Archive January 2014 XV, No. 1

Are Your Endoscopes Clean Enough?

A manager's guide to successful reprocessing.

Karen Swanson, LPN, CSPM


brushes for endoscopes SCRUB IN The right sized brushes are a must for different sized lumens and channels.

Several of the biggest medical malpractice headlines in recent years have involved the improper reprocessing of flexible endoscopes. The thorough manual cleaning, decontamination and high-level disinfection of these complex instruments is critical to infection prevention and patient safety, but there's a lot of room for error in the process. These 4 pointers can help you manage your reprocessing staff to ensure they're delivering the cleanest possible scopes to your endo cases.

1. Don't cut corners
The easy efficiency of an endo doc who's on a roll is a thing to behold. For the sterile processing staff readying the scopes for his upcoming cases, though, the pressure of keeping up with the schedule can be intense. When people are rushed, it's easy for them to skip a step, intentionally or not, or lose their focus on the task at hand.

Endoscope reprocessing is no time for cutting corners. Your staff must follow each and every step of the scope manufacturer's instructions for use, from bedside pre-cleaning (use water and/or enzymatic detergent to remove gross soil from the exterior surface and flush the channels as soon as possible after use, enlisting your OR staff to assist) to post-reprocessing storage (hang the scopes vertically, with all detachable components removed). What's more, they shouldn't assume that all scopes can be reprocessed in the exact same way. Each model is different, and manufacturers' specifications are intricately detailed for a reason.

Routine in-service sessions and certification courses through professional organizations can reinforce the importance of process among your reprocessors. Also take advantage of your scope manufacturer as an educational resource. Many offer free laminated instruction posters, videos to download and training visits from company reps who always understand the scopes you're using inside and out.

As for the actual written copies of scope manufacturers' instructions, don't just file them and forget them. Be sure you have the most current version stored where your staff will be able to consult them in the event that reprocessing and handling questions arise. Surveyors are eager to see easily accessible instructions during their visits.

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