Our facilities Washer/disinfector cycle is approximately 50 minutes long and many times we run into problems when trays are needed that are still in the washer. Is there any way to shorten the wash time without compromising the cleanliness of the instruments?
Here I would like to first say that if there are trays in the washer that are needed for cases, your facility…
A) Probably needs to increase the inventory of those trays (how a facility can expect to do 15 carpal tunnel cases etc… in a limited amount of time with only 5 trays is ridiculous. The first 5 patients get properly washed and terminally sterilized trays, the remaining 10 don’t? Where is the continuity of care here?)
B) If you do have sufficient inventory, yet still seem to have trays that are needed for cases in the washer, then someone needs to speak to the OR scheduling department. Obviously cases are being booked too close together.
C) If scheduling nor insufficient inventory are the cases then, trays are not being delivered to decontamination from the OR in a timely fashion, so I suggest you speak to the Nursing Director in the OR explain your predicament. Instruments that are allowed to sit with debris on them are harder to clean and more prone to corrosion.
If any of the above factors are the reason trays are still in the washer when they are needed I would also suggest you get your infection control department involved in this problem, since they will be your best advocates here.
When it comes to shortening the time instruments are in the washer/disinfector, the only possible place I can see doing that is in the dry time part of the wash cycle, and doing it there will necessitate you employing some chemistry help before hand. Instrument manufacturers, as well as washer/disinfector and cleaning chemistry manufacturers validate the cleaning parameters stated in their Instructions For Use. When you follow the IFU you are doing so to ensure the efficacy of your cleaning process. If the IFU states that you should run said instruments in the ultrasonic for 20 minutes and you do not do so, you are processing the instruments off label. This holds true for the automated washing of your instruments. If you machine is validated pre-wash time is 4 minutes and the validated wash time is 10 minutes and you remove the pre-wash all together and shorten the wash time by 5 minutes are you following the IFU?
I stated before that you can shorten the wash cycle in the dry time part of the total cycle but you would need the help of chemistry to do that, so let me explain. If you add a rinsing aide ( http://www.potomaclabs.com/deconex-64.php ) in the final thermal rinse of your wash cycle you can lessen your dry time. Rinse aides are basically made of surfactants and lubricants, the introduction of a rinse aide in the rinse water cause the water to bead off surfaces while mildly lubricating the instruments. This means by the end of the thermal rinse your instruments will not be as wet and you can cut the dry time up to 50%. Having dry instruments is important at the end of a wash cycle to help prevent corrosion of the instruments this not only uses a lot of energy but also is one of the dry time can be one of the longest parts of the wash cycle. The only remedy for that is to make them “less wet” before hand and to do that you need a rinse aide.