Ample space for 26 staff members, validation of reprocessing methods and cost savings which still do not fail to surprise the CSSD manager at the Tübingen University Clinic: "Refurbishing our department was a huge success in every respect", claims Toni Zanette. And, after the first year of operation, the figures speak for themselves: Since the recommencement of operations, the volume of effluent alone has dropped by approx. 40%. Significant reductions have also been made regarding manual pre-processing. Such huge savings are the result of the use of the latest medical technology – above all, 5 decontamination units from Miele's most recent generation of washer-disinfectors.
In May 2007, this 2000 m² area, where every single action is part of a carefully choreographed routine, was declared a building site. During reconstruction, this area was sectioned off and hermetically sealed with plastic sheeting. Work in CSSD continued uninterruptedly during construction to serve a suite of 18 central theatres and various day-surgery theatres, 1200 beds and other outpatient and diagnostic departments (including neurology, orthopaedic surgery, urology and heart surgery units).
The provisional solution for a period lasting almost 8 weeks met all the relevant legal requirements. Four out of five Miele machines were connected provisionally to supplies. With the aid of a diaphragm wall, operations were further divided into contaminated and clean areas. Electricity supply cables under the ceiling and water pipes in provisional floor ducts were instrumental in keeping the machines running. While CSSD employees reprocessed instruments from 7 to 22 h on the one side of the screen, construction work continued apace on the building site on the other side: Old machines were dismantled and removed and new pipework and a new air-conditioning system was installed to create permanent space for the washer-disinfectors. A new screed floor required pouring 12 tonnes of concrete.
Five Miele machines connected in a single day
By mid-July 2007 the time had finally come: On one single day, four Miele PG 8528 decontamination units were relocated from the middle of the room to their final position alongside a fifth new machine of the same type. 'It all took just a few hours as the preparation had been meticulous', explains CSSD manager Toni Zanette. This was the responsibility of the Miele medical technology dealer Günter Schneider from Sandhausen who oversaw the entire project from the initial planning stage through to machine installation. Even large-scale templates were created to aid perfect equipment positioning.
Since its reinauguration, the CSSD unit is well positioned to meet future challenges: Reprocessing methods and processes have been certified according to the international ISO 13485 standard since 2005. The decision to go for Miele was heavily influenced by special-purpose programmes (OxiVario and OrthoVario) ensuring gentle but thorough cleaning of heavily soiled and challenging instruments and special mobile injector units for minimally invasive surgical instruments. The machines installed also offer all the options available on the latest washer-disinfectors: These include the PerfectPure conductivity meter able to detect residual alkalinity in the wash liquor. "That is crucial because we intend to reprocess instruments on behalf of eye doctors and other specialists in and around Tübingen and will have to assume product liability", says Zanette.
As a long-standing board member of the German CSSD Association and still active on the association's training and education committee, Zanette is also partly responsible for training courses at the University of Tübingen, offerring instrument reprocessing courses for medical employees together with his staff. Last year alone, more than 700 attended these courses. In the CSSD unit, data loggers and conductivity meters are in constant use to monitor the installed medical equipment. Each machine (and the autoclaves) clock up approx. 4900 operating hours per year.
Containers for fully automatic instrument transportation
To ensure that sterile instruments reach their destinations throughout the Tübingen clinic fast, the CSSD unit connects with a 9 km subterranean rail system on which 200 to 300 containers per day arrive fully automatically for thorough cleaning and disinfection. Since refurbishment a year ago, even the containers used to transport sterile supplies can be decontaminated fast: "We have now included a special line operation supplied by Meiko which has undergone technical modifications to meet specific needs and to ensure compliance with DIN EN ISO 15883", says the proud head of the department. All technical innovations are part and parcel of a complex logistics system linking all parts of the expansive clinic: From the central warehouse for medical products to water treatment systems installed in the basement. The CSSD, handling goods with a value of EUR 0.5 m each day, is an important link in this chain - and needs to be up and running even in the midst of hectic construction work.
Further information available from:
Miele & Cie. KG
Tel.: 0180/220 21 21 (EUR 0.06 per minute) or fax: 0800/2255755