The Principles of Medical Device Decontamination

Biofilm build up will also occur in washer disinfectors and microbiological monitoring of the water should be carried out. Where factory testing has been carried out by the manufacturer and incomplete draining and disinfection has taken place then biofilms may become established and may be present upon delivery of the washer disinfector (or other such tested equipment). Where manufacturers have factory tested equipment prior to delivery they should provide certification of decontamination and assurance that the components do not contain microbial contamination. The interface between the water supply and equipment with the decontamination unit is important. This is particularly the case where lengths of flexible pipework are used to connect equipment such as the washer disinfectors. If the disinfection regimes of the treatment system and the washer disinfector do not allow water or chemical to pass through this section of flexible hose, then biofilm will develop. Where microbiological monitoring is indicating that the water quality is not acceptable then regular replacement may be the only answer to long standing biofilm problems which may be present both up and down-stream. In designing a system or re-engineering an existing one, limit the length of flexible hoses by taking the water treatment flow and return points (of the continuous loop) as close to the washer disinfectors as possible. Keep flexible hoses as short as possible and allow them to naturally drain. Alternatively, flexible hoses should be designed out. In some circumstances additional ultra-filtration (bacterial retention filters) may be needed near the point of use or internally within the EWD to prevent the microbial contamination of the final rinse water. To facilitate problem solving and tracing of pipework routes, schematic diagrams of the layout of the water system to illustrate plant and equipment, including servicing and control valves should be available. When microbiological problems are reported then a check list can assist in analysing the systems (see Table 6.1)

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