The summary of the presentations at the Institute of Decontamination Science Annual conference on protein removal and detection that appeared in the January 2014 edition of The Clinical Services Journal clearly and concisely reported what was presented.
However, the figures stated by Nigel Tomlinson for residual protein levels were suggested levels and he described a possible traffic light system i.e. 200 μg as “red”, 50-200 μg as “amber” and below 50 μg as “green”. He also went on to say that research at some hospital SSDs suggests that 5 μg per instrument may be defined in the future.
However, unfortunately some readers of this article have taken this as an inference that these protein levels are now ‘recommended’. When Nigel Tomlinson gave his presentation he was very clear that he was not stating Department of Health policy, merely expressing his own personal view on what would be reasonable given his understanding of the literature.
Some results found in the field at present are not consistent, and illustrate the need for further work, possible trials, comparison tests and formal agreement. If such testing is to be adopted in future as a method to periodically assess cleaning efficacy and protein detection, then it is recommended that a consensus is reached on a consistent standard method of test.
The traffic light system and the possible levels of protein have certainly presented a lot of food for thought but the figures stated need to be qualified with good scientific evidence, a method of protein detection that is reproducible to an agreed sensitivity, accurate over the measurement range and available to all and clearer in what is meant i.e. is this per instrument or a unit area on an instrument. A formalisation process and acceptance by the DH, and other bodies, needs to be agreed and placed in the relevant NHS guidance after a process of consultation.
We would advise that until these levels are included in national guidance e.g. CFPP documents and any guidance documents as issued in each of the Devolved Administrations, that the current levels and methods of protein detection should continue to be used as recommended in current guidance documents used throughout the UK (e.g. CFPP, WHTM etc).
Members of the Professional Expert Communication Forum:
Decontamination of Medical Devices Central Sterilising Club.
Institute of Decontamination Science.
Healthcare Infection Society.
Infection Prevention Society.
Association of British Healthcare Industries.
Association for Perioperative Practitioners.
Institute of Healthcare Engineering & Estate Management.
