In 2006 I had the pleasure of touring a purpose built outsourced CSSD in Manchester, England. It was a fascinating tour, but the most amazing feature that stood out for me at the time, was the bank of automated instrument washers. I watched in amazement as the operator received the dirty sets, scanned the set’s barcode and loaded it into a pass through washer disinfector.
Many hospitals in South Africa have now installed washer disinfectors. It is often assumed that the washer is working correctly. Combinations of physical and chemical forces are required to remove soil and debris from surgical instruments. In order for a washer to disinfector to clean effectively it is critical that the spray arms rotate freely, that the water jet outlets are not clogged, the correct chemistries are used and the washer has been correctly loaded. All instruments placed in a washer should be disassembled, loaded in suitably meshed trays that are not overloaded. There are only 2 ways to make sure your washer disinfector is working properly and that is to visually inspect the instruments after they have been washed and to make use of test soils. A soil test provides evidence of cleaning and does not rely on human interpretation. The Browne STF load check is an example of an easy to use soil test that complies with ISO 15883 Washer-Disinfectors.