Monitoring the Cleanliness of Reusable Surgical Instruments in Central Sterile Supply Department by Adenosine Triphosphate Method.

BACKGROUND: Cleaning is very important in reusable surgical instruments (RSI) reprocessing. The adenosine triphosphate (ATP) method is widely used to assess cleanliness, but few studies focus on using this method on RSIs. OBJECTIVE: To assess the effectiveness of the ATP Bioluminescence Assay for monitoring the cleanliness of RSIs. METHODS: The study was conducted in three central sterile supply departments (CSSD) from 2015 to 2020. Surgical scissors, hemostatic forceps, and other non-lumen instruments were sampled after cleaning. The surface of each instrument was swabbed in a uniform manner, including hinged joints and teeth, and the amount of ATP (amol) was calculated. RESULTS: A total of 871 RSIs were tested, the mean ATP lg (amol) was 2.829 ± 0.539 and the qualified rate was 80.57%. Washer-disinfector cleaning was more efficient than manual cleaning, the mean ATP lg (amol) were 2.776 ± 0.513 and 2.948 ± 0.575, respectively; the qualified rates were 84.97% and 70.59%, respectively. With the time of bare instruments expose to environment increased, the qualified rate was decreased (Ptrend = 0.044). CONCLUSION: ATP levels are stable and repeatable for continuous monitoring of the cleanliness of RSIs. It is a rapid and viable method for assessing the cleanliness of RSIs. Washer-disinfector cleaning is recommended and cleaned instruments should be placed in sterile packaging in good time. HIGHLIGHTS: The ATP method is viable for assessing the cleanliness of RSI in CSSDs.