The gke Clean-Record® cleaning test system is used for validation and routine monitoring of cleaning processes. The indicators can be used in washer disinfectors (WD) and also in ultra sonic baths for the manual cleaning for all kinds of instruments. To test hollow instruments, a special hollow flow process challenge device (PCD) can be connected to the hose connection of minimal invasive surgical (MIS) instrument and endoscope carts. Cleaning process monitoring indicators can also be used on containers and transport carts and adhered directly on metal surfaces.
Surgical instruments are contaminated with various soils. Depending on the pre-treatment of instruments the adhesion may be different. Body fluids consist 75-85% of water soluble proteins and can be washed off with cold water.
Instruments should be cleaned with cold water directly after use before the soils can adhere and before disinfectants are used which are fixing soils.
The use of cleaning detergents is very important for the efficacy of cleaning processes if non water-soluble soils are contaminants. Only watersoluble soils can be washed off with water.
Fats and other non water soluble soils, e.g. lipids can only be washed off, if a cleaning detergent is used. Some cleaning detergents are alkaline and hydrolyse the non water soluble substances by using a high pH-value making them water soluble. Other cleaning agents have a neutral pHvalue containing enzymes. Both mechanisms can be combined in one cleaning detergent.
Cleaning detergents are optimized depending on the contaminations on the instruments. Therefore, the optimal cleaning agent has to be chosen accordingly. Instruments made of aluminiummagnesium corrode at high pH-values. The water quality (hardness, salt content) highly influences the effectiveness of cleaning detergents.
gke offers different cleaning process monitoring indicators for washer disinfectors which represent different challenge levels as proof of the cleaning efficacy. It is recommended to test all indicators at the same time together with the most difficult instrument sets as a preliminary test. For this evaluation an introduction pack is available which contains different indicators and three holders. Alternatively an introduction pack with multi-level indicators is also available which contains the three mostly used indicators in one indicator (see order information).
The indicator which has just been washed off completely in the WD-program and is also more difficult to clean than the most critical soil should be used for routine monitoring later on. For validation the results of the cleaning performance need to be compared with the results of the indicators to prove the „worst-case“ scenario.
Within the WD chamber there are completely different spray conditions caused by different reasons:
- Lower spray conditions can be found in the corners and at the centre of the spray arm axles.
- Loads create spray shadows.
- Instruments have areas that are difficult to reach, e.g. splits.
- Channels which have to be flushed have different flow through characteristics because of their dimensions.
These situations must be considered during testing by positioning the indicator holder and/or using a hollow flow PCD in the WD. Testing shall be carried out in different locations and the most difficult location should be selected for routine monitoring. Alternatively the indicators can be directly adhered on metal surfaces.
In addition gke offers four different test sheets to check ultra sonic baths. The indicators should be immerged in fluids vertically or horizontally to check the different intensity in mechanical force inside the volume of the liquid. It is recommended to use these indicators at least once a day in every program used to ensure that there are no changes of the process parameters.
For bedpan washers gke has developed a special cleaning indicator to check the efficacy of those processes. Other indicators are available to monitor laundry processes. Please see separate data sheets