Recommendations by the Quality Task Group (106): No reprocessing of kidney bowls or wash bowls in bedpan washer-disinfectors

Authors: B. Amann, M. Bertram, P. Bröcheler, D. Diedrich, C. Fassbender, K. Gehrmann, T. Gerasch, A. Jones, S. Krüger, I. Mock, P. Sauer, K. Wiese, U. Zimmermann

The washer-disinfectors regulated by standard EN ISO 15883-3 [1] are also known colloquially as BEDPAN WASHER-DISINFECTORS. The terms automatic bedpan washers or faecal washers are also occasionally used. These washer-disinfectors (WDs) are primarily designed and intended for disposal of faeces together with reprocessing of the associated containers such as urine bottles, bedpans and toilet commode buckets.
However, it can be noted time and again in everyday practice that other items are also reprocessed in these washer-disinfectors. Contrary to the manual reprocessing method formerly used for wash bowls, the standard practice now in many healthcare institutions and homes for the elderly is to reprocess in such washer-disinfectors also kidney bowls, including those used for oral hygiene, as well as the wash bowls used for basic personal hygiene or partial medicinal baths.
The technical features of these washer-disinfectors are virtually unable to demonstrate the required proof of validated processes, and certainly do not assure the safety expected of modern WDs in a Reprocessing Unit for Medical Devices (RUMED). THE A0 VALUE REQUIRED FOR SAFE DISINFECTION exceeds the capacity and technical facilities of the majority of the (older) washer-disinfectors currently in operation.
In an age of multi-drug resistant organisms there is a particularly high risk of their transmission when disposing of faeces.

Historical background
The development of these washer machines dates back to the 1930s [2]. Connected to the cold-water pipeline (drinking water), the most they could do was to rinse off the utensils, while their main purpose was to improve the removal of faeces. Hence, manual pre-and, possibly, post-cleaning could not be avoided.
It was not until the 1960s that washer machines also facilitating chemical disinfection after cleaning were developed. These were operated by staff by activating the cleaning pushbutton but by no means was such a washer-disinfector equipped with the programme sequences as we know them today.
A further 30 years would go by before new BEDPAN WASHER-DISINFECTORS WITH THERMAL DISINFECTION were introduced. Their introduction was expedited by the knowledge that the majority of central dosing units for chemical disinfectants were colonized with biofilm.

Read more in Steri-World Issue 02/18.

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