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Ensuring contamination-free instruments

Synoptics Health’s ProReveal test for accurately detecting proteins on surgical instruments is being used at Nottingham University Hospitals NHS Trust – in one of the UK’s largest NHS-run Sterile Services Departments – to check that the unit’s washer-disinfection process maintains excellent cleaning standards

The Trust’s ‘SSD’ is one of the UK’s first to adopt the ‘highly sensitive’ ProReveal in-situ fluorescence test to quantify the protein levels remaining on surgical instruments post-decontamination. SSD personnel are testing how well their washer-disinfection equipment has performed, using the ProReveal test to directly measure proteins on instrument surfaces which cannot be detected by eye or with a swab test. This is making checking the efficacy of the decontamination process more accurate. Synoptics Health added: “ProReveal is the only commercial in-situ protein detection test currently available that complies with new Department of Health guidelines.” 

Alison Gee, the Trust’s Sterile Services and Stores manager, explained: “The Department of Health guidance has changed, and SSDs are now expected to move to in-situ testing for residual protein on surgical instruments. This is particularly important for instruments likely to have been in contact with tissue potentially harbouring prions that could cause infections such as vCJD. This change in regulations has, in fact, allowed us to more easily access the funding to purchase and install a ProReveal system in our department.” 

She continued: “Since using ProReveal in the past year we have had very good results, but have found a few instruments sometimes have slightly more than the target of five micrograms of protein on them, due to factors such as positioning in the washer-disinfector. We have also identified one instrument type that we cannot clean adequately for re-use, which is therefore being replaced. Neither of these problems were identified using swab testing. This has prompted us to re-train our staff on how to load our machines correctly, and to contact the instrument manufacturer to discuss decontamination processes for its products. 

“Additionally, when we had an issue with our water softener, we used ProReveal, and it assured us that the water quality had not affected the decontamination process, and that the surgical instruments were safe to use. 

“We therefore didn’t have to undertake routine manual pre-cleaning on everything, thereby avoiding having an operational backlog and cancelling patients’ surgery. We are very pleased to have ProReveal, as it is assuring us that the surgical instruments we are returning for use on patients are both safe, and fit for purpose.”

 

 

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