Cleaning methods of neurosurgical instruments and evaluation of the effectiveness

OBJECTIVE To explore and analyze the difficulties of cleaning neurosurgical instruments, and to develop targeted solutions and to improve the quality of cleaning. METHODS The study was performed in two stages（stage 1: Jan. 1, 2018-Aug 31, 2018 and stage 2: Sep. 1, 2018-Apr 30, 2019）. In each stage, 120 pieces of neurosurgical instruments were randomly selected from the disinfection supply center, and were equally divided into the ATP and OPA groups, with 60 instruments in each. In the first stage, the conventional cleaning process was used. After cleaning, samples were collected and the cleaning effect was detected by visual inspection, ATP bioluminescence and protein OPA fluorescence. Cleaning process was continuously improved according to protein fluorescence detected in the OPA group, which showed residual protein contaminants. In the second stage, the continuously improved cleaning process was adopted, and the instruments were sampled after cleaning, and the cleaning pass rates between the two groups in the two stages were compared. RESULTS The qualified rate of cleaning efficacy in the second stage was significantly higher than that in the first stage, and the difference was statistically significant（P＜0.05）. CONCLUSION Because of the difficulty of cleaning surgical instruments in neurosurgery, the use of protein fluorescence detection technology can guide the operator to effectively improve the cleaning process and improve the quality of cleaning.