Single-use and multiple-use of Medical Devices
Paper by M. Simmons (Chair of All Wales Decontamination Advisory Group) and and Pete Phillips (Director of SMTL).
The Welsh Decontamination Committee (WDC) have been asked on a number of occasions to provide advice regarding single use items. The questions are generally:
- Does single-use imply single use within a determined period of time on more than one patient?
- Can the device be used more than once on a single patient?
This paper [PDF] attempts to give some advice in this area.
Endoscope contamination and rinse water TVCs
Pamela Ashman, Paul Hay, Emma Lindsay, Fara Shadroo Joanna Ford and Pete Phillips
October 6th 2015
The link between contaminated endoscopes and outbreaks of infection (both genuine outbreaks of infection and pseudo-outbreaks where positive samples are taken from patients not exhibiting clinical symptoms of infection) has long been established (Srinivasan et al., 2003 and Wang et al., 1995). Failure of procedures can cause contamination (Moses and Lee 2004) and monitoring bacterial levels in rinse water can be a useful indicator of system or technique failures (Leung et al., 2003). The Choice Framework for local policy and procedure (CFPP 01-06) and the equivalent policy in Wales (WHTM 01-06) states that less than 10 colony forming units (or CFUs) of bacteria detected in 100ml of rinse water is considered acceptable. This figure is frequently referred to as the TVC (total viable count).
However, the relationship between rinse water CFU levels and endoscope contamination is still unclear - does a high level of rinse water CFUs correlate with contamination of the endoscope itself?
Fluid flow accuracy of syringe drivers
Gavin Hughes, Joanna Ford, Pete Phillips
Syringe drivers are used for controlled administration of fairly small quantities of drugs. They can be set at a particular flow rate or controlled by the patient/healthcare professional in the case of analgesia. This article focuses on the accuracy of flow from syringe drivers that are set at a particular flow rate. Manufacturers often make claims regarding the flow rate accuracy of their products but they do not always stand up to the scrutiny of laboratory tests.
Factors that could potentially affect the accuracy of flow rate in syringe drivers could include the temperature of the medication (increased temperatures decrease the viscosity of fluids) (Capes et al., 1997) or the height of the syringe driver compared with the patient (Donald et al., 2007).
This paper sets out to investigate flow patterns and accuracy using one model of syringe driver over the course of an administration period.
Speciality needles - an update
Joanna Ford and Pete Phillips
22 June 2015
Historically, spinal needles have been used for a wide range of non-spinal procedures where regular hypodermic needles are not long enough. However, changes to the connectors on spinal needles in the near future mean that this will no longer be possible. This paper aims to explain the background and rationale for the proposed changes as well as presenting the current options for health care professionals who must find alternatives to spinal needles for non-spinal procedures.
Peri-operative bodywarming paper published in Journal of Anaesthesia
A review entitled 'Peri-operative warming devices : performances and clinical application' has been published in collaboration with Mark Harper and John Martin. Click on the citation below to view the abstract.