Audit of nasendoscope disinfection practice

Street, I.; Hamann, Jonas Janner; Harries, Meredydd

doi:10.1016/s1479-666x(06)80015-6

Cited by 12 publications

(18 citation statements)

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“…The use of chlorine dioxide wipes has been shown to be cost saving compared with the use of disposable sheaths. 3 The manufacturer of Tristel wipes (Tristel, Snailwell, UK) claims its system provides thorough and safe sterilisation of nasendoscopes. However, there are no clinical reports in the literature to date that evaluate the efficacy of this system in a clinical setting (as confirmed using MEDLINE ® and the keywords 'Tristel wipes', 'nasendoscopes disinfection', 'chlorine dioxide' and 'wipes').…”

mentioning

confidence: 99%

Evaluation of disinfection of flexible nasendoscopes using Tristel wipes: a prospective single blind study

Tzanidakis

Choudhury

Bhat

et al. 2012

annals

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INTRODUCTIONThe otorhinolaryngology department at Northwick Park Hospital uses the Tristel wipes system for cleaning nasendoscopes in the outpatient clinics. This system uses chlorine dioxide as its only disinfectant. The manufacturer claims the system provides safe sterilisation of nasendoscopes. However, there appear to be no reports in the literature to date that evaluate the efficacy of this system in a clinical setting. The aim of this study was to evaluate the 'in use' efficacy of Tristel wipes in decontaminating nasendoscopes and to identify any significant contamination between cleaning and usage. METHODS A total of 31 cleaning episodes were performed. Each cleaning episode included two swabs after cleaning the scopes, one from the tip and the other from the handle. Another two swabs from the same areas were also taken before application to the patient. The microbiology unit evaluated all swabs for bacterial, fungal and mycobacterial growth. RESULTS Overall, 123 swabs from 31 cleaning episodes were tested. None of the swabs taken from the tips (n=31) or handles (n=31) after cleaning with Tristel wipes developed any organism growth. Furthermore, none of the swabs taken from the tip of the scopes before using on patients (n=31) developed any growth. Of the 31 swabs taken from the handle before use, 3 developed significant staphylococcal growth. CONCLUSIONS In our study, the 'in use' efficacy of Tristel wipes in cleaning the scopes of bacteria, fungi and mycobacteria was 100%. Attention to hand hygiene and the use of gloves should be considered when handling the cleaned scopes to minimise the risk of contamination between cleaning and application to patients.

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confidence: 99%

Evaluation of disinfection of flexible nasendoscopes using Tristel wipes: a prospective single blind study

Tzanidakis

Choudhury

Bhat

et al. 2012

annals

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“…On a cost basis, Street et al have shown that the chlorine dioxide wipes are the most cost-effective disinfection technique when compared to sheaths and automated reprocessing machines. 12 However, this technique puts the highest burden on medical staff in terms of adequate disinfection.…”

Section: Discussionmentioning

confidence: 99%

Disinfection of flexible fibre-optic endoscopes out-of-hours: confidential telephone survey of ENT units in England – 10 years on

et al. 2013

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“…The mean time was calculated from timing a series of five cycles for each of the three methods (Steris System 1 AER, Steris Canada Inc.; Cidex OPA AER, Advanced Sterilization Products; and the Revital‐Ox soak, Steris Canada Inc.). Labor data for the Tristel Trio Wipes System (Tristel plc) was taken from the literature . Because the Revital‐Ox (Steris Canada Inc.) soak and Tristel Trio Wipes System (Tristel plc) are performed in the clinic space; transportation to the decontamination area within the clinic was used rather than requiring transportation to the central processing department (CPD).…”

Section: Methodsmentioning

confidence: 99%

“…Nasopharyngoscopy repair and/or replacement data for the Steris System 1 AER (Steris Canada Inc.) and the Cidex OPA AER system (Advanced Sterilization Products) were obtained retrospectively by reviewing hospital data for the 2013 and 2014 fiscal years for hospital C and hospital S. Data for repairs with the Tristel Trio Wipes System (Tristel plc) was taken from existing published literature. Street et al reported no damage from processing with the Tristel Trio Wipes System (Tristel plc) with 1,250 reprocessing cycles; this was used as a conservative estimate for the minimum number of events before a repair would be required for the wipe system . Repair information was not available for the Revital‐Ox system (Steris Canada Inc.); therefore, because it is a manual reprocessing technique, the NP repair rate was assumed to be the same as the Tristel Trio system (Tristel plc).…”

Section: Methodsmentioning

confidence: 99%

“…Labor data for the Tristel Trio Wipes System (Tristel plc) was taken from the literature. 7,8 Because the Revital-Ox (Steris Canada Inc.) soak and Tristel Trio Wipes System (Tristel plc) are performed in the clinic space; transportation to the decontamination area within the clinic was used rather than requiring transportation to the central processing department (CPD). Technician time was rounded to the closest 0.5 minute.…”

Section: Cost Minimization Analysismentioning

confidence: 99%

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The cost of being clean: A cost analysis of nasopharyngoscope reprocessing techniques

Sowerby

Rudmik

2017

The Laryngoscope

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Objective Nasopharyngoscopes are an essential instrument to otolaryngologists; reprocessing them in a high‐value manner is paramount. Although several different techniques for reprocessing exist, all methods yield similar effectiveness. Given equivalent effectiveness outcomes, a cost analysis of four nasopharyngoscope reprocessing techniques was performed. Study Design Cost‐minimization analysis. Methods Four techniques were evaluated: 1) an automated reprocessor using peracetic acid (Steris System 1; Steris Canada Inc., Mississauga, Canada), 2) an automated reprocessor using ortho‐phthalaldehyde (OPA) (Cidex OPA; Advanced Sterilization Products, Johnson and Johnson Inc., Markham, Canada), 3) a manually performed accelerated hydrogen peroxide bath (Revital‐Ox; Steris Canada Inc.), and 4) a chlorine dioxide wipe (Tristel Trio Wipes System; Tristel plc, Cambridgeshire, U.K.). The costing perspective was a third‐party payer that was adjusted to 2014 Canadian dollars. The base‐case scenario used an annual volume of 4,153 reprocessing events in a tertiary care setting, and a scenario analysis assessed the impact of volume and capital expense. Results The cost per reprocessing event for the Steris (Steris Canada Inc.) automated endoscope reprocessing, Cidex OPA (Advanced Sterilization Products), Revital‐Ox (Steris Canada Inc.), and Tristel Trio Wipes (Tristel plc) were $20.58, $14.20, $9.57, and $13.14, respectively. Scenario analysis demonstrated the Tristel Trio Wipes System (Tristel plc) was the least expensive method in practices with low reprocessing volumes (a threshold of less than 6 events per day, or 22 per week), whereas the Revital‐Ox (Steris Canada Inc.) system was least expensive at higher volumes and became substantially more so as volumes increased. Conclusion A manual accelerated hydrogen peroxide bath offers the least costly approach to nasopharyngoscope reprocessing. The convenience and portability of the Tristel Trio (Tristel plc) system may be a good alternative for low reprocessing volumes, or when rapid turnaround is necessary. Level of Evidence NA. Laryngoscope, 128:64–71, 2018

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Audit of nasendoscope disinfection practice

Cited by 12 publications

References 11 publications

Evaluation of disinfection of flexible nasendoscopes using Tristel wipes: a prospective single blind study

Evaluation of disinfection of flexible nasendoscopes using Tristel wipes: a prospective single blind study

Disinfection of flexible fibre-optic endoscopes out-of-hours: confidential telephone survey of ENT units in England – 10 years on

The cost of being clean: A cost analysis of nasopharyngoscope reprocessing techniques

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