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Hospital visitations of the Dutch Health Care Inspectorate in 1999 showed the cleaning and disinfection procedures in endoscopy departments to be neither completely validated nor integrated as a part of a quality system. One reason that insufficient attention was paid to the validation of the cleaning proces was the nonavailabilityof a standard validation test for measuring cleaning efficiency. A cleaning test needs to be simple and easy to perform in hospital practice. This report describes a test using a surrogate device to mimic the channelsystem and valves of a real endoscope. In the test the surrogate endoscope was soiled with an compound mixture of blood proteins and mucus, which served as a model for practical conditions. Tests showed that preparation, application and verification of the test soil needed a thorough validation. The application of the method in 17 hospitals proved to be feasible and showed that it was able to discriminate between different washing procedures such as those using a precleaning step and warm or cold cleaning processes. This method allows optimisation of critical parameters for each individual washing proces, for instance, after maintenance or installation of the washing machine or after a defect has been remedied. |
