Authors (including presenting author) :
Chan KL(1), Got ML(1), Chau VK(2)
Affiliation :
(1)Endoscopy Center, United Christian Hospital,(2)Family Medicine and Primary Healthcare Department
Introduction :
Outbreak of endoscopes-transmitted infections continues to be challenging. Endoscopes reprocessing serves as a gatekeeper from the outbreak. It consists of mechanical cleaning of external and interior channels including brushing and flushing of water and detergent. Due to laborious procedures and occupational safety and health (OSH) issues, ball brush channel cleaner is designed as a new device for manual cleaning and brushing. Adenosine triphosphate (ATP) is used to indicate the presence of human blood and other tissue fluids.
Objectives :
The aim of this study is to compare the cleaning effectiveness between ball brush and traditional channel cleaner by using ATP bioluminescence.
Methodology :
ATP level is measured on rinsate from suction-biopsy (SB) channels of gastroscopes after manual cleaning with either ball brush or traditional brush. Time spent for both methods was also recorded. The difference of ATP level of ball brush and traditional brush was compared using Wilcoxon signed-rank test. Total 60 samples were taken by convenience sampling during March and April 2019.
Result & Outcome :
After collecting 60 samples, 26 out of 30 gastroscopes using traditional brushes for cleaning achieved the target benchmarks of < 200 RLUs. The median ATP was 40 RULs and median time used was 52.2s.
27 out of 30 gastroscopes using ball brushes for cleaning has also achieved ATP level < 200 RULs. The median ATP for ball brush group was 43.5 RULs and median time spent was 20s. By undergoing the data analysis with Wilcoxon signed-rank test, it showed that the ATP difference between two methods has no statistically significant difference but the time used for ball brush is significantly shorter than that of traditional brush.
In term of cleaning effect represented by ATP level, ball brush channel cleaners can be the alternative tool to traditional brushes. The study result is promising and aligned with international evidence. For the time spent on brushing channels, ball brush is more efficient than traditional method (20s vs 52.2s). By decreasing the intensive manual brushing action and operator-dependent variation, ball brushes can facilitate endoscope reprocessing and potentially replace traditional brushes for cleaning other types of endoscopes such as colonoscopes as a usual practice.
