Sterile reprocessing on the smallest possible area and of the highest standard

When a quality management (QM) system is implemented, the hygiene processes are also put to the test in many dental practices. Does the floor plan of the practice correspond to the latest requirements? Is there a separate reprocessing unit that is strictly divided between sanitary and non-sanitary areas? Are sterilised, sealed instruments and containers stored properly? Is it necessary to purchase a modern thermal disinfector and a Class B steriliser? How is the recording of processes, the device books, and the staff training organised?

A broad selection of equipment for flawless and efficient sterile reprocessing is on the market; furthermore, a medical devices software package like DIOS MP makes it possible to manage and archive the employees, the equipment inventory, and the sterile reprocessing logs perfectly. However, only rarely is it possible to study the state of hygiene technology with the interaction of all components or to teach the work sequences in advance in a real environment.

Moreover, many operators have to work within the confines of practice floor plans, which cannot be extended at will. Many practices would prefer to switch to automated reprocessing now rather than later. But where can all the equipment be put?

From idea to rolling reprocessing unit

Fully integrated legally sound sterile reprocessing of the highest technical standard on an area of less than seven square metres in a type of motor home. A model reprocessing unit, which can be demonstrated to dentists at any location.

With this idea in mind, graduate designer Gerold Kalter sat at his desk in autumn 2009 and extended this self-imposed framework by the following requirements:

1. a two-row facility with sanitary and non-sanitary areas;
2. employment of the latest instruments, which are capable of being validated and have data interfaces;
3. non-contact operation of all components where possible;
4. cabinets, work tops and floor surfaces that are perfectly designed in terms of hygiene, and
5. inclusion of all the devices in the DIOS MP medical device management software.

Floor plans were drawn and extended by the necessary motor home components. The weights, volumes, and device power ratings had to be considered, for alongside the actual technical equipment in the reprocessing unit, all the water and energy supply components had to be installed in the vehicle's loading space, too. Formerly developed by Kögel and now built by SAXAS, the postal service parcel van proved an ideal base for the project, as this has two convenient access points, as well as a low chassis and well-insulated body. Use of this type of transporter as a courier vehicle is still extremely common.

After solving all the technical requirements in principle, the next stage involved visualisation of 3D illustrations on the computer and an exposé was developed in conjunction with DIOS, the project's lead initiator. This exposé outlined the vehicle's equipment and capabilities, but also the involvement of sponsor partners in the idea.

An abbreviated version of the exposé follows: The HygieneMobil – the working title and also final name of this ambitious project – demonstrates that sterile reprocessing in line with the highest standards of hygiene is also possible in confined spaces. The vehicle will be used as a perfect example of the latest state of technology at trade fairs, training sessions, lectures, and in-service training. Use by DIOS, the project partners, and other appropriate parties on a loan-basis will ensure that the HygieneMobil is constantly 'on the road' in Germany, as well as in neighbouring EU countries.

Professionally implemented with leading industry partners

Thanks to a compelling concept and DIOS product manager Otto Wiechert's good personal contact with leading device manufacturers, it did not take long for all the approached sponsor partners to arrive at a positive decision with respect to participating in the project.  It was possible to acquire leading industry partners – including Aesculap (instruments and containers), hawo (sealing devices), Miele Professional (thermal disinfectors), Sirona (DAC Universal autoclave), StepOver (signature pad), and last not least W&H (sterilisers, contra-angle hand pieces) – for material and financial support in the shortest possible time.

In spring 2010, a brand new SAXAS Integral vehicle with sliding side and large rear doors was purchased in white and pre-fitted with network, electrical, water, and compressed air systems in Rheine. An air conditioning system for the body, as well as air suspension were installed, meaning the vehicle can be set to a pleasant temperature in the summer and the rear access point can be lowered to a convenient height.

The first major journey of the 'skeleton structure' took it to the Offenberg-based Karl Baisch GmbH, recently acquired by the Ziegler Group, in Bavaria. Under the direct control of Baisch CEO Achim Bickelmann – also enthusiastic about this joint project from the outset – the experts from Baisch equipped the HygieneMobil with quality fixtures that fitted down to the last millimetre, including Corian worktops and stainless steel basins with no joints, as well as white-coated steel fronts. The tray-like, zero-joint welded PVC flooring was also fitted in Offenberg.

Hardware

The vehicle was then taken back to Rheine for completion and the following was installed:

• one Miele G7881 thermal disinfector, which was specially adapted to the 230V electrical system;
• one SIRONA DAC Universal for reprocessing and maintaining contra-angle hand pieces;
• one W&H Lisa Class B steam steriliser, and
• one hawo hd 680 DEI-V rotary sealer.

All the devices can be validated and are equipped with EDP interfaces so that reprocessing logs can be exported directly.

W&H also supplied the contra-angle hand pieces. Aesculap provided the containers, baskets, and various instruments.

Sterile item batch releases and the encryption of process logs for permanent, legally sound archiving take place in the HygieneMobil by means of a handwritten electronic signature using a StepOver signature pad.

Rieth, a specialised supplier of dental equipment, provided its optically appealing compressed air gun, two non-contact soap and disinfectant dispensers, as well as a lab-cam system for the HygieneMobil. As a true innovation in a sterile reprocessing unit, this high resolution 'video magnifier' can be operated without contact; furthermore, in addition to photographic recording of the equipment of baskets, it facilitates the visual inspection of instruments at extreme magnification and in perfect image quality. The standard equipment of the DIOS HygieneMobil also includes a IOSS data matrix reader, which makes it possible to import and manage laser-coded instruments.

The DIOS HygieneMobil had its first public appearance on 17 and 18 September 2010 at the Fachdental Leipzig trade fair. The features and capabilities of the HygieneMobil were explained to numerous visitors from the industry, as well as many interested exhibitors in a number of one-to-one and group presentations. Put into effect jointly by so many partners, the enthusiasm for the project by all involved was enormous.

The CEO of DIOS GmbH, Werner Oskamp, formally put the DIOS HygieneMobil into operation on the evening of the first day of the trade fair in the presence of many sponsors and industry representatives.

If you are a government agency, a specialised company or a training establishment and would like to use the DIOS HygieneMobil on a loan-basis for demonstration, educational or training purposes, please contact DIOS GmbH on +49 (0) 2864/9492-0.

Delighted with the successful trade fair launch of the HygieneMobil

Werner Diener (Aesculap), Werner Oskamp (DIOS), Bernd Stroppel (Aesculap), Oliver Maiß and Andreas Nicolaus (Miele)	Werner Diener (Aesculap), Christine Wächter and Claudia Morell (W&H), Werner Oskamp (DIOS), Wolfram Krattinger (hawo), Stefan Rippel and Rico Zschoche (W&H), Melanie Mogge (B.Braun), Robert Nemeth (W&H), Bernd Stroppel (Aesculap)