London Bridge Hospital
27 Tooley Street London,
SE1 2PR
Tel: +44 (0) 20 7407 3100
www.londonbridgehospital.com
Pictured left:
Staff nurse
Mark Calnan loads
the Lancer AER
Pictured right:
Central
decontamination
manager
Susanne Chamberlain
with the Sterrad 100NX
Capital choice: London Bridge Hospital, part of HCA International, has a Thames-bank location
Pictured right:
Staff nurse John Garnett with boxed scopes for reprocessing
Back to the top
Staff nurse Jarek Kowalik loads the Lancer drying and storage cabinet
|
-
A best practice protocol including a combination of Lancer automatic endoscope reprocessors and ASP’s Sterrad
low-temperature gas plasma sterilizers is ensuring patient safety at one of London's leading private hospitals
 It’s the result of a team’s ‘can do’ attitude and it was the team that explained to Inside Hospitals how the system came about and how it’s delivering a highly professional, safety first service for its patients.
Overlooking the Thames and Tower Bridge, London Bridge Hospital is one of the capital’s most respected private hospitals and part of HCA International, recognised with national awards for achieving gold standard quality in healthcare.
Sharon Stringer, deputy outpatient manager (right),
and Anna Verge, outpatient sister
Across the hospital’s busy endoscopy department, ENT clinic and satellite units over forty scopes are in regular use and are now decontaminated and sterilized before being transported to the various facilities.
Sharon Stringer, deputy outpatient manager, explained: “We had a number of challenges: the volume of scopes we were processing, the high profile of BSE, and we were unhappy with sheathing. We looked further and enquired. And when the regulations for endoscope decontamination changed we decided we would lead rather than follow.
“ASP’s Wendie Love and Sarah Morgan were so supportive about the whole process and so open-minded. We now have a combination of decontamination and sterilization. We were definitely the first with this. The whole process means we can package-up the scopes.
“We decontaminate, dry, sterilize and package-up as if they are theatre goods - which is perfect for the satellite diagnostic and treatment centre at 31 Old Broad Street. It’s meant we’ve been able to extend our services and now have a purpose-built ENT treatment facility.”
Sharon added: “Once you’re aware there’s a better way of doing something you want to move on.”
 Outpatient sister Anna Verge said: “In endoscopy we’ve Lancer equipment. The first Sterrad machine was brought in for day surgery and last year we added the second.
“When scopes have been processed they’re in heavy duty polythene bags and packaged up in white boxes. They’re taken to the various departments around the main site in a transportation trolley. Two members of staff are with the trolley for safety reasons.
“When the consultant receives the scope it’s all packaged and has a tracer label. It looks much more professional and patients can see they’re clean scopes.”
Immediately the scopes have been used they are sprayed with Prepzyme XF and the channels flushed as appropriate to prevent mucus crust from forming. The scope is placed on the mat in its designated white box, which is placed in a clear polythene bag and loaded into a transportation trolley. Once the scope tracking form is completed the unit is ready to be returned for reprocessing.
After the used scopes have been removed the dirty containers and mats are reloaded onto the transportation trolley and taken to be reprocessed. Outpatient staff collect the boxes with the clean and dry scopes from endoscopy and transport them to CSSD, where the Sterrad machines are located, for sterilization.
Once sterilized the scopes are loaded onto the transportation trolley, and the process begins again.
Anna Verge added: “The system ensures we’re following best practice and giving the highest quality care to our patients. Scopes arrive in the consulting room wrapped in thick clear polythene so the patient can see the scope is clean and has not been touched.”
The endoscopy unit has a Lancer Fibro-Cleaner FC4 pass-through automatic endoscope reprocessor (AER) that can process up to four scopes of any make or model in around 30 minutes. Lancer’s machines achieved one of the highest technical performance results in the NHS Supply Chain’s AER Framework Agreement. Indeed, Lancer believes it has won nearly 50% of the UK’s AER orders since the Framework Agreement was introduced earlier this year.
The hospital’s AERs use Lancer’s Aperlan, a fast acting, non-toxic sporicidal disinfectant, based on active oxygen. The department’s staff are trained on the Lancer Academy course.
In the department’s clean room are two of Lancer’s popular FD8 drying and storage cabinets that quickly dry endoscopes inside and out using warm, sterile HEPA 99.999% filtered air. The scopes can be stored in the cabinet’s sterile conditions for up to 72 hours.
Phillip Deppeler, charge nurse endoscopy, who joined the team at London Bridge Hospital four years ago, is no newcomer to Sterrad equipment having worked with instruments that had been sterilized in the machines when he was a theatre nurse in Australia. Speaking in the new endoscopy suite, he said: “We transport the scopes around the hospital. Staff do a ‘dirty’ run and a ‘clean’ run. The scopes are well protected in a hard container.
 “We process all scopes through the Lancer washer-disinfectors and can store them for up to three days in the drying cabinets. Our involvement is up until they’re dry but we needed a solution to be able to take them off-site to our outpatient satellite units.”
In the endoscopy department Jarek Kowalik explained: “All the scopes have an initial manual clean. The Lancer machines are easy to use and the connectors easy to attach. The cycle’s 40 minutes on average, including blowing through with filtered air.”
On the clean side the scopes are disconnected and placed in the drying cabinets where they can be stored for up to three-days awaiting use.
Phillip Deppeller added: “In the end it wasn’t practical, due to space, to have the Sterrad units in endoscopy, so they’re in sterile services.
“It’s a very good solution for heat labile equipment. We’ve got a robust tracking and traceability system using Health Edge software. Outpatients keep a record of which scope is used on which patient. It’s best practice - the gold standard. Before they are used on a patient we can guarantee there are no bugs on them, rather than possible environmental bugs. We’ve had no complaints or infections.”
 Due to space restrictions in endoscopy, the two Sterrad gas plasma machines are located in the sterile services department, where London Bridge Hospital’s central decontamination manager, Susanne Chamberlain, explained: “Health & Safety and COSHH led everyone to move towards a solution in a closed environment that was not hazardous. As a group we were all involved in the selection. We visited a couple of hospitals that already had the Sterrad machines.
“We’ve the Sterrad NX and the 100NX - they’re also used for the sterilization of flexible scopes. They come out sterile and go off-site to the satellite units. The machines are fine, with a short cycle time. We’ve a contract in place for servicing and validation.”
The compact Sterrad NX, installed in 2005, offers speed and safety. It was amongst the first UK installations of the technology and the hospital quickly came to rely on it for low-temperature sterilization of medical devices before it was adopted for the use on flexible endoscopes.
The fastest low-temperature hydrogen peroxide gas plasma sterilizer available, its 28-minute cycle helps ensure fast turnaround for a wide range of instruments, including single-channel flexible endoscopes and semi-rigid ureterscopes. It provides the flexibility of having dry, packaged, sterile instruments ready whenever you need them. While it’s sited in SSD at London Bridge Hospital the compact Sterrad NX can be cart-mounted and only requires a simple plug-in to be operational.
Installed in 2008, the hospital’s Sterrad 100NX pass-through machine, offers the same low temperature sterilization with increased chamber capacity, processing two flexible endoscopes in just 42 minutes with the scopes fitted two per chamber and individually wrapped. Previously the hospital could process one scope per chamber - so not only is there a considerable time-saving with the 100NX but there is a large cost saving too - processing two scopes for around only 25% more than processing one, and processing two scopes in only a little over half the time it would have taken to process two in the smaller machine.
 Hydrogen peroxide residuals are non-toxic and non-carciogenic. Process by-products are water vapour and oxygen - eliminating the need for aeration or external ventilation.
Partially used cassettes can be reinserted to avoid wastage.
The 100NX’s ergonomic footpad allows hands-free opening and closing of the chamber door.
The final word goes to Sharon Stringer, who added: “We’ve never cut corners on it. We’ve got a ‘can do’ attitude - we take it seriously. We said ‘this is the problem’. It’s been a big investment. I’m very proud of how the staff have taken this on board and made it work. We’ve had to ‘nurse-lead’ this because of the speed that the consultants wish to work at.”
For more on Lancer AERs and drying cabinets, call 01223 861 665,
e-mail sales@lancer.co.uk or visit www.lancer.co.uk
For more on ASP Sterrad, call 01344 871081
or visit www.sterrad.com
|
