Authors: (including presenting author): :
Tang CS(1), Lee LY(1), Wong KK(1), Lee CC(1), Yeung WC(1)
Affiliation: :
(1)Sterile Services Department, Tuen Mun Hospital
Keyword 1: :
laparoscopic instruments
Keyword 2: :
cleaning validation
Keyword 3: :
protein residue testing
Keyword 4: :
staff compliance
Introduction: :
The complexity of Minimally Invasive Surgery (MIS) instruments creates significant decontamination challenges for the Sterile Services Department (SSD). Because instrument cleanliness is essential to patient safety and quality standards, a structured validation study was undertaken to assess the effectiveness of laparoscopic instrument cleaning. The study evaluated staff compliance with cleaning guidelines and confirmed that instruments were safe and fit for surgical use.
Objectives: :
The primary objective was to validate the cleaning efficacy of laparoscopic instruments via protein residue testing and to determine the compliance rate of SSD staff. Beyond that, the project also aimed to verify the robustness of the department’s internal quality assurance mechanisms, specifically the multi-stage inspection system, in detecting errors and ensuring that all sterilized items meet clinical safety standards regardless of initial cleaning outcomes.
Methodology: :
From 1–26 December 2025, a four-week randomized sampling plan was implemented in the packing areas. 40 LAP sets, representing about one-third of routine operating theatre usage, were inspected. Lumened instruments were tested using protein residue detection. Detailed records including staff identifiers, time, and photographic documentation ensured traceability. Randomization prevented bias and reinforced credibility, while the low-cost design minimized operational impact.
Result & Outcome: :
Of the 40 validated LAP sets, 39 passed and 1 failed, resulting in a pass rate of 97.5% and a fail rate of 2.5%. These results confirm the reliability and effectiveness of current cleaning procedures. Randomized inspections also demonstrated a high level of staff compliance with established protocols, underscoring the critical role of frontline staff in infection prevention. The single failure served as constructive feedback for the colleague involved, facilitating targeted improvements and fostering accountability. Importantly, the study validated the critical "count check system," a two-tier inspection process. This safety net proved essential when the second tier identified elevated rehandling rates, triggering immediate first-tier decontamination improvements and preventing potential systemic errors. The dual inspections ensure initial errors are detected and corrected, guaranteeing final instrument safety. Overall, randomized inspection is an effective, practical method to verify adherence to cleaning guidelines and ensure surgical instrument safety. It provides a replicable framework for continuous quality improvement aligned with international standards.
