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Advocate Good Samaritan Eliminates STERIS System 1*—With Impressive Results
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With the recent mandate that hospitals eliminate STERIS System 1* (SS1), many facilities are working to make a smooth and rapid switch to alternative reprocessing methods. Advocate Good Samaritan Hospital, a 333-bed Level 1 trauma center serving metropolitan Chicago, is one step ahead. More than five years ago, the hospital eliminated SS1 in the operating suite, replacing it with low-temperature hydrogen peroxide gas plasma sterilization for flexible endoscopes. The impressive results achieved by the hospital include optimized availability of expensive instruments, increased instrument turnover, and decreased instrument repair costs.
“We are fortunate that we were ahead of the curve in eliminating STERIS System 1*,” said Grant Smith, RN, clinical manager operations, surgical services at Good Samaritan. “We know that many SPD [Sterile Processing Department] and OR managers and staff are going to have to quickly educate themselves about alternatives to STERIS System 1*…” READ MORE |
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Key Steps to Follow when Going STERIS System 1* Free
• Understand Instrumentation
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• Understand Workflow
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• Understand Capital Requirements
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• Understand
Behavior Setting
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We are transitioning from STERIS System 1* to manual reprocessing of flexible endoscopes. What do we need to know to ensure that we are following the proper reprocessing procedures?
To ensure the safe and successful treatment of patients, it is critical to properly reprocess flexible endoscopes and accessories.1 All staff involved in instrument reprocessing should consult SGNA standards and guidelines for detailed information about how to clean and high-level disinfect gastrointestinal endoscopes.2 The following steps are required:2,3
- Precleaning
- Leak testing
- Cleaning
- Rinsing
- Disinfection
- Rinsing
- Drying
- Storage
Precleaning is necessary immediately after removing the endoscope from the patient. Endoscopes then should be transported to the reprocessing area in containers large enough that they will not be damaged by being coiled too tightly and with lids to prevent cross contamination.2
Leak testing follows in the endoscope reprocessing area, as well as manual cleaning—a critical step in removing the microbial burden from an endoscope. Endoscopes then are thoroughly rinsed with clean water, and the exteriors are dried to remove water that could dilute the disinfectant.2
High-level disinfection, recognized as the standard for reprocessing gastrointestinal endoscopes, comes next. When manually disinfecting, the endoscope and all removable parts should be completely immersed in a basin of high-level disinfectant, such as CIDEX® OPA Solution (0.55% ortho-phthalaldehyde) from ASP. All channels of the endoscope should be injected with disinfectant, with no air pockets remaining within the channels.2
Soak the endoscope for the time required in the instructions for use—for example, CIDEX® OPA Solution provides high-level disinfection with a 12-minute soak time at room temperature (20°C). Endoscopes should then be thoroughly rinsed and dried (with air and alcohol). Store endoscopes by hanging them vertically in a clean, well-ventilated, dust-free area.2
For more information about manual reprocessing, visit www.sgna.org.
References
1. Infection control during GI endoscopy. Gastrointestinal Endoscopy. 2008;67:781–790.
2. Standards of Infection Control in Reprocessing of Flexible Gastrointestinal Endoscopes. Chicago, IL: Society of Gastroenterology Nurses and Associates, Inc. (SGNA); 2009.
3. WGO/OMED Practice Guideline Endoscope Disinfection. Munich, Germany: World Gastroenterology Organisation; 2005.
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Do you have questions about transitioning away from STERIS System 1* for reprocessing flexible endoscopes?
E-mail us at: frontiers@aspus.jnj.com.
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Literature Update
White Paper Published on Efficacy of High-Level Disinfection with CIDEX® OPA Solution
Each year in the U.S., more than 2 million patients are affected by healthcare-associated infections (HAIs), which pose a serious threat to patient safety.1 With more than 10 million gastrointestinal endoscopic and 500,000 flexible bronchoscopic procedures performed annually in the U.S., reusable flexible endoscopes have the potential to play a role in HAIs.2,3 Proper cleaning and disinfection of expensive, delicate endoscopes are crucial to ensure patient safety and maintain optimal function.4,5 As a result, selecting detergents and high-level disinfectants are important clinical and risk management decisions.
As part of its commitment to protecting lives against infection, ASP has published a new white paper, “Efficacy of High-Level Disinfection with CIDEX® OPA Solution,” which details the extensive testing conducted to evaluate the efficacy of the high-level disinfectant.
CIDEX® OPA Solution has been proven effective against a broad range of viruses, fungi, and bacteria in more than 10 years of clinical use and efficacy testing. Click here for a complimentary copy of the white paper.
References
1. Centers for Disease Control and Prevention. Public health focus: Surveillance, prevention and control of nosocomial infections. Morbidity and Mortality Weekly Report. 1992;41(42):783–787.
2. Mehta A, Prakash U, Garland R, et al. Prevention of flexible bronchoscopy-associated infection. Chest. 2005;128:1742–1755.
3. Nelson D, Jarvis W, Rutala W, et al. Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. Infect Control Hosp Epidemiol. 2003;24:532–537.
4. Rutala W, Weber D. Disinfection of Endoscopes: Review of new chemical sterilants used for high-level disinfection. Infect Control Hosp Epidemiol. 1999;20:69–76.
5. Miller M. ICRE-1108: Instrument processing overview: cleaning, disinfection, sterilization. http://www.iceinstitute.com/. Accessed Nov. 11, 2008.
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Documentation in the Endoscopy Center
By Cathy Rocco, Clinical Education Consultant, ASP
The Standards of Infection Control in Reprocessing of Flexible Gastrointestinal Endoscopes recommend that a number of variables be documented in the patient’s record for endoscopy procedures:1
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The procedure date & time
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The patient’s name & medical record number
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The endoscopist
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The endoscope model & serial number or other identifier
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The AER (if used) model & serial number or other identifier
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The staff member(s) reprocessing the endoscope
This information needs to be recorded whether reprocessing is done manually or in automated endoscope reprocessors (AERs). The EVOTECH® Endoscope Cleaner and Reprocessor (ECR) from ASP simplifies documentation by producing a complete report, which is printed out at the end of every cycle. The printout clearly identifies the high-level disinfectant used and documents the minimum effective concentration (MEC) on every cycle. As surveyors are known to ask, “How do you know the scope you are using on a patient has undergone high-level disinfection?”, the EVOTECH® ECR gives the assurance that proper reprocessing procedures are in place for the safety of patients and staff members. All of the required information can be found on one printout, simplifying compliance with the guidelines.
References
1. Standards of Infection Control in Reprocessing of Flexible Gastrointestinal Endoscopes. Chicago, IL: Society of Gastroenterology Nurses and Associates, Inc. (SGNA); 2009. |