Bowie Dick Test Efhss Conf2006 Lecture17 En

8/10/2019 Bowie Dick Test Efhss Conf2006 Lecture17 En

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The Bowie and Dick TypeThe Bowie and Dick Type

TestTest

Does size and penetrationDoes size and penetrationreally matter?really matter?

Presented byPresented byTerry McAuleyTerry McAuleySterilisation and Infection ControlSterilisation and Infection ControlConsultantConsultant


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Discuss the purpose of the Bowie Dick type testDiscuss the purpose of the Bowie Dick type testExa ine the applicable European !or s "E!# $Exa ine the applicable European !or s "E!# $International Standards %r&anisation "IS%#International Standards %r&anisation "IS%#standards that refer to Bowie'Dick type testsstandards that refer to Bowie'Dick type tests%utline the basic re(uire ents in the E! $ IS%%utline the basic re(uire ents in the E! $ IS%standards that can be used to e)aluate clai s ofstandards that can be used to e)aluate clai s oftest confor ancetest confor ance

Explain the correct ethod for perfor ance*Explain the correct ethod for perfor ance*interpretation and docu entation of the Bowie'Dickinterpretation and docu entation of the Bowie'Dicktype testtype test


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Its a matter of physicalIts a matter of physical

chemistry..chemistry.. A Bowie'Dick is a physical test uses a A Bowie'Dick is a physical test uses ache ical indicator to de onstrate thatche ical indicator to de onstrate thatstea penetration has been ade(uate bystea penetration has been ade(uate byshowin& a unifor colour chan&e in theshowin& a unifor colour chan&e in theindicatorindicator + In order for the indicator to chan&e colour aIn order for the indicator to chan&e colour a

che ical reaction ust occur at certainche ical reaction ust occur at certainte peratures in the presence of oisturete peratures in the presence of oisture

+ By default* a satisfactory result translates into anBy default* a satisfactory result translates into anassu ption that air re o)al was ade(uateassu ption that air re o)al was ade(uate


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Size matters..Size matters..

,e(uired for the test-,e(uired for the test- + .uckaback towels "/01 x 231 # folded to &i)e 4 thicknesses.uckaback towels "/01 x 231 # folded to &i)e 4 thicknesses

of clothof cloth

25'26 were re(uired to create a stack of the ri&ht hei&ht25'26 were re(uired to create a stack of the ri&ht hei&ht + Two 721 strips of autocla)e tape placed in the for of aTwo 721 strips of autocla)e tape placed in the for of a

cross on a 781 x 41 sheet of un&la9ed papercross on a 781 x 41 sheet of un&la9ed paperThese sheets could be inserted at )arious le)els throu&houtThese sheets could be inserted at )arious le)els throu&houtthe stack* althou&h one sheet in the centre of the pack wasthe stack* althou&h one sheet in the centre of the pack wasacceptableacceptable

+ .uckaback towels in a 781'771 hi&h stack were then.uckaback towels in a 781'771 hi&h stack were thenplaced in a rectan&ular dressin& casket* cardboard box orplaced in a rectan&ular dressin& casket* cardboard box orwere wrapped in fabricwere wrapped in fabric

+ Bowie et al "760/#Bowie et al "760/#


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In their own words.In their own words.

: : This test is essentially a test of steaThis test is essentially a test of steapenetration* not of ti e'at'te perature1 penetration* not of ti e'at'te perature1

: : A satisfactory test will indicate rapid stea A satisfactory test will indicate rapid steapenetration* ade(uate air re o)al andpenetration* ade(uate air re o)al andfreedo fro si&nificant air leaks;1 freedo fro si&nificant air leaks;1

: : A unifor colour chan&e ay be obtained A unifor colour chan&e ay be obtained

without ade(uate initial air re o)al if thewithout ade(uate initial air re o)al if theholdin& ti e is artificially extended1 holdin& ti e is artificially extended1 + Beyond / < inutes= 7/3Beyond / < inutes= 7/3 88CC



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In their own words.In their own words.

: : In so e sterilisersIn so e sterilisers "where stea is ad itted durin&"where stea is ad itted durin&)acuu phases#)acuu phases# penetration will occur and thepenetration will occur and theload te perature will rise before the end ofload te perature will rise before the end ofthe pre)acuu period; In such sterilisers athe pre)acuu period; In such sterilisers asatisfactory result indicates ade(uate steasatisfactory result indicates ade(uate steapenetration but does not necessarily confirpenetration but does not necessarily confira suitable de&ree of air ti&htness >a suitable de&ree of air ti&htness >;;therefore an air leaka&e test ay be;;therefore an air leaka&e test ay beneeded in addition;1needed in addition;1



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Change is ine ita!le.Change is ine ita!le.

That was then>That was then> + Sin&le deep )acuuSin&le deep )acuu

phase ?@' conditionin&phase ?@' conditionin&

+ Ma ority of ite sMa ority of ite sprocessed were porousprocessed were porousin naturein nature

+ Sur&ical instru entsSur&ical instru entsostly constructed ofostly constructed ofetaletal

+ ery few ulti'part or ery few ulti'part orcannulated de)icescannulated de)ices

This is now>This is now> + Superat ospheric*Superat ospheric*

transat ospheric ortransat ospheric or

subat ospheric pulsin&subat ospheric pulsin& + Ma ority of ite sMa ority of ite s

processed are non'processed are non'porousporous

+ Sur&ical instru entsSur&ical instru entsconstructed of a )arietyconstructed of a )arietyof aterialsof aterials

+ ar&e percenta&e ofar&e percenta&e ofulti'part and lon&'ulti'part and lon&'lu ened de)iceslu ened de)ices


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#hat do we need to#hat do we need to

check for?check for?Cha ber inte&rity + to ensure no airCha ber inte&rity + to ensure no air

leaka&e is present at any sta&e of theleaka&e is present at any sta&e of thesterilisation cyclesterilisation cycle

Ability of the )acuu pu p to eli inate air Ability of the )acuu pu p to eli inate air

fro the cha ber and loadfro the cha ber and load

Stea (ualityStea (uality


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$erformance Testing of$erformance Testing of

Steam SterilisersSteam Sterilisers Air eaka&e Test Air eaka&e Test + Establishes that no air leaka&e will occurEstablishes that no air leaka&e will occur

durin& )acuu sta&es of the sterilisationdurin& )acuu sta&es of the sterilisationcyclecycle

eak rate tests are now an auto aticeak rate tests are now an auto atic

test cycle on ost odern steriliserstest cycle on ost odern sterilisers


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Steam SterilisersSteam Sterilisers Air detectors Air detectors + Co only fitted to ost odernCo only fitted to ost odern

steriliserssterilisers + Sa ples the conditions present in theSa ples the conditions present in the

steriliser cha ber after the air re o)alsteriliser cha ber after the air re o)alsta&e and durin& stea ad ission* insta&e and durin& stea ad ission* ine)ery cyclee)ery cycle

+ Is set to cause the cycle to abort ifIs set to cause the cycle to abort ifte perature differences F 2te perature differences F 2 88 C areC aredetecteddetected


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Steam SterilisersSteam Sterilisers Air re o)al and stea penetration Air re o)al and stea penetrationtesttest

+ Establishes efficacy of )acuu systeEstablishes efficacy of )acuu systeand can &i)e an indication of steaand can &i)e an indication of stea(uality +i;e; presence of non'condensable(uality +i;e; presence of non'condensable&ases&ases

Co ercially a)ailable alternati)es toCo ercially a)ailable alternati)es tothe ori&inal Bowie $ Dick test are inthe ori&inal Bowie $ Dick test are inwidespread usewidespread use


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#hat Standards are there#hat Standards are there

that refer to B"D tests?that refer to B"D tests?%TSGGGGGG%TSGGGGGG


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#hich Standards?#hich Standards?

E! 40H'/-766HE! 40H'/-766HE! 40H'3-2887E! 40H'3-2887IS% 75442-288/IS% 75442-288/E! 245 @ prE!245 "2880#E! 245 @ prE!245 "2880#

prE! IS%@ DIS 7H005'7prE! IS%@ DIS 7H005'7 IS%@CD 7H005'2IS%@CD 7H005'2IS% 77738 Parts 7'5IS% 77738 Parts 7'5

Just to na e the ost

rele)ant few>>>>;


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IS%@DIS 77738'3IS%@DIS 77738'3 + Specifies the perfor ance of the indicatorSpecifies the perfor ance of the indicator

syste in co bination with the test load withsyste in co bination with the test load with

which it is intended to be usedwhich it is intended to be usedMay be sin&le or ulti'use with a new indicator eachMay be sin&le or ulti'use with a new indicator eachti e of useti e of use

+ Intended to indicate that stea penetration hasIntended to indicate that stea penetration hasbeen inade(uate in the case of a nu ber ofbeen inade(uate in the case of a nu ber ofdifferent causes for fault cyclesdifferent causes for fault cycles

+ Does not include test ethods to establish theDoes not include test ethods to establish thesuitability of the indicators for use in steriliserssuitability of the indicators for use in sterilisersthatthat do notdo not use a )acuu sta&e for air re o)aluse a )acuu sta&e for air re o)al


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IS%@DIS 77738'5IS%@DIS 77738'5 + Specifies the re(uire ents for an indicator andSpecifies the re(uire ents for an indicator and

alternati)e test syste used to e)aluate thealternati)e test syste used to e)aluate theeffecti)eness of air re o)al durin& theeffecti)eness of air re o)al durin& thepre)acuu phase of pre)acuu steapre)acuu phase of pre)acuu steasterilisation cycles or durin& the pulsin& sta&e ofsterilisation cycles or durin& the pulsin& sta&e ofpositi)e pulsin& cyclespositi)e pulsin& cycles

+ ailure of the test could be due to retention ofailure of the test could be due to retention ofair* an air leak or non'condensable &ases durin&air* an air leak or non'condensable &ases durin&the air re o)al sta&ethe air re o)al sta&e


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S*mmary of theS*mmary of the

differencesdifferences ,IS% &- /0,IS% &- /0

Hk& pack Hk& pack Hk& pack 3k& pack


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ail condition per 77738'5

"inade(uate air re o)al#

T8 incha berdrain

ail condition per 77738'/"%ri&inal Bowie $ Dick result#

ail conditions per77738'3",an&e of Causes#

IS% 75442* Annex A


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#hich test is right for my#hich test is right for my

steriliser?steriliser?hat air re o)al syste does your steriliserhat air re o)al syste does your steriliserha)eha)e

+ Subat osphericSubat ospheric + Pulses occur all below at ospheric conditionsPulses occur all below at ospheric conditions + Transat osphericTransat ospheric

+ Pulses occur abo)e and below at osphericPulses occur abo)e and below at osphericconditionsconditions

+ Superat osphericSuperat ospheric + Initial )acuu pulses followed byInitial )acuu pulses followed by

superat ospheric pulsessuperat ospheric pulses

Check both the steriliser and BD testCheck both the steriliser and BD test

anufacturerKs reco endationsanufacturerKs reco endations


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#hat are yo* *sing the#hat are yo* *sing the

Bowie and Dick test to do?Bowie and Dick test to do?

Check only for ade(uate air re o)alCheck only for ade(uate air re o)al + Select a test co pliant with IS% 77738'5Select a test co pliant with IS% 77738'5

Check for both air re o)al and steaCheck for both air re o)al and steapenetrationpenetration + Select a test sheet co pliant with IS%77738'/Select a test sheet co pliant with IS%77738'/

Check for both air re o)al* steaCheck for both air re o)al* steapenetration and possible failures due topenetration and possible failures due toother causesother causes + Select a test co pliant with IS%77738'3Select a test co pliant with IS%77738'3


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#hat to look for in a#hat to look for in a

testtestConfor ance to the applicable E! orConfor ance to the applicable E! orIS% StandardsIS% Standards + Independent certification of confor anceIndependent certification of confor ance

in preference to self certificationin preference to self certification + Clear instructions on how to store*Clear instructions on how to store*

handle* use and interpret the testhandle* use and interpret the test + Infor ation on the reliability inInfor ation on the reliability inaintainin& end point chan&eaintainin& end point chan&e


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#hat to look for in a test..#hat to look for in a test..

The indicator sheetThe indicator sheet + ,ea&ent ust co)er F /8L of the sheet with no,ea&ent ust co)er F /8L of the sheet with no

ore than 28 &ap between areas of rea&entore than 28 &ap between areas of rea&ent + The pattern ust enable clear interpretation ofThe pattern ust enable clear interpretation of

the colour chan&ethe colour chan&e + The ed&es ust be able to be co pared withThe ed&es ust be able to be co pared with

the centre and be of A3 si9ethe centre and be of A3 si9e "IS% 77738'/ only#"IS% 77738'/ only#

+ The dye ust be non'toxic and non'transferableThe dye ust be non'toxic and non'transferable + The indicator itself or the pre'asse bled packThe indicator itself or the pre'asse bled pack

ust allow writin& to be ade on itust allow writin& to be ade on it


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Clear colo*r changeClear colo*r changeUnprocessed Processed (Pass)


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#riting can !e made on#riting can !e made on

the pack or the test sheetthe pack or the test sheet


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)ow to perform the test)ow to perform the test

E pty cha ber except for cha berE pty cha ber except for cha berfurniture and the test itself furniture and the test itself

ocate the test in the &eo etric centre ofocate the test in the &eo etric centre ofthe hori9ontal plane of the usable cha berthe hori9ontal plane of the usable cha berspace between 788'288 fro thespace between 788'288 fro thecha ber base "E! 245#cha ber base "E! 245# + This ay or ay not be o)er the cha ber drainThis ay or ay not be o)er the cha ber drain


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This is 2%T how to *se aThis is 2%T how to *se a

BD type test 3BD type test 3


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)ow to perform the test)ow to perform the test

The sterilisin& sta&e of the cycle ustThe sterilisin& sta&e of the cycle ustbe no lon&er than / < inutesbe no lon&er than / < inutes + Many sterilisers now incorporate a pre'setMany sterilisers now incorporate a pre'set

air re o)al and stea penetration testair re o)al and stea penetration testcyclecycle

+ Dryin& ti es should not be extendedDryin& ti es should not be extended


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)ow to interpret the)ow to interpret the

res*ltres*ltStandard Procedure toStandard Procedure tobe followedbe followed

All staff trained to All staff trained tointerpret the resultinterpret the resultaccordin& toaccordin& toanufacturerKsanufacturerKsinstructionsinstructionslat surface and clearlat surface and clearo)erhead li&htin&o)erhead li&htin&Co pare ed&es toCo pare ed&es tocentrecentre


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4ecord 5eeping4ecord 5eeping

There is no specified &uidance withThere is no specified &uidance withrespect to the len&th of ti e to keep arespect to the len&th of ti e to keep a

che ical indicator result* e)en a BDche ical indicator result* e)en a BDindicatorindicator + IS% 75442 states that users ay recordIS% 75442 states that users ay record

the outco e or result of the indicator* orthe outco e or result of the indicator* orchoose to retain it for )aryin& periods ofchoose to retain it for )aryin& periods ofti e accordin& to local re(uire entsti e accordin& to local re(uire ents


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In concl*sionIn concl*sion

: : e hope that others will use it*e hope that others will use it*perhaps in con unction with oreperhaps in con unction with ore

refined ethods* to exa inerefined ethods* to exa inesterilisers>and in doin& so>;they willsterilisers>and in doin& so>;they willcollect uch needed infor ation aboutcollect uch needed infor ation about

the current status of sterilisers>1 the current status of sterilisers>1 + Bowie et al "760/#Bowie et al "760/#


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4eferences and 6*rther4eferences and 6*rther

4eading4eadingBowie* J; .;* elsey* J; C;* Tho pson* N; ,; "760/#Bowie* J; .;* elsey* J; C;* Tho pson* N; ,; "760/#The Bowie and Dick Autocla)e Tape Test;The Bowie and Dick Autocla)e Tape Test; TheTheancet* pp540'54Hancet* pp540'54H

Bowie* J; "7643#Bowie* J; "7643#

Dr John Bowie on the Bowie andDr John Bowie on the Bowie and

Dick test;Dick test; Journal .SPD March@April ol 2 !o;2 ppJournal .SPD March@April ol 2 !o;2 pp20'2420'24Maywor * D; "7643#Maywor * D; "7643# The Bowie'Dick type test>AreThe Bowie'Dick type test>Arethere alternati)e waysthere alternati)e ways Journal .SPDJournal .SPD ol 2* !o; 2 ol 2* !o; 2 pp /7'/3 pp /7'/3 ,yan* P; "7643#,yan* P; "7643# The Bowie'Dick type test>TheThe Bowie'Dick type test>Thediscrepancies between theory and practice;discrepancies between theory and practice; JournalJournal.SPD March@April ol 2* !o;2; pp28'23.SPD March@April ol 2* !o;2; pp28'23


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4eading4eadingBorchers* O; $ Mielke* M; "2883#Borchers* O; $ Mielke* M; "2883# .ow.owaterial* len&th* wall thickness andaterial* len&th* wall thickness and

dia eter of hollow de)ices affect thedia eter of hollow de)ices affect theinacti)ation of biolo&ical indicators wheninacti)ation of biolo&ical indicators whensub ected to oist heat treat ent;sub ected to oist heat treat ent; entralentralSterilisation ol; 72 "5# pp/73'/22Sterilisation ol; 72 "5# pp/73'/22

Eifler* P; "2883#Eifler* P; "2883# Is the stea % The airIs the stea % The airdetector knows the answer;detector knows the answer; entralentralSterilisation ol; 72 "3# pp2H6'247Sterilisation ol; 72 "3# pp2H6'247


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4eading4eadingIS% 77738 '7 2885IS% 77738 '7 2885 Sterilisation of .ealth CareSterilisation of .ealth CareProducts + Che ical indicators + Part 7 NeneralProducts + Che ical indicators + Part 7 Neneral,e(uire ents ,e(uire ents + IS% 77738 '/ 2888IS% 77738 '/ 2888 + Sterilisation of .ealth Care Products ++ Sterilisation of .ealth Care Products +

Che ical indicators + Part / Class 2 indicators for steaChe ical indicators + Part / Class 2 indicators for steapenetration test penetration test sheets sheets

+ IS% 77738 '3 2887IS% 77738 '3 2887 + Sterilisation of .ealth Care Products ++ Sterilisation of .ealth Care Products +Che ical indicators + Part 3 Class 2 indicators for steaChe ical indicators + Part 3 Class 2 indicators for steapenetration testpenetration test packs packs

+ IS% 77738 '5 2888IS% 77738 '5 2888 + Sterilisation of .ealth Care Products ++ Sterilisation of .ealth Care Products +Che ical indicators + Part 5 Class 2 indicators forChe ical indicators + Part 5 Class 2 indicators for airairre o)al test sheets and packs re o)al test sheets and packs


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4eading4eadingIS% 777/6 "draft 2885#IS% 777/6 "draft 2885# Sterilisation ofSterilisation ofhealth care products + ocabulary 2 health care products + ocabulary 2 nd nd edition edition

IS% 75442-288/IS% 75442-288/ Sterilisation of .ealth CareSterilisation of .ealth CareProducts + Che ical indicators + NuidanceProducts + Che ical indicators + Nuidancefor selection* use and interpretation offor selection* use and interpretation ofresults results

IS% 75442 "draft 2885#IS% 75442 "draft 2885# Sterilisation ofSterilisation ofhealth care products + Che ical indicators +health care products + Che ical indicators +Nuidance for the selection* use andNuidance for the selection* use andinterpretation of results;interpretation of results;


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Bowie Dick Test Efhss Conf2006 Lecture17 En

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