Kate James, RPh Deborah Ruriani Glassware Washers: Cleaning Glassware and Implements Used in Compounding, Part 2 Abstract Compounding with glassware and utensils that are contaminated with drug residues or pyrogens is a recipe for disaster. Using a powerful glassware washer, which can ensure that compounding implements are clean and free of contaminants, may be a worthwhile investment for compounding pharmacies in which the volume of preparations justifies the washer s cost. A glassware washer provides cleaning superior to that of residential or commercial dishwashers and offers other advantages that range from reproducible cycle parameters to programs that can be configured for specific cleaning needs to the ability to provide a purifiedwater rinse. In this article, a compounder s decision to purchase a glassware washer and the results of that decision are described, and factors that are critical in the selection of a washer for use in a compounding laboratory are listed. Specifications for glassware washers are compared in a Table, and an easy method of determining the time and cost of automatic washing versus handwashing is presented. 396
When upgrades to a compounding laboratory are made, the installation of a glassware washer to replace a residential or commercial dishwasher is often considered. The purchase of a glassware washer is a substantial investment, however, and selecting the right washer for a specific pharmacy setting can be daunting. A glassware washer provides cleaning superior to that of residential or commercial dishwashers and offers other advantages 1 : Reproducible cycle parameters Liquid dosing Assurance that the correct temperature is achieved and maintained throughout the cycle Programs that can be configured for the specific needs of a compounding laboratory An optional printer that provides evidence of the programmed cycle sequence, the type of water used, the temperatures set and reached, and the type and amount of detergent selected and released The ability to provide a purifiedwater rinse This second article of a two-part series compares specifications for glassware washers (Table 1) and presents an easy method of determining whether washing compounding implements by hand or with a glassware washer is of most value. A compounder s experience with a glassware washer is described, and factors to consider before a purchase is made are listed. The authors affiliations are as follows: Kate James, Broadway Apothecary, Eugene, Oregon; Deborah Ruriani, Miele Professional Products, Princeton, New Jersey Choosing and Using a Glassware Washer: A Compounder s Experience by Kate James, RPh Broadway Apothecary Eugene, Oregon Glassware washer: Miele Professional Laboratory Glassware Washer G7804 (Miele Professional Products, Princeton, New Jersey) In our compounding-only pharmacy, all freshly washed glassware and implements used for nonsterile preparations receive a final rinse with purified water, and those used for sterile formulations receive a rinse with purified water and then a final manual rinse with sterile water for injection. Until we purchased our undercounter Miele glassware washer two years ago, we used a residential dishwasher provided by another manufacturer, and our compounding staff had to devote far too much time to performing manual purified-water rinses. To save that time, which was better spent in compounding, and also the 100 to 140 minutes necessary for rinsed items to air dry, we decided to purchase a new glassware washer that (unlike a residential or commercial dishwasher) would perform both a purified-water rinse and automatic forced-air drying via attachments designed for laboratory glassware. Before we made that decision, we had considered several options: Continuing to use a residential dishwasher but connecting it to a very high-end, high-volume water purification system Purchasing a used glassware washer Using a large purified-water tank connected to two residential dishwashers Using a medium-sized tank of purified water connected to a glassware washer However, when we considered our water use, maintenance costs (replacing filters, etc.), and the time required to complete the necessary cleaning cycles, we found that installing a new glassware washer was the most economical choice for the long term, though it was a greater investment up front. If we had purchased a used washer, we d always have been unsure about what had been washed in that unit previously. Our choice of a new Miele glassware washer was based on the ability of that company to integrate their unit with our water purification system. We selected a model that, for ergonomic reasons, could be installed at a height that ensures the washer is comfortable to use. We then constructed a dishwashing room that is central to our laboratory and now houses our water purifier, the glassware washer, and all the drying racks and sterile-water hookups used for sterile-rinse items. Since it was installed, the glassware washer has required no maintenance other than replenishing the detergent and water stabilizer. We greatly appreciate the washer s safety features. For example, once, after our water purifier had been unplugged accidentally, the glassware washer used all the purified water in the storage tank and then automatically shut off and locked, thus terminating the cycle in progress. If a malfunction of the glassware washer were to occur, we d be alerted by a digital readout, an alarm, and/ or lockdown, depending on the severity of the problem. At the time of this writing, we ve had our Miele glassware washer for two years, and it has already paid for itself. We remain very happy with its performance. It is very easy for all staff to operate, and it greatly outperforms the high-end stainless steel residential dishwasher that we had. The residential dishwasher required about two hours to complete a good wash, after which additional time was required to air dry the handrinsed items. Because the clean- 397
Table 1. Specifications for Glassware Washers Appropriate for Use in a Compounding Laboratory. Miele Undercounter Laboratory Glassware Washers with the Organica Program Miele, Inc., Gütersloh, Germany We re so sure we ve got it right... We ve guaranteed it. Note: Miele provides a full line of glassware washers that offer fully validated processes and more customizable programming, but the following washers are recommended for drug-compounding laboratories. Models G7883, G7883 CD, and G7893 Features of the models listed: Multitronic controller 8 Standard programs, 2 utility programs, and 1 custom program, and deionizedwater rinse 106 gal/min high-flow circulation Separate drain and circulation pumps Door-cup powder detergent dispenser Automatic liquid organic-acid neutralizing agent dispenser Stainless steel exterior Exclusive waterproof system Washing and deionization rinses at temperatures as high as 93 C Neodisher detergent packages Free application assistance for the life of the washer Free call-center support for the life of the washer HEPA-filtered drying (G7883CD and G7893 washers) Wide array of baskets and inserts System4Lab is Miele s guaranteed cleaning solution for laboratory glassware, featuring: Highly competent machinery Neodisher detergent packages World class application assistance (lifetime of product) Nationwide service network & free call center support (lifetime of product) So sure we ve guaranteed it with a five year limited warranty.* ing power of the Miele glassware washer is far greater than that of a dishwasher, we rarely have to rewash glassware and other compounding implements (spatulas, beakers, weights, mortars and pestles, weights). However, we don t wash capsulemachine parts in the Miele washer; they must be handwashed because they are damaged by the temperature (70 C for most wash or rinse cycles) in the washer, 800.991.9380 proinfo@mieleusa.com labwasher.com 398
which was set internally at the time of installation and varies by cycle. (It should be noted that the Miele models listed in Table 1 are better suited for washing capsule-machine parts.) Before we use our glassware washer, we remove visible particles and creamy residues from the items to be washed. We then perform a tap-water handrinse with a spigot in our sink and load the washer, which produces spotless glassware. We can program the length of each cycle and specify whether purified or municipal tap water should be used in each rinse cycle. For the wash cycle of the glassware washer, we use both neodisher LaboClean GK (Chemische Fabrik Dr. Weigert GmbH & Co. KG, Hamburg, Germany) as a detergent and neodisher z (Chemische Fabrik Dr. Weigert GmbH & Co. KG), which is a water stabilizer. We load the detergent before each wash cycle is run, but the water stabilizer is added in quantity only periodically to a reservoir in the unit. Our usual cleaning routine involves a prewash, a main wash, a first interim rinse that uses municipal water, a second interim rinse that uses purified water, and a third (final) rinse that uses purified water before the drying cycle begins. The entire washand-rinse cycle takes a maximum of 30 minutes (instead of 2 hours) to complete. Glassware and implements used for sterile compounding then receive a manual rinse in sterile water for injection. A compounder who considers purchasing a glassware washer should determine the time and money required daily to wash, rinse, and dry compounding implements, as well as the space available for that equipment. There s a point at which purchasing a glassware washer will save money in the long run. We ve found that when compared with a dishwasher, a glassware washer produces compounding tools and glassware that are much cleaner at cycle completion, and we can use those tools much sooner. Although we could have chosen to purchase addon attachments designed to clean oddly shaped items, we found that the Miele washer thoroughly cleans our narrownecked beakers and similar tools without those special options. However, we did purchase additional containers for our spatulas and weights and have found those extra baskets useful. Buying a glassware washer was one of the purchases we made that truly saved our staff time, improved morale, and produced exactly the result that we wanted. Selecting the Best Glassware Washer for a Compounding Pharmacy: Tips from the Experts by Deborah Ruriani Miele Professional Products Princeton, New Jersey Cleaning the equipment used for drug compounding is crucial because the pharmacist must ensure that glassware and other compounding tools contaminated with residues of active ingredients, excipients, etc., from the previous run can be safely reused. Using a glassware washer ensures that thorough washing, rinsing, and drying of soiled implements have been accomplished by the end of the cleaning cycle. Compounding pharmacists who are contemplating the purchase of a glassware washer should consider the following features of the units they consider: Temperature Control Using hot wash water and rinse water is crucial in achieving a proper cleaning result. An increase of 10% in degrees Celsius will double the rate of cleaning. Pharmacists should look for a glassware washer that heats wash water to the desired temperature quickly and that can provide deionized rinse water at a temperature of at least 70 C. In general, higher water temperatures mean better rinses, but in some applications, lower temperatures are desirable. Although some laboratory glassware washers provide water at a temperature as high as 93 C, we recommend using rinse water at a temperature of 80 C, like that recommended for the Miele Organica program (Miele Professional Products, Princeton, New Jersey) (Table 1). Appropriate Mechanical Action It is often assumed that a high-pressure wash and rinse are essential, but using higher water pressure also means a greater likelihood of breaking glassware during the cleaning cycle. A high rate of water circulation at a low discharge pressure provides the best cleaning result without the risk of breaking glass items. The number of times that water and detergent contact the surface to be cleaned is more important than how hard the water hits the items to be cleaned, and above a certain minimum detergent concentration, doubling the detergent may provide only a 10% increase in cleaning and a 25% increase in bath life. Using a professional glassware washer provides greater assurance that the implements washed will be cleaned. For example, one of the Miele glassware-washer circulation pumps is rated at 106 gal/min; typical laboratory glassware washers are rated at 60 gal/min, and typical household dishwashers are rated at 25 gal/min. A high water-circula- 399
tion rate is energy efficient and requires relatively less detergent but helps to ensure analytically clean results. Cycle Time Increasing the length of the wash cycle improves cleaning results, but most laboratories cannot afford to wait the time required for a glassware washer to complete long cycles. If a glassware washing system that provides both a high water-circulation rate and extremely hot water is used, a shorter cycle time is effective in cleaning glassware and implements. Beyond a certain minimum cleaning time, doubling the cleaning time may provide only a 10% increase in cleaning capability. Although two washer brands may have almost identical specifications, one brand will eliminate trace metals in 45 minutes but the other will require more than 2 hours to produce the same results. Noting cycle-time specifications is important. Use of Detergent Selecting the proper detergent is an important step in ensuring clean glassware and compounding tools. Some detergents work optimally at a certain temperature; thus a higher temperature will not necessarily produce cleaner washed items. Pharmacists who purchase a professional glassware washer should review the extensive line of available powder and liquid detergents and acid neutralizers that remove residues from glassware and other implements. Deionization Water Rinse The complete elimination of residues is best achieved by using one or more heated deionized-water rinse cycles. Some laboratory glassware washers, such as the Miele models G7883 and G7893 (Miele Professional Products) (Table 1), feature a deionization water connection that heats the water to temperatures up to 93 C. Typically, one to three deionized-water rinses are sufficient to ensure clean glassware and implements. Of most benefit is a glassware washer that can be programmed to use purified water for any or all steps of the cleaning process and that provides a flow meter for all incoming water types, which enables extremely precise filling as well as the ability to vary the fill volume by program step. The glassware washer construction must be robust enough to withstand heated 18-MΩ deionized water. Conclusion Using glassware and implements that are contaminant free is essential to ensuring the safety of compounded preparations. Glassware washers, which are equipped with attachments designed to thoroughly wash, rinse, and dry contaminated utensils, offer a variety of cleaning cycles that can be customized to a pharmacy s particular requirements. A pharmacist who is contemplating the purchase of a glassware washer should consider the space available for that equipment; determine the time and money required daily to wash, rinse, and dry compounding implements; inquire about warranties and guarantees; and ask whether a test wash can be run on samples. We suggest that when compared with a dishwasher, a glassware washer more quickly produces compounding tools and glassware that are much cleaner at cycle completion. Due diligence is required, however, to determine whether purchasing a glassware washer will save money long term. Acknowledgment The authors appreciate the assistance of Jane Vail in the compilation and completion of parts 1 and 2 of this article. Reference 1. Zatarski M, Nolan O, Corbetti R. Glassware washers and implements used in compounding, Part 1. IJPC 2012; 16(4): 312 320. [Before print.] For additional information, contact Jane Vail at janevail@sbcglobal.net Special Cleaning Options To clean glassware used to prepare organic compounds, a washer that removes residues such as oils, fats, wax, and agar; cleans moderately to heavily soiled items; and has moderate rinse requirements may be of benefit. Using a liquid or powder alkaline-based detergent in a glassware washer that supplies cold or warm deionized water can ensure that no residue will remain. We suggest that using an organic-acid neutralizing agent in addition to detergent produces the best result. 400