Disinfecting regimes

[Ian Wilde]

Hi,

Just wondering what everyone's disinfecting regimes may be.
For instance, our machines go through an auto heat before the day starts and then a heat after every patient.
We do a degreasing Sporotal once a week.

I'm looking to suggest dropping the auto heat first thing.  It's one of those things where it just always the way its been done (before my time!)

[Garry]

We disinfect after each treatment with heat/citric only.  Twice per week equipment also receives a heat disinfection combined with our ring main disinfection.  We allow a maximum of 48 hours between disinfections so equipment used last thing on Saturday is just run up as normal on Monday mornings.  I think the 48hr limit is historical though we did perform microbiological testing some time ago to confirm that RA guidelines for water quality was still being met.

Satellite units without a central thermic disinfection are just disinfected after each treatment.

Home patients disinfect after each treatment and between treatment if they have a two day break.

[Ian Wilde]

Cheers Garry.

[fraser gilmour]

We discontinued the historical early morning disinfection a few years ago, the machines are set to come on and do an automatic disinfection every day at 10 am unless they are in use, so that the machines not in use get a regular disinfection also. Machines in use will get a disinfection after each treatment according to our policy. We do set an auto disinfection on Sunday for all machines. Once a week all our machines do a hot rinse integrated with the RO loop cycle to sanitise the connection pipework. Bleach disinfection is done once per week also.
Our home patients disinfect the machines pre and post treatment, RO is thermally disinfected once a week, but not integrated with the machine.

[Ian Wilde]

Good idea with the 10am disinfection setting Fraser.

[Chris Bates]

Hi,
We heat disinfect first and last thing but we only rinse between patients, except for isolated machines which are heat disinfected.
I think Kings used to do the same.
Does anyone else not disinfect between patients ? Or do you know of anyone else ?
Chris

[KevinJGibbs]

Hi Ian,

Here in Newcastle we heat citric the machines after each treatment.
Potable WRO in house are cleaned with Dialox once a month and Citric and Alkaline cleaned 3 monthly. (this is also the case for home patients).
The Water system loops are heat cleaned once a week and WRO' chemically cleaned every six months!

Hope this is the info you're after.

Cheers

Kevin

[Ian Wilde]

Hi all,

Quite surprised this thread got a second chance some 4 years on from the original posting :-)

Just to update - we opted to drop the morning disinfection on all of our machines with a heat with citric happening after every treatment.  Once a week a Sporotal/Hypochlorite disinfection is done.

Auto heat on our machines is now set for 10am on Tuesdays and Fridays only.  This catches any machines that may not have been used on a patient.  We have the 72 hour warning enabled on our 5008 machines.

We now save a fair chunk on the purchase of Citrosteril and the use of water and electricity.

[Chris Bates]

We haven't disinfected between patients since before I arrived 12 years ago, and this is being reviewed.

Although I always felt uncomfortable with the rinse only regime, when challenged as to why by one of the consultants, I found it difficult to define what the actual risk is.
It seems any risk would involve "A series of unfortunate events"

1. patient 1 needs to have a BBV.

2. the BBV needs to pass through the dialyser membrane from the blood into the dialysis fluid.

3. the BBV needs to get to the fresh dialysis fluid side of the hydraulics despite being rinsed for 9 minutes.

4. the BBV needs to pass back through the dialyser membrane from the fluid side to the blood side for the next patient.

Any thoughts

[Ian Wilde]

I think there are far more ways to pick up HBV that have more chance of happening than cross contamination from the INSIDE of the machine.