Authors (including presenting author) :
Fong YL (1), Fung HY(1), Wong WK (1), Yan KH (1), Chan PT (1), Yeung KW (1), Wai SMG (2), Fung PSH (2), Kan CH (3), Cheung SFE (4), Li, SW (5), Au Yeung KHS (6)
Affiliation :
(1) Specialist Outpatient Department (SOPD), Pok Oi Hospital (2) Facility Management, Poi Hospital
(3) ICN Team, NTWC
(4) IT Team, Pok Oi Hospital
(5) EMSD Team, Pok Oi Hospital
(6) Foreman Team, Pok Oi Hospital
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Introduction :
Endoscopes are medical devices which required high-level disinfection before and after use. The medical devices should be cleaned and disinfected to ensure they are safe to use. In SOPD POH, standard operating procedures have been developed.In current practice, the high-level disinfection of endoscopes is carried out by AERs, it widely used in the ENT clinics to reprocess endoscopes and accessories. Due to service expansion, the daily utilization rate of endoscopes are facing increasing trend by 285%. Therefore, ENT clinic staff have to handle around 60 endoscopes daily. There were several problems identified: 1. All handling procedures were taken place in the limited space (~10m2) of same working area, mixing up clean/dirty zone. 2. The endoscope storage cabinet was too small. 3. The record was kept in thermal paper format, staff required to validate the endoscope being disinfected.
Objectives :
1. To well design the working area by separation of clean and dirty area even in limited space 2. To set up two more AER machines & two Smartline’s Rotascope Cabinets with 72 hours sterilization with using CBV funding. This maximizes endoscope turnover & storage up to 36 numbers in 2 cabinets, including electronic tracking system and standard Pass Through cabinet with toughened glass front and rear door, electronic door locking as well as data system. 3. To install a “DSD” Data Management Software including wall mounted computer to monitor the completeness of AER cycle and barcode scanner kit to replace manual data entering 4. To organize comprehensive training & audit to all staff working in ENT clinic
Methodology :
In order to facilitate ENT clinic service expansion, the renovation and improvement work was conducted from December 2017 to April 2018. It was fully supported by the top management; the annual plan bids for renovation/improvement work around 1.6M (including all OPD clinics in POH) while the ENT renovation & improvement work only costed $280,000. It was relatively low cost. The plan was well discussed with all stakeholders including ENT Chief of Service (COS), Facility Management team, ICN team, IT team, EMSD and hospital foreman.
Result & Outcome :
Firstly, the existing working area was divided into two separate rooms, the AER room and equipment room, dirty area and clean area are well defined, so as to avoid cross-contamination. Secondly, two Smartline’s Rotascope Cabinets were installed which provided a sterile environment for maximum 36 endoscopes up to 72 hours; it reduces manpower and costs. In addition, the endoscope reprocessing record labels could be generated upon taking out the endoscopes from storage cabinets. Staff could monitor the storage capacity and observe the validity of endoscopes. The enhancement work was highly appreciated by Quality and Safety (Q&S) team during Patient Safety Walk Round in September 2018. Small amount of budget can have a high standard with quality endoscope storage and AER cycle monitoring. The new workflow and related handling procedures were prepared & uploaded in the SOPD intranet for staff information. These include cleaning & safety checking procedure of endoscopes, handling of AER with using safety checking system and handling of endoscope in and out from storage cabinets. All staff were briefed for the workflow and passed the audit prior working in ENT clinic. The result of enhancement in Endoscopes storage and AER cycle monitoring is encouraging. There are zero incident after renovation and service resumed in ENT clinic. All doctors, nurses and supporting staff welcome the improvement work. The way forward is to share these good practices (precise workflow and space planning) to another ENT clinic in Tuen Mun Hospital in NTWC.
Co-location with:
