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Archive Infection Control 2018

Are Your Endoscopes Really Clean?

Don't bet on it. A study shows just how difficult the devices are to disinfect.

Jim Burger

Jim Burger, Senior Editor


Skin Prep
TO THE LETTER Make sure endoscope reprocessing guidelines are always followed and document that your scopes are clean and in good working order.

Is there a medical device that's harder to reprocess than a flexible endoscope? You can do everything right — wipe it down at the bedside, manually clean it with the properly sized brush and run it through an automatic endoscope reprocessor — and still find bacteria in its channels.

Those were the findings of an eye-opening study conducted at a surgery center specifically chosen for the quality of its endoscope care protocols ( Staff members at the facility did an impeccable job of following reprocessing guidelines. Moreover, the study took place over the course of 7 months, and during that time, members of the research team dropped in for 9 unannounced audits. Not a single deficiency was seen. Staff carefully followed all the recommended steps thoroughly and timely, and yet their scopes still showed signs of microbial growth, visible irregularities, discoloration and debris in channels.

It's particularly bad news that their scopes still fared so poorly, but there's a silver lining to the report: It should increase your awareness of just how challenging endoscope reprocessing is to get right and hammer home the importance of constantly monitoring the integrity and cleanliness of your scopes.

Plenty of problems

The surgery center was using 17 endoscopes when the study was initiated. Over the 7-month study period, they also brought in 5 loaners. In all, those 22 scopes included 7 adult colonoscopes, 8 pediatric colonoscopes and 7 gastroscopes. All were less than 2½ years old and most had been used between 400 and 500 times.

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