Pinnacle EDT Training


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Pinnacle EDT Training

  1. 1. Training 2012
  2. 2.  Purpose of the PINNACLE™ Enzymatic Detergent Test Factors involved in automated cleaning Verification of the cleaning process How to use the PINNACLE™ Enzymatic Detergent Test What does a FAIL result indicate? References Test your skills
  3. 3. ..follow all washer-disinfector and detergent manufacturer instructions and guidelines and all hospital policies/procedures regarding washer-disinfectors  3
  4. 4.  The test is to be used to monitor the effectiveness of the washer-disinfector’s instrument cleaning cycle when using enzymatic detergent. Recommended use: once daily in each washer-disinfector The test will not react to other wash cycle additives such as rinse aids or lubricants. 4
  5. 5.  The indicator pad detects enzymatic detergent concentration and activity The test is also sensitive to the medical washer- disinfector’s: - mechanical action - detergent contact time - temperature of the wash cycle 5
  6. 6.  testing bedpan or cart washers that utilize lower detergent concentrations and/or shorter cycle times plastic ware wash cycles using low temperature settings and/or shorter wash cycles wash cycles using neutral detergents NOT containing enzymes 6
  7. 7.  A large portion of the cleaning action is dependent on the detergent chemistry used. When using neutral enzymatic detergents exposure time as well as the wash temperature plays an important role in the action of the active enzyme on the contaminating soils. 7
  8. 8. Wash Time: Mechanical Action:Too short • Involves water pressure,• Detergent does not have spray arm rotation and enough time to remove soil spray nozzle locationTemperature:Too hot Detergent Chemistry :• Blood coagulates and • Chosen for the soil type becomes difficult to remove • Use optimal detergent• Enzymes may be inactivated concentrationToo cold • Enzymes in the detergent• fats cannot be dissolved must be active• enzyme activity is decreased 8
  9. 9.  The first critical step of Infection Control is cleaning and decontamination of the instruments after use! • ANY retained soil on the instrument can protect microbes during sterilization. • Adherences to cleaning procedures are imperative !! 9
  10. 10.  Definitions from Guidelines and Standards: - AAMI TIR 301: Removal of contamination from an item to the extent necessary for further processing or the intended use. - ASTM E23142: Removal of foreign materials, including organic soil (for example, protein) and microorganisms from medical instruments. - CDC Guideline 20083: Removal of visible soil (e.g., organic and inorganic material) from objects and surfaces See reference section for more info. 10
  11. 11.  ANSI/AAMI ST794 recommends: - “Mechanical cleaning equipment should be tested upon installation, weekly (preferably daily) during routine use, and after major repairs”. Verification of “visibly clean” may be difficult when inspecting complicated instruments after a cleaning cycle. The washer-disinfector’s functionality can be verified by using a PINNACLE Enzymatic Detergent Test. 11
  12. 12.  Testing equipment upon installation is not enough. Weekly - preferably daily - monitoring of your washer- disinfectors efficiency is not just recommended, it is necessary to ensure adequate cleaning results. Disinfection and sterilization depend upon a successful cleaning process. 12
  13. 13. Test Device Components: - Test Strip containing the Indicator Pad and the Internal Color Standard. - Comparison of Indicator Pad color with Internal Color Standard determines a PASS or FAIL condition - Test Strip Holder with hook to secure test device onto racks or baskets in washer. 13
  14. 14.  Preparation of test - Remove as many test strips from bottle as needed - Write date/time, washer ID and location on strip - Test devices should be used within 8 hours of preparation 14
  15. 15.  Placement in Washer-Disinfector Test Device has to hang freely, without the pads being obstructedIn Baskets… • Use the hook to attach the PINNACLE test device to the handles or wire openings of baskets • Place baskets on middle and bottom rack • These locations represent potential problem areas for decontamination and are recommended for use in evaluating the efficacy of the wash cycle. • In rare occurrences, high impingement from the upper spray arm may damage one or both of the test pads on the strip. 15
  16. 16.  Placement in Washer-Disinfector Test Device has to hang freely, without the pads being obstructedOn Racks Hook the test around the perimeter of… the rack, do not obstruct the spray arm movement …away from spray arm 16
  17. 17.  Wrong or Incorrect Placement in Washer-DisinfectorTest pads are obstructed 17
  18. 18.  The Serim PINNACLE test incorporates a dyed protein that is bound in the indicator pad. During the “Instrument” wash cycle the color of the indicator pad will change in response to detergent concentration and exposure time, enzyme activity, wash cycle temperature and mechanical action. 18
  19. 19.  Interpretation of Results: PASS: Indicator Pad is lighter than color - Remove strip from holder, standard ensure that you hold strip with the PAD SIDE UP! - Interpret the results by CAUTION: comparing the color of Approaching FAIL conditions the LARGER indicator pad to the smaller internal color standard. FAIL: Indicator Pad is similar to or darker than color standard 19
  20. 20.  It is essential that either both pads are wet or both pads are dry when interpreting results. In this case, for easier interpretation, pads can be wetted with a small amount of water. PASS FAIL dry wet 20
  21. 21.  Record the appropriate results in a log sheet - Download the log sheet from the Serim website at or use your own - Record date/time, washer ID and operator on the log sheet and attach the test strips to the record. - The color of reacted pads will not change if kept away from heat and light - A reacted Serim PINNACLE enzymatic detergent test strip can be kept as a record for up to 2 years for auditing purposes 21
  22. 22. To monitor each washers efficiency over time use PINNACLE tests : - with the same wash cycle (e.g. “Instrument”; “MIS”) - with the same enzymatic detergent - at the same locations in the washerCompare the results of the reacted test pads over timeA darkening of the indicator pad color can indicate a drift in the washer’sperformance and should be investigated according to the hospital’spolicies and procedures. 22
  23. 23.  Check your washer! Since a washer’s cleaning efficiency is dependent upon mechanical action, detergent chemistry, time and temperature, check for the following possible problems: - Are spray arms moving freely, are nozzles clogged? - Is the detergent dosage as recommended by manufacturer? - Is the detergent expired or close to the expiration date? - Is the wash cycle time and temperature adequate? - Is an enzymatic detergent being used? For more information, download the PINNACLE Reference Guide from Serim’s website at 23
  24. 24. Clogged spraynozzles Cracked and leaking spray arm 24
  25. 25. • Hard water can clog and damage pipes and ultimately cause leaks.• Calcium build-up in the washer could immobilize spray arms.• Debris from surgical instruments can accumulate in the washer and eventually end up in spray nozzles. 25
  26. 26. Crack in tubingLeaky pump tubing Plugged or kinked delivery tubing or expired detergents 26
  27. 27.  1) AAMI TIR30:2011, A compendium of process, materials, test methods, and acceptance criteria for cleaning reusable medical devices. 2) ASTM E2314-03(2008) Standard Test Method for Determination of Effectiveness of Cleaning Processes for Reusable Medical Instruments Using a Microbiologic Method (Simulated Use Test). 3) CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. 4) ANSI/AAMI ST79:2010/A2:2011 ‘Comprehensive guide to Steam Sterilization and Sterility Assurance in Health Care’ . 27
  28. 28.  Download more information at - Reference Guide - Test Record Log Sheets - Instructions for Use wall chart The Competency Test can be found on the next slides. PINNACLE™ Enzymatic Detergent TestPatent pending. 28
  29. 29.  Read each question carefully and answer by clicking the appropriate answer button. Navigate back and forth between pages by clicking the arrow on the bottom right or left. Once you hit the ”Submit” button your test will be sent and answers cannot be changed. Answer at least 4 of the 6 questions right and you will receive a certificate of completion. 29
  30. 30. ANSI/AAMI ST794 recommends: “Mechanicalcleaning equipment should be tested…  annually  whenever something seems wrong  upon installation, weekly (preferably daily) during routine use, and after major repairs 30
  31. 31. Besides mechanical action, other factorsinvolved in washer-disinfector cleaning are:  Time  Temperature  Detergent Chemistry 31
  32. 32. The PINNACLE indicator pad is a detector of…  concentration of neutral detergents containing no enzymes  enzymatic detergent concentration and activity  the presence of rinse aid in the rinse cycle 32
  33. 33. A PINNACLE Test failure could indicate that:  No enzymatic detergent was present  Cycle time was too short for sufficient cleaning of instruments  Wrong wash cycle used, e.g. plastic ware cycle with low temperature setting and short wash time 33
  34. 34. When interpreting results, the PINNACLE enzymaticdetergent test …  contains an external color standard  can be read wet or dry  can be kept as a record for auditing purposes 34
  35. 35. True or False:Disinfection and sterilization cannot be assuredunless cleaning process is successful.  True  False 35