Selection of the type of dosing to use at your sinks
There are many best practices to consider when you are selecting and using your detergents or cleaning chemistries in the decontamination of sterile processing. No matter what product is being utilized, each variety of cleaning chemistry comes with specific reprocessing instructions that must be adhered to. Many of these variances as well as department workflows will determine the type of dosing best for your department. Some considerations include the size of the bottles, storage space requirements, amount to be dosed each time, the type of sink set up available and most importantly the inventory being reprocessed and safety or use around the chemistry chosen.
being the most common, requires a simple practice of measuring a product with a marked cup, nozzle, or hand pump. Manual dosing requires patience and attention to detail while verifying the amount necessary, as well as having the proper measuring device available for each sink. Some hand pumps are pre-measured but for the most part you will need to measure into a basin or cup and then add the solution to your sink water. Making sure not to splash the product and checking the safety data sheet for recommendations if any solution was to make contact with human skin, as well as spill protocols. This method is chosen when smaller gallon jugs or bottles are used that are easy for the team to pick up and pour or pump through the hand pump. If larger inventories are needed and solution flow is high, a manual process might delay operations and cause hand fatigue for the staff. Here are a few key reminders;
- Make sure you check the amounts necessary as listed on the product label
- Check the concentration to determine the level of fill required
- Educate all staff members on the variances in low-medium-high ends of dosing ranges
- Check with the IFU(instructions for use) to determine concentration and pH levels
- Verifying the water requirements as well as temperature requirements for effective use
Mechanical or automated
dosing includes the use of a dosing pump or reservoir. This method can be helpful in departments with higher volumes and increased need in detergent. The mechanical dosing pumps are extremely helpful because they provide the correct amount of solution each time, and is pre-set at levels determined at installation by the manufacture and department leadership. Important things to remember if using a automated method, is to ensure the detergent is dosing properly by completing calibration steps as well as verification, and maintenance on the pumps themselves. Here are a few key reminders;
- What are the settings selected on the pump and do they meet your required needs?
- Have you checked the fill lines on the sink to ensure they match the settings?
- Is there a thermometer on the probe, and if so is it working properly ?
- Are the lines clean, free from build up and debris and how frequently do they require changing?
- Does the pump require servicing and if so who is responsible to do so?
- Has the pump been calibrated and does it does the proper amount daily?
Understanding concentration and Fill levels
Whether you are using manual or mechanical dosing, there are shared steps to complete in order to verify dosing happens effectively. First and foremost, understanding what level of dosing your department requires and what level of water is to be filled the sink will be driven by the detergent instructions. Some chemistries provide a dosing range, for example from 0.5oz.-2oz. per gallon, this will drive what amount is added to the water. It will also allow CSSD professionals to fill their sinks to the appropriate amount. Every reprocessing sink does not come with marked measurement lines in the sink, and additional lines can be added to help the staff easily see where they should be filling, here at Belimed we provide both marked sinks as well as pre-fill lines, see image below.
Temperatures and Utilization
Storage of the detergent and chemistries is extremely important in ensuring the product stays active and effective before use. It is just as critical to verify the temperature of the water being used as well as the temperature range required for effectiveness. Some mechanical dosing pumps come with the thermometer probe at the end of the hose, which can be used at every fill point. CSSD professionals will want to verify the temperature probe is measuring properly and is on at all times, and have a backup thermometer probe available in cases of emergency or breakage. For manual dosing practices, a normal thermometer device can be used to measure the water at time of fill.