchwork Europe: Still no Uniform Regulations for Decontamination of Medical Devices
Dr. Meinrad Lugan New Chairman of BVMed Board of Directors

MAIN ARTICLES

T. Friedrich, K. Roth, J. Gauer, P. Heeg:
Binding Properties and Other Important Considerations when Interpreting Results Obtained with the Radionuclide Method
(Zentr Steril 2007; 15 (3): 191-200)

Abstract
Background:
The stability of the Tc99m-albumin complex, in addition to standardisation of the measured values, is a decisive factor when evaluating the results of the radionuclide method (RNM).

Methods and Aim:
On using specific protein precipitation methods and varying the temperature, acidity, alkalinity and combinations of the latter parameters, it is possible to identify these binding characteristics. Testing also included an investigation of the physical conditions related to the gamma camera: homogeneity, measurement constancy and temporal parameters.

Results:
Radionuclide-albumin binding is shown to be largely stable, even in worst-case scenarios. Only minor fluctuations in gamma camera measurements are noted for repeat measurements.

S. Terzaki*, K. Amazian, L. Dhidah, S. Sekkat, T. Abdelmoumène, M. Njah, J. Fabry und Mitgleider des NosoMed network:
Quality of the Organization of Sterilization: an Audit in Euro-Mediterranean Hospitals
(Zentr Steril 2007; 15 (3): 201-211)

Abstract
Introduction:
Management of sterilization in a health care facility is a sensitive aspect of infection control (IC) and of the quality of care in many countries. In the context of NosoMed, an EU-funded Euro-Mediterranean project, an audit tool was developed to assess the quality of this function in the hospitals of this region. It was tested in different hospitals in Algeria, Egypt, Morocco and Tunisia.

Methodology:
The observation tool was designed by IC practitioners having been trained in sterilization methods. It was tested in 21 hospitals who had volunteered. Observation and data collection were carried out by an external observer who was trained in sterilization management. International (France, UK) and national official recommendations were used where available. Data collection covered hospital characteristics, sterilization scheme, staff, premises, equipment, processes and quality control.

Results:
Among the 21 hospitals audited, 14 had an exclusive central sterilization unit (six in Egypt, seven in Morocco and one in Tunisia). For some of the items, the results conformed to the recommendations, particularly with respect to the availability of trained managers and staff, the practice of regular quality control and with respect to the sterilization cycle.

Some aspects, however, were insufficient and should be improved. These concerned mainly architecture and equipment:
1. insufficient barrier between dirty, clean and sterile areas in 3 SU
2. insufficient space for cleaning of trolleys and maintenance of equipment in 4 US
3. lack of air filtration, pressure gradient and even "natural ventilation" in most facilities; condition of sterilizers: 16/65 (25%) of the sterilizers in use being classified as insufficiently reliable; staff clothing for reception and transport; frequent overloading of sterilizers; unprotected storage of sterile items: storage in cupboards or containers in 4 CSSDs only.

Conclusion:
The NosoMed audit tool for sterilization quality was globally found to be easy to use. The results from Egypt show that NICC support (by training) succeeded in implementing recommended procedures, but that hospitals still have to improve their physical environment and their equipment. The Euro-Mediterranean countries need more support in training and improvement in the equipment provided and implementation of recommended procedures.

Quality Management in the CSSD - Standard Surgical Instruments (4):
Visual Inspection and Functional Testing of Standard Forceps

RECOMMENDATIONS BY THE QUALITY TASK GROUP (AK »QUALITÄT«)

Requirements for Construction or Conversion of a Hospital Central Sterile Supply Department