CLEANR Study Identifies Inconsistencies in Endoscope Reprocessing
The results of a new observational study, Clinical Evaluation and Assessment of Endoscope Reprocessing (CLEANR), found that while participating facilities have written endoscope reprocessing guidelines in place, there were significant variations in manual reprocessing techniques. These inconsistent practices could expose patients and staff to risks associated with hospital-acquired infections (HAIs). The results were presented in May 2009 at the Society of Gastroenterology Nurses and Associates (SGNA) Conference in St. Louis. READ MORE…
New CDC Guideline for Disinfection & Sterilization
In November 2008, the Centers for Disease Control and Prevention (CDC) released a new “Guideline for Disinfection and Sterilization in Healthcare Facilities.” This 158-page document replaces the relevant portions of the 1985 CDC guideline and was the culmination of a rigorous process that involved reviewing 1,035 scientific articles. It was developed by Drs. William Rutala and David Weber in collaboration with the Healthcare Infection Control Practices Advisory Committee (HICPAC).
White Paper Explores Single-Use High-Level Disinfectant for AERs
Each year, more than 10 million gastrointestinal endoscopic and 500,000 flexible bronchoscopic procedures are performed in the U.S.(1) And, because a single flexible endoscope might be used 300-1,200 times a year, many busy endoscopy centers and GI departments have adopted innovative automatic endoscope reprocessors (AERs) and high-level disinfectants not only to reduce staff time and workload spent on reprocessing but also to ensure consistent, effective results.
As part of its commitment to infection prevention and raising the level of health and safety for patients and staff, ASP has published a new white paper, “Disinfection of Flexible Endoscopes in Automatic Reprocessors Using a Single-Use Disinfectant,” that provides a concise review of the available literature and data surrounding the fast, safe, and effective high-level disinfection of flexible endoscopes with CIDEX® OPA Concentrate Solution.
ASP’s single-shot AER, the EVOTECH® Endoscope Cleaner and Reprocessor, utilizes CIDEX® OPA Concentrate Solution, a proven high-level disinfectant offering broad materials compatibility in a unique formulation that ensures fresh disinfectant for every endoscope. It also reduces the risk of cross contamination and staff exposure to disinfectant and pathogens. Click here for a complimentary copy of the white paper.
1. Mehta A, Prakash U, Garland R, et al. Prevention of flexible bronchoscopy-associated infection. Chest. 2005;128:1742-1755.
How can hospitals reduce damage to flexible endoscopes?
The lifespan of an endoscope may be 5-8 years if appropriately handled and maintained.(1) However, that often is not the case. In fact, a high percentage of endoscope damage can be attributed to improper handling practices,(1) and the resulting damage can lead to compromised patient safety, as well as significant repair bills. As a result, safely transporting fragile and expensive endoscopes is imperative. The good news is that an estimated 70-90% of that damage is preventable. In fact, proper care and handling can dramatically improve the useful life of an endoscope.(1)
Guidelines from AORN and SGNA include:
1) Transport endoscopes in enclosed containers—when transporting a scope to the reprocessing area, an enclosed container will prevent escape of airborne and droplet contaminants. It is important to consider both the protection of the apparatus and the environment during transport.(2,3)
2) Avoid over-coiling insertion tubes as this may lead to buckling and scope leaks.(2–4)
3) Avoid stacking endoscopes with other accessories or transporting multiple endoscopes simultaneously(4) as this “…increases component contact and leads to an increased risk of puncture damage.”(3)
The new CLEANASCOPE System, a unique transportation system available from ASP, addresses many of the challenges associated with transporting endoscopes before and after reprocessing. Color-coded sterile liners allow staff to quickly identify clean versus contaminated endoscopes. Reusable trays guard against costly equipment damage, and a protective transportation box allows easy mobility around the GI suite. The system also provides a high level of standardization for the processing of endoscopes and can be used with manual or automated reprocessing systems, providing a total GI solution.
Click on the following links to learn more about Safe Endoscope Transport and Handling or for the CLEANASCOPE Data Sheet.
1. Dilulio R. Service solutions: protecting your endoscope investment. 24X7. October 2006; Available at: http://www.24X7mag.com/issues/articles/2006-10_05.asp. Accessed June 26, 2008.
2. Standards of infection control in reprocessing of flexible gastrointestinal endoscopes. Gastroenterol Nurs. Mar-Apr 2006;29(2):142-148.
3. Thomas LA. Transporting the endoscope. Gastroenterol Nurs. Mar-Apr 2005;28(2):145-146.
4. Dix K. Scope cleaning and repair: top 10 ways to keep scopes happy. Infection Control Today. Available at: http://www.infectioncontroltoday.com/articles/scope-cleaning-and-repair.html. Accessed June 26, 2008.
CLEANASCOPE is a registered trademark of Medicart International Limited.
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Ensuring Correct Time & Temperature Settings for AERs
By Bettyann Hutchisson, Clinical Education Consultant, ASP
The exposure time and temperature of detergents and high-level disinfectants are critical elements in the successful high-level disinfection of flexible endoscopes in automatic endoscope reprocessors (AERs). As a result, it is important to make sure that the time and temperature settings are correct before starting an AER cycle. Guidelines may vary depending on the AER and chemicals used, so be sure to consult the disinfectant manufacturer’s instructions for use to determine the correct time and temperature settings in the AER.
Time begins when the entire endoscope is submerged in the disinfectant. All internal and external surfaces must be immersed in the high-level disinfectant. This includes all internal channels of the endoscope. The endoscope must be connected to the AER using a correct set of tubings. When connecting the tubing sets, care should be taken to prevent kinks that may impede fluid flow. Certain channels on endoscopes, such as elevator channels, may require special attention because of their small internal diameter. To prevent patient harm, the time should be verified before each cycle is run.
Temperature for the high-level disinfectant is based on the manufacturer’s recommendations. A thermometer will be needed if the AER used does not display the temperature. The temperature should be verified before each cycle is run.