Tristel Rinse Assure: Reducing TVCs down to zero at Neath & Port Talbot Hospital

Wednesday, 21 September, 2016

The Endoscopy Outreach Department at Neath & Port Talbot Hospital uses four QED Washer Disinfectors (WDs) to disinfect medical devices including bronchoscopes, gastroscopes, colonoscopes, cystoscopes and duodenoscopes. The quality of the water going into the washers had been tested in accordance with HTM2030.
In September 2013 a review of rinse water quality testing found endoscopy final rinse water issues. As a result of testing changes in February 2013 – from a three-day testing regime to the new five-day regime – the department was regularly exceeding the acceptable levels for rinse water. The average was in excess of 100 TVC’s (Total Viable Count) per 100ml of sample water.
Decontamination Manager Shirley Kivi explains: “A lot of remedial work had been done such as changing filters, using new flexible tubing and self-disinfecting the WDs with double doses of chlorine tablets, but water testing results did not improve. All the practical changes we could make, we made, but with no resolution.” After a chance meeting with Tristel, the hospital decided to trial their new Rinse Assure System.
Tristel Rinse Assure is a management system for rinse water in WDs. It provides a continuous supply of HTM 01-06 and EN15883 compliant rinse water. Tristel Rinse Assure doses low levels of Tristel’s patented chlorine dioxide chemistry into the water used during a WDs decontamination process, ensuring that all water delivered is of the highest quality.
Prior to the installation of Tristel Rinse Assure, full water samples were taken to three labs to independently assess the quality of the water that was supplied to the four QED WDs. All results showed high TVCs. On 11 April 2014, T.E.S.T. engineers installed one Tristel Rinse Assure to dose two of the four QED WDs, while the other two bays continued to operate with the existing filtered mains water configuration to act as control bays. Once the installation of Tristel Rinse Assure was complete, several high dose cycles were run to purge the WDs. Daily samples were taken by the hospital and sent to the three laboratories.
By 16 April and up to 13 May 2014, all T.E.S.T. water sample test results from the units using Rinse Assure showed zero TVCs. One of the labs took water samples from all four bays during the same period; these results showed that the non-Rinse Assure bays had high TVCs in excess of 100cfu. The Tristel Rinse Assure bays passed with no growth detected. Only five days after installation, Tristel Rinse Assure had reduced TVCs to zero.
The results continued to show the success of Rinse Assure – so much so that the hospital purchased a system before the trial had even finished. While the hospital also considered UV disinfection, eventually they decided against it as they were unsure how efficient it would be, and the installation and use of Tristel’s Rinse Assure was so simple. Soon after, a second Rinse Assure unit was installed at a new site, replacing an RO Water System. Most recently, a third Tristel Rinse Assure system was installed at Moriston Hospital; three hours after installation, water sample test results showed zero TVCs. Chlorine dioxide was dosed at 0.5ml/L.
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