Assessing the impact of a washer/disinfector on a dental practice

Automated washer disinfectors are recommended to improve the cleaning of re-usable instruments and to reduce the risks of cross infection. Objectives: The aims of this project were to assess the impact of placing a washer disinfector in a general dental practice and to test the effect of different loading patterns on the efficacy of washer disinfector instrument cleaning. Methods: The impact on the practice was determined by use of a staff questionnaire, video timing analysis and costings. The efficacy of cleaning was assessed using the Edinburgh test soil on a variety of instrument loading patterns for the presence of residual soiling. Results: Increased time was spent on initial staff training, but this was compensated by staff spending less time manually cleaning instruments. A decrease in sharps injuries was noted. Increased costs were associated with machine validation, testing, maintenance, staff training and increased numbers of instrument sets to cope with the increased cleaning cycle time. The loading pattern of instruments had a marked effect on cleaning efficacy with residual soiling noted on instruments which were superimposed on one another. Conclusion: There is a financial implication of introducing washer disinfectors into general practice. This must be balanced against gains in productivity, and health and safety of staff. Validated instrument cassettes that separate instruments during the automated washing process result in more efficacious cleaning.