A/Prof Karen Vickery1, Sister Dayane Costa1, Dr Lillian Lopes2, Sister Roel Castillo1, Dr Anaclara Tipple2, Dr Honghua Hu1
1Macquarie University, North Ryde, Australia,
2Federal University of Goias, , Goias, Brazil
Following cleaning, reusable surgical instruments (RSI) are frequently touched during functionality testing and packaging. Standards detailing the frequency of hand washing or the use of gloves in this area are lacking. We, therefore, aimed to determine the effect on instrument soiling of packing instruments with either gloved and ungloved hands.
Following manual and automated cleaning, Halsted-mosquito forceps were assessed for adenosine triphosphate (ATP), protein and microbial contamination after being packed using gloved and washed but ungloved hands, using an ATP surface swab test, bicinchoninic acid (BCA) assay, and standard culture plate/broth, respectively. The effect of time since handwashing on instrument soiling was assessed by packing instruments one, two or four hours after washing hands.
Packing instruments with hands that had been unwashed for two hours or four hours resulted in a significant increase in contaminating ATP when compared to all other treatment groups (P < 0.05). There was a significant correlation between the time since washing the hands and the amount of ATP (R = 0.93; P ≤ 0.001) and the resulting microbial load (R = 0.83; P ≤ 0.001) contaminating the forceps, where the longer the time the hands remained unwashed the higher the contamination. Significantly more contaminating protein was found on forceps handled with ungloved hands that had not been washed for two or four hours (P < 0.001).
Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or recently washed hands.
A/Professor Vickery is Scientific Director of the Surgical Infection Research Group, and Vice-Chancellor Innovation Fellow at the Faculty of Medicine and Health Sciences, Macquarie University. She has been at the forefront of research into detecting biofilm associated with medical implants, equipment and environmental surfaces. Her research aims to prevent healthcare associated infections by focusing on both surgical strategies for preventing biofilm infection of medical implants, treating biofilm infections of chronic wounds and strategies that improve instrument and environmental decontamination. She has been a member of expert advisory committees for the Australian Therapeutic Goods Administration (TGA), GENCA and Standards Australia.