enzymatic detergent test training

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

Contents

..follow all washer-disinfector and detergent manufacturer instructions and guidelines and all hospital policies/procedures regarding washer-disinfectors

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Remember to…

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.

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Purpose of the PINNACLE Enzymatic

Detergent Test

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

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Purpose of the PINNACLE Enzymatic Detergent

Test

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

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Do NOT use the PINNACLE Enzymatic Detergent Test for:

Factors involved in Mechanical Cleaning 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.

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Factors involved in Mechanical Cleaning

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Detergent Chemistry :

• Chosen for the soil type

• Use optimal detergent concentration

• Enzymes in the detergent must be active

Temperature:

Too hot • Blood coagulates and

becomes difficult to remove

• Enzymes may be inactivated

Too cold• fats cannot be dissolved• enzyme activity is

decreased

Wash Time:

Too short

• Detergent does not have enough time to remove soil

Mechanical Action: • Involves water

pressure, spray arm rotation and spray nozzle location

Verification of the Cleaning ProcessExpected Soils: Blood, Protein, Fats, Mucous

The first critical step of Infection Control is cleaning and decontamination of the instruments after use!

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• ANY retained soil on the instrument can protect microbes during sterilization.

• Adherences to cleaning procedures are imperative !!

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

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Verification of the Cleaning ProcessSo…What is CLEAN?

See reference section for more info.

ANSI/AAMI ST794 recommends:

- “Mechanical cleaning equipment should be tested upon installation, weekly (preferably daily) during routine use, and after major repairs”.

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Verification of the Cleaning ProcessThe Recommendation

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.

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.

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Verification of the Cleaning ProcessWhen to use the test- how often?

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How to use the PINNACLE Enzymatic Detergent Test

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.

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

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Placement in Washer-Disinfector Test Device has to hang freely, without the pads being

obstructed

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In 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.

Placement in Washer-Disinfector Test Device has to hang freely, without the pads being

obstructed

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On Racks …

…away from spray arm

Hook the test around the perimeter of the rack, do not obstruct the spray arm movement

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Wrong or Incorrect Placement in Washer-Disinfector

Test pads are obstructed


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.

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Interpretation of Results:

- Remove strip from holder, ensure that you hold strip with the PAD SIDE UP!

- Interpret the results by comparing the color of the LARGER indicator pad to the smaller internal color standard.

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PASS: Indicator Pad is lighter than color

standard

CAUTION:Approaching FAIL

conditions

FAIL : Indicator Pad is similar to or darker than color standard

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.

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PASS FAIL

dry

wet

Record the appropriate results in a log sheet

- Download the log sheet from the Serim website at www.serim.com 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

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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’s performance and should be investigated according to the hospital’s policies and procedures.

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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 www.serim.com.

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What does a FAIL result indicate?

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Clogged spray nozzles

Cracked and leaking spray arm

What does a FAIL result indicate?Automatic washer – mechanical failures

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What does a FAIL result indicate?

• 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.

What does a FAIL result indicate?Chemical delivery problems

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Crack in tubing

Plugged or kinked delivery tubing or expired detergents

Leaky pump tubing

1) AAMI TIR30:2011, A compendium of process, materials, test methods, and acceptance criteria for cleaning reusable medical devices. www.aami.org

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). www.astm.org

3) CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. www.cdc.gov

4) ANSI/AAMI ST79:2010/A2:2011 ‘Comprehensive guide to Steam Sterilization and Sterility Assurance in Health Care’ . www.aami.org

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References

http://www.aami.org/

http://www.astm.org/

http://www.cdc.gov/

Download more information at www.serim.com- Reference Guide- Test Record Log Sheets- Instructions for Use wall chart

PINNACLE™ Enzymatic Detergent TestPatent pending.

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Serim Website Information

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