CONF-7-Matthias-Tschoerner.pdf

1、Hygiene safety and resource savings in automated cleaning A contradiction?Name:Dennis EisertUlf KlungMatthias TschoernerBastian WulffAffiliation:Chemsiche Fabrik Dr.WeigertGmbH&Co.KGEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20232.like such a conservation and cult

2、ivation of wood/that there is a continuous,constant and sustainable use/because it is an indispensable thing/without which the country cannot remain in its being.“https:/digital.slub-dresden.de/werkansicht/dlf/85039/9Print:Leipzig:Braun,1713,Online-Ed.:Dresden:SLUB,2013https:/en.wikipedia.org/wiki/S

3、ustainabilitySustainabilityHann Carl von Carlowitz,(1645-1714)Sylvicultura Oeconomica,1713,pp.105106Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20233Ecologically viable Socially justEconomically efficientSUSTAINABILITYSustainability means meeting the needs of the p

4、resent in a way that does not limit the opportunities of future generations.Federal Ministry for Economic Cooperation and Developmenthttps:/www.bmz.de/de/service/lexikon/nachhaltigkeit-nachhaltige-entwicklung-14700Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20234Ex

5、amples of energy efficient hospitalsEnergy efficiency standardConsumption characteristics of electrical primary energyarithmetic.MiddlekWh/maElectrical energy consumption figuresGHG emissions arithm.Middlekg/maAdministration building7720Primary care hospitals(-250 BE)17145Hospitals standard care(251

6、-450 BE)21757Hospitals maximum care(from 1000 BE)13435Energy and CO2balancesEnergy consumption characteristics of energetically highly efficient buildings,final report,KWEFF2015,C.Zeine,S.Gausling,C.Cassebaum,M.Gebhardt,N.Goldau,J.Peters,Society for Energy Planning and System Analysis mbH,Mnster,Sep

7、tember 2015Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20235Environmental aspects in the SPD/CSSDReducing the environmental footprint of gastrointestinal endoscopy:European Society of Gastrointestinal Endoscopy(ESGE)and European Society of Gastroenterology and Endo

8、scopy Nurses and Associates(ESGENA)Position Statement;de Santiago Enrique Rodrguez et al.Reducing the Endoscopy 2022;54:797-826wfhss 2015 Lille:Kristian Hemstrm,study on the impact from production to disposal on energy consumption and the climate:The use of single-use instruments releases 600 times

9、as many greenhouse gases(GHG)consumes 17 times as much energy as the use of reusable instruments;Report:G.Westermann,Central Sterilization,2015,388Eco-Sterilization:A challenge for all of us;Christophe Lambert,7thSwiss conference SGSV,2011Sustainable development in processing,32nd French National St

10、erilization Days in Lille,April 28th and 29th,2010;Report:G.Westermann,Central Sterilization,2010,144Latent questions for more than 10 years(Selection)Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20236Model CSSD 4 WD,1 Trolley washer,225 operating days,1 shift opera

11、tionMaterial and energy balanceChemistryml/lElectricity cyclekWhwatercycleLCyclesYearChemistryYearLElectricityYearkWhWaterYearLWD5101207200432072000864000Trolley washer313.31602700129636000432000Total consumption56161080001296000Costs37800 51840 GHG emissions54540 kg CO2Operating days:225 p.year,WD:

12、8 cycles p.day,Trolley washer 12 cycles p.dayElectricity costs 0.35/kWh,deionized water costs 0.04/LGreenhouse gases CO2equivalent:0.505 kg/kWh,IWU 2020,Institute for Housing and Environment,26-02-2020Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20237Energy savingth

13、rough optimized program sequencesEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20238TemperatureTimeDosingElectricityWaterEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20239Intermediate rinseCleaningDOS.at 38 C,6 ml/l55C,10 minContact

14、time ofdetergentNeutralizationFinal rinse/Thermal disinfection DryingPre-rinseT(C)t(min)WD Standard program sequenceEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202310WD:MMM UniClean PL IITest spicemen:Crile clamp 1Test soil:Coagulated blood 1,2Pre-rinse:2 min,coldC

15、leaning:10 min at 55 C6 ml/l mild-alkaline enzymatic cleanerNeutralization:2 min,coldIntermediate rinse,Thermal disinfection,Drying1 Guideline compiled by DGKH,DGSV and AKI for the validation and routine monitoring of automatedcleaning and thermal disinfection processes for medical devices;5th Editi

16、on.Central Service 2017;25,Suppl.2 ISO 15883-5:2021 Table A.1,1stRow;3 AAMI ST98(2023)WD Standard program sequenceParameterResult per cycleWater178 LTime49 minsElectricity10 kWhProcess chemistry220 mlCleaning performance(residual protein)14.4 g 5.9 gEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.

17、Weigert GmbH&Co.KG19 October 202311Final rinse/Thermal disinfectionDryingPre-rinseDos.1 ml/lT(C)t(min)Cleaning1 ml/lDOS.at 25 C40 C,5 minIntermediate rinsesContact time of detergentWD energy optimized program sequenceEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 2023

18、12WD energy optimized program sequenceWD:MMM UniClean PL II,electrical heatedTest specimen:Crile clamp 1Test soil:Coagulated blood 1,2Pre-rinse:2 min,cold,1 ml/l optimized detergentCleaning:10 min at 35 C1 ml/l optimized detergent,dos.25 CIntermediate rinse,Thermal disinfection,Drying1 Guideline com

19、piled by DGKH,DGSV and AKI for the validation and routine monitoring of automatedcleaning and thermal disinfection processes for medical devices;5th Edition.Central Service 2017;25,Suppl.2 ISO 15883-5:2021 Table A.1,1stRow;3 AAMI ST98(2023)ParameterResult per cycleWater141 LTime36 minsElectricity8 k

20、WhProcess chemistry75 mlCleaning performance(residual protein)15.6 g 11.5 g*3,0 g/cm2Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20231350%20%20%30%WD enegy optimized program sequenceStandardOptimizedDosageCycle timeWater consumptionEnergy consumptionEisert,Klung,Ts

21、choerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 2023141 Guideline compiled by DGKH,DGSV and AKI for the validation and routine monitoring of automated cleaning and thermal disinfection processes for medical devices;5th Edition.Central Service 2017;25,Suppl.2 ISO 15883-5:2021 Table A.

22、1,1st Row;3 AAMI ST98(2023)Consistent cleaning result despite energy savingswarning valuelimitCleaning performanceEnergy optimized*3,0 g/cm2*StandardOptimizedResidual proteinEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202315Real use -WD Validation FranceWD:Belimed

23、WD 290,electrical heatedLoad(selection):Surgical instrumentsMIS instrumentsGynecological instrumentsOphthalmic instrumentsAnesthetic equipmentRigid endoscopes/opticsContainer(anodised aluminium)DaVinci OpticsEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202316WD:Beli

24、med WD 290,electrical heatedContamination from real use(selection):Blood,ProteinDenatured blood(e.g.RF-Technology)Mucus,blood-mucus mixtures(e.g.gynecology)Mucus(ENT)Dental dirt,mouth,jaw and palateBone meal,dentinContamination from ophthalmology _Antiseptic Residues(containing iodine)Real use -WD V

25、alidation FranceEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202317Real use -WD Validation FranceCommonly used mild-alkaline enzymatic detergentOptimized mild-alkaline enzymatic detergentPre-rinseUnchangedUnchangedCleaning4 ml/l,10 min,55 C,dosing at 38 C1 ml/l,5 mi

26、n,45 C,dosing at 25 CIntermediate rinseUnchangedUnchangedWater35 l in the cleaning step35 l in the cleaning stepProcess chemistry140ml35mlEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202318Real use -WD Validation FranceEisert,Klung,Tschoerner,Wulff-Chemische Fabrik

27、Dr.Weigert GmbH&Co.KG19 October 20231950%75%Real use -WD Validation FranceDosageCycle timeEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 2023201 Guideline compiled by DGKH,DGSV and AKI for the validation and routine monitoring of automated cleaning and thermal disinfe

28、ction processes for medical devices;5th Edition.Central Service 2017;25,Suppl.2 ISO 15883-5:2021 Table A.1,1st Row;3 AAMI ST98(2023)Consistent cleaning result despite energy savingswarning valuelimitCleaning performanceEnergy optimized*3,0 g/cm2*StandardOptimizedResidual proteinEisert,Klung,Tschoern

29、er,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202321WD:Steelco DS 1000,steam heatedLoad(selection):Surgical instrumentsMIS instrumentsGynecological instrumentsEndoprosthetic setsRigid endoscopes/opticsContainerStationware(instruments,utensils)Real use -WD Validation Service provider Germ

30、anyEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202322WD:Steelco DS 1000,steam heatedContamination from real use(selection):Blood,ProteinDenatured blood(e.g.HF-technology)Mucus,blood-mucus mixtures(e.g.gynecology)Mucus(ENT)Bone meal,dentinReal use -WD Validation Ser

31、vice provider GermanyEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202323Commonly used mild-alkaline enzymatic detergentOptimized mild-alkaline enzymatic detergentPre-rinse2 min,cold2 min,cold,Dos.0.5 ml/lCleaning6 ml/l,10 min,55 C,dosing at 38 C2 ml/l,5 min,35 C,dos

32、ing at 20 CIntermediate rinseUnchangedUnchangedWater170 l170 lProcess chemistry270 ml113 ml(23 ml+90 ml)Real use -WD Validation Service provider GermanyEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202324 =4,19 40 20 K=3352 kJ =,energy demand heated by steam,calculat

33、edother energy savings per cycle,measured =0,033 Real use -WD Validation Service provider Germany=,=Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 20232512%58%Real use -WD Validation Service provider GermanyStandardOptimizedDosageCycle timeEisert,Klung,Tschoerner,Wulf

34、f-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 2023261 Guideline compiled by DGKH,DGSV and AKI for the validation and routine monitoring of automated cleaning and thermal disinfection processes for medical devices;5th Edition.Central Service 2017;25,Suppl.2 ISO 15883-5:2021 Table A.1,1st Row;3 A

35、AMI ST98(2023)Consistent cleaning result despite energy savingswarning valuelimitCleaning performanceEnergy optimized*3,0 g/cm2*StandardOptimizedResidual proteinEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202327Model CSSD 4 WD,1 Trolley washer,225 operating days,1

36、shift operationMaterial and energy balance savingsSavingProcess chemicalsp.cycleml/lElectricityp.cycle kWhProcess chemicalsYearElectricityYearWD2.522160 L14400 kWhTrolley washer22.7864 L7200 kWhTotal savings3024 L21600 kWhCosts 7560GHG emissions10908 kg CO2Operating days:225 pa,WD:8 cycles p.day 320

37、0 pa.,Trolley washer:12 batches pd.2700 paElectricity costs 0.35/kWh,deionized water costs 0.04/LGreenhouse gases CO2equivalent:0.505 kg/kWh,IWU 2020,Institute for Housing and Environment,26-02-202050%20%Eisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202328Other beneficial effects Less packaging material Lower transport costs and transport emissions Less storage space for replacement containers Fewer container replacement Less wasteEisert,Klung,Tschoerner,Wulff-Chemische Fabrik Dr.Weigert GmbH&Co.KG19 October 202329Questions?Thanks!