A case study: Utilization of ATP bioluminescence assay in monitoring medical device cleaning process, environment and hand hygiene in CSSD

Mr Roel Beltran Castillo1

1Macquarie University Hospital, Macquarie University, Australia

Introduction:  The current CCSD monitoring are qualitative interpretations. Adenosine triphosphate ATP bioluminescence assay measures micro contamination on surfaces expressed in relative light units (RLU) to assess surface cleanliness of reusable medical devices or RMDs, equipment, environment and hand hygiene. This provides a clearer interpretation of surface cleanliness.

Methods: Processed RMDs are strategically sampled daily on both cleaning utilising an ATP swab sampling. This study will base a ≤50 RLU as the acceptable limit.

Environmental surface and related equipment will be monitored weekly with a pass ≤250 RLU. Study will base a ≤50 RLU as limit on related equipment’s internal surface.

Hand sampling will done pre and post World Health Organization (WHO) Hand Hygiene (HH) Protocol. A ≤50 RLU as limit post WHO hand hygiene protocol.

Results: Results of RMD surface monitoring indicate a consistent pass on all RMD surface sampling from the automated and manual cleaning method. Most readings are ≤ 20 about 93% and the rest is within limit. This resulted to lower the limit to ≤25 RLU.

The environmental monitoring provided to change the current environmental wipe. The readings indicate well above recommended ≤250 RLU as high as 1,689 RLU. The switch resulted in readings within ≤ 37 RLU.

Pre HH readings as high as 1687 RLU, post records below 98 RLU. Acceptable limits adjusted to ≤100 RLU.

Conclusion:  Straightforward information is required to determine the level of surface cleanliness in CSSD, in this case a quantitative based data. This provides decisive information if an item require attention.


Responsible for the provision of Sterilisation and Infection Control Services at Macquarie University Hospital. In particular supports activities of the Operating Suite, Angiography/Endoscopy Unit, the Intensive Care/Coronary Unit and all hospital wards. The role ensures that quality, evidence based practice and cost effective service are delivered within a safe patient and team environment.

Previously commissioned a new CSSD and eventually became Manager of CSSD at The Chris O’Brien Lifehouse in Sydney.

Currently teaching Sterilization at NSW TAFE Randwick Health Precinct.

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