Improvement And Effect Evaluation Of Cleaning Means Of Rigid Endoscopy Equipment

ObjectiveTo explore a rapid and effective cleaning procedure of rigid endoscopic equipment and to find a scientific and objective evaluation method of cleaning effect. To simplify washing procedures and shorten the cleaning time, "Endoscopic cleaning and sterilization technology practices (2004 edition)" can be implemented not only on institutional norms but also on actual operation and can be promoted widely at all levels of hospital in the premise of ensuring the quality of cleaning.MethodsAccording to the sub-clinical trials, the 240 contaminated endoscopic equipment in line with "the standard" were divided into four groups randomly. The norms cleaning group (standard process: rough washing→6min multi-enzyme soaking→unpicking and washing→6min ultrasonic cleaning→washing down→Detecting); the 3min multi-enzyme soaking group (standard process: rough washing→3min multi-enzyme soaking→unpicking and washing→6min ultrasonic cleaning→washing down→Detecting);the 6min multi-enzyme soaking and ultrasonic cleaning group (improved process: rough washing→unpicking and washing→6min multi-enzyme soaking and ultrasonic cleaning→washing down→Detecting);the 3min multi-enzyme soaking and ultrasonic cleaning group(improved process: rough washing→unpicking and washing→3min multi-enzyme soaking and ultrasonic cleaning→unpicking and washing→washing down-Detecting). Each equipment after cleaning was detected by four ways to evaluate the washing effect: Visual detection with five times magnifying glass, white gauze experiment, Pro-tect M detection (3M Company), Jie Li paper detection (Shanxi Datong Fine Chemical Factory production).Test results were recorded respectively. All the data were analyzed by SPSS13.0 statistics package. The statistical methods were: Statistical description, Kruskal-Wallis H test for completely randomized samples, x~2 test, Friedman M test for relative samples.Results1. The positive detection rates in the norm washing group were: 10% in visual detection with five times magnifying glass, 8.3% in white gauze experiment, 45% in the detection by Pro-tect M cultivation 10min, 85% in the detection by Pro-tect M cultivation 45min, 40% in the detection by Jie Li paper.2. The positive detection rates in the 3min multi-enzyme soaking group were: 13.3% in visual detection with five times magnifying glass, 13.3% in white gauze experiment, 45% in the detection by Pro-tect M cultivation 10min, 85% in the detection by Pro-tect M cultivation 45min, 43.3% in the detection by Jie Li paper.3. The positive detection rates in the 6min multi-enzyme soaking and ultrasonic cleaning group were: no positive result in visual detection with five times magnifying glass, 3.3% in white gauze experiment, 15% in the detection by Pro-tect M cultivation 10min, and 55% in the detection by Pro-tect M cultivation 45min, 18.3% in the detection by Jie Li paper.4. The positive detection rates in the 3min multi-enzyme soaking and ultrasonic cleaning group wre:5% in visual detection with five times magnifying glass,6.7% in white gauze experiment, 20% in the detection by Pro-tect M cultivation 10min, 90% in the detection by Pro-tect M cultivation 45min , 33.3% in the detection by Jie Li paper.5. The comparison of detection effect of four cleaning methods: The positive detection rate was lower in the visual detection with five times magnifying glass and the white gauze experiment, was higher in Pro-tect M and Jieli paper test. To compare both of them, there was statistical significance between Pro-tect M cultivation within 45min and 10min (P<0.05), Pro-tect M cultivation 45min and Jie Li paper test (P<0.05). And there was not statistical significance between Pro-tect M cultivation 10min and Jie Li paper test (P>0.05).6. The comparison of cleaning effect of four cleaning methods: Detecting by Pro-tect M cultivation 10min: there was statistical significance between the norms cleaning group and 6min multi-enzyme soaking group (P<0.05), and 3min multi-enzyme soaking group (P<0.05), between 3min multi-enzyme soaking group and 6min multi-enzyme soaking and ultrasonic cleaning group (P<0.05), and 3min multi-enzyme soaking and ultrasonic cleaning group (P<0.05), respectively. Detecting by Pro-tect M cultivation 45min: there was statistical significance between 6min multi-enzyme soaking and ultrasonic cleaning group and other groups (P<0.05), and there was not statistical significance between other each two groups (P>0.05). Detecting by Jie Li paper test: there was statistical significance between 6min multi-enzyme soaking and the ultrasonic cleaning group with the norm washing group(P<0.05), and the 3min multi-enzyme soaking group(P<0.05). There was not statistical significance between other each two groups (P>0.05).Conclusions1. The cleaning effect was not affected when shortening the time of multi-enzymes soaking from 6min to 3min, with the implementation of cleaning norms of the endoscopic equipment and other cleaning procedures, but they are not very satisfactory.2. The cleaning effect was not affected when shortening the time of the ultrasonic cleaning time from 6min to 3min, when applying modified procedures of overlapping two steps of the ultrasonic cleaning and multi-enzyme marinating.3. The cleaning effect of the modified procedures irrespective of the action time of ultrasonic cleaning was 6min or 3min was better than the norm cleaning. The modified procedures could shorten the cleaning time and improve the effect. It was suggested to apply the modified procedures in cleaning the endoscopy equipment.4. The positive detection rate by the visual detection with five times magnifying glass and the white gauze experiment were lower than Pro-tect M test and Jieli paper test. The visual detection with five times magnifying glass and the white gauze experiment cannot evaluate accurately the cleaning effect after cleaning and can only be used to be the preliminary judge of the cleaning effect of endoscopic equipment.5. Pro-tect M test and jieli paper test had objective and actual detection effect and could be used as the terminal quality inspection. The Pro-tect M cultivation 10min and jieli paper test have the same detection level. The Pro-tect M cultivation 45min had the highest level, but with time-consuming and too high accuracy (protein residues <3 ug), could not be accepted easily.