Data loggers for Dentists’ Decontamination Data
Do you know what data is recorded when you sit in your dentist’s chair? It would be reasonable to assume that it’s entirely about you, but that’s only part of the story.
For each pouch of instruments that are used the associated serial number referencing the sterilisation cycle that has been performed on these instruments is recorded against your name. The reason being that failure to follow the correct methods of decontamination and recording, to prevent cross-infection, could leave the dentist liable to a charge of serious professional misconduct.
So, what is this decontamination data and how is it captured? To understand this, we first need to take a quick look at the journey taken by an instrument that has been used on a patient.
The decontamination process commences with cleaning and disinfection, the most critical part; if it’s not clean it certainly can’t be made sterile.
Visual Inspection will reveal if instruments have been properly cleaned, but testing is the only way to ensure proteins (in blood and tissue) have been removed.
Finally steam sterilisation, using the autoclave cycle applicable to the load being processed is the only way to guarantee instruments are safe for use on the next patient. Steam is the recognised method for sterilising reusable medical devices in healthcare environments because it has high lethality, is rapid and is non-toxic. In order to be effective, steam, at the required temperature for the required duration, must come into direct contact with the surface of the instrument to kill micro-organisms.
Steam sterilisers, also known as autoclaves are pressure vessels so subject to the Pressure Systems Safety Regulations 2000 and in the case of dental decontamination of re-useable instruments the guidelines contained in HTM 01-05: Decontamination in primary care dental practices
This document lays down the ‘Essential quality requirements’ that should be achieved by every single dentists’ practice, and ‘best practice’ recommendations to be achieved in a timescale determined by the Dental practice.
And this is the nub of what HTM 01-05 has to say:
All decontamination equipment should be validated, tested, maintained and serviced as recommended by the manufacturer. Validation is needed for new decontamination equipment at installation and annually thereafter.
A record of every single sterilisation cycle should be made. This record should demonstrate that the steriliser is working within validated parameters such as time, temperature and pressure, using the machine’s own indicated measurements on the display.
Records need to be kept for a minimum of two years.
So, there we have it in the second paragraph, records need to be made and kept! Traditionally this has been done in a laborious paper-based system with reliability 100% dependent on the user, but this is where data loggers are really coming into their own.
Eschmann Technologies Ltd, a UK supplier of washer disinfectors and autoclaves, are by far and away the leaders in this field of electronic data capture. They provide for their customers, a wireless data logger (known as the Little Sister AutoLog – and visible sitting on top left of the autoclave in the photo below) designed and manufactured by the technology company Richard Paul Russell Ltd.
The data from the logger is then transferred by Wi-Fi for analysis in their custom designed software programme called Real-time Cycle Data Manager – also supplied by Richard Paul Russell Ltd. This provides effectively an electronic notebook with automatic management of all cycle records and maintenance of daily and weekly test cycle records. This avoids the inconvenience of the highly time consuming task of manual record keeping, and greatly increases the reliability of record keeping – a double benefit for the dentist.
The cycle data output (coming from the washer or autoclaves’ own sensors), is replicated exactly in the software on the left-hand side as below:
In the centre section is a list of all the selected machine’s cycles and a quick red/green visual reference as to whether the cycle is a pass or a fail. Reporting then allows the user to save individual cycles in a pdf format, plus complete and save also as a pdf the daily/weekly test record sheet as Eschmann (the manufacturer’s) recommendations.
Clearly this is clever use by Eschmann of a Wi-Fi datalogger with bespoke software to very successfully assist their customers, our dentists, in their everyday task of adhering to the regulatory compliance within HTM 01-05. Compliance requirements for the decontamination of re-useable instruments in veterinary, podiatry and tattooing practices are as yet not as stringent as for dentists, but would I put money on that still being the case in 10, 5, or even 2 years? I doubt it.