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Visiting Elisabeth-Tweesteden Hospital (ETZ) in Tilburg, the Netherlands


Monique Rijpert (Team Leader outpatient ENT) and Noor Everts (UV Smart) talked about the big change that took place last summer (2022) at the Elisabeth-Tweesteden Hospital (ETZ) in Tilburg. Namely, the ENT outpatient clinic installed three UV Smart D60s through Pentax Medical. These are used to disinfect all channel-less ENT endoscopes in the department. The first months have gone well and therefore we would like to share some impressive and instructive insights about the new working method within the outpatient clinic.

How did you disinfect endoscopes in the department before the D60s arrived?

Looking back, it seems like a cumbersome process now that we're used to the D60. We would take our endoscopes to the sterile processing department (SPD) at the end of the day in transport containers. There, they would be disinfected overnight. The next morning, we would retrieve the endoscopes from the SPD. There wasn't enough time and capacity to disinfect the endoscopes during the day at the SPD. That's why we used an Endosheath for the endoscope between patients. After removing an Endosheath, the endoscope would be cleaned with alcohol before it could be used again.

Why weren't the endoscopes disinfected after each use?

Because we didn't have enough endoscopes for that, and the SPD didn't have enough capacity. The ETZ (Elisabeth-TweeSteden Ziekenhuis) has three locations: ETZ Elisabeth, ETZ TweeSteden, and ETZ Waalwijk. The SPD is only located at the Tilburg sites, so the endoscopes used in Waalwijk had to be transported to Tilburg once a day for disinfection. This was time-consuming. The use of Endosheaths also had drawbacks as these covers obstructed the view for the doctor. The doctors had a decent image, but now that they work without an extra layer between the scope and the patient, they realize the improvement. The Endosheaths cost about ten euros each and can only be used once. We are glad that we now work in a more sustainable way with the D60.

"We are happy to work in a more sustainable way with the D60 now."

Did you often have damage to endoscopes?

If doctors did not remove the Endosheath carefully from the endoscope, the end of the scope would get caught, resulting in damage to the tip. These endoscopes then had to be repaired at a high cost, and we would be without them for a long time. We also used bins to transport the endoscopes on a cart. Occasionally, the tip of an endoscope would get stuck between a bin and its lid, causing damage when the bin was pressed onto the cart rails. With the introduction of the D60, we have not had any damage to the endoscopes so far. This is because we now have them under our own management with fewer people handling them. They know how valuable they are and handle them with care.

"With the arrival of the D60, we have had no damage to our endoscopes so far."

And why did you choose the D60?

Mainly because of the time we save. We had been looking at other options before because we were so dependent on the SPD. The idea of having a washerdisinfector on our own ward was quickly dismissed because even the fastest washer disinfector takes around 20 to 25 minutes. With the number of endoscopes we have, the washer would need to be constantly running, or we would need multiple washers.

"When the D60 came into the picture, with manual cleaning and disinfection in 60 seconds, the decision was quickly made!"

And how have you organized the process now?

We have set up one room at the outpatient clinic at ETZ Elizabeth for pre-cleaning and disinfection. There are two D60 units placed side by side in this room. We have hired two employees who are responsible for the disinfection of endoscopes. Above the examination rooms, there is a light that turns on when a used scope is hanging in the room. It is then collected and taken to the disinfection room. In this room, we have holders for easy manual cleaning of used endoscopes. The endoscopes are cleaned and undergo a leak test in rotation. After that, they can be processed in the D60 for 60 seconds and are ready for use again. On some days, we have 5 to 6 consultations running simultaneously, including the oncology clinic. This means we require over 50 endoscopes in a day.

"With that number of endoscopes on such a busy day, the D60 makes it a piece of cake!"

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