Make room in your guidelines and manuals binder: Leading GI and infection control groups have updated their guideline for the reprocessing of flexible endoscopes for the first time since 2003.
The 2011 multisociety guideline from the American Society of Gastrointestinal Endoscopy (ASGE) and Society for Healthcare Epidemiology of America (SHEA), replaces the initial 2003 document on flexible endoscope reprocessing. "Given the ongoing, but rare, occurrences of endoscopy-associated infections attributed to lapses in infection prevention, an update of the multisociety guidelines was warranted," says Bret T. Petersen, MD, FASGE, chairman of ASGE's quality assurance in endoscopy committee.
In a press release announcing the new document, the 2 organizations note that high-level disinfectants, automated endoscope reprocessors and the scopes themselves "have all evolved" since the 2003 guideline first came out. "However, the efficacy of decontamination and high-level disinfection is unchanged, and the principles guiding both remain valid."
Thus, the new guideline covers old ground (thorough cleaning followed by, at minimum, high-level disinfection of flexible scopes) and adds discussion of new or evolving issues and research, including:
a "review of expanded details related to critical reprocessing steps," such as cleaning and drying;
"reprocessing issues for various endoscope attachments such as flushing catheters";
discussion of risks unrelated to endoscope reprocessing, such as medication delivery; and
mention of issues for which there is not enough data to guide practice, such as endoscope "hang time," the role of microbiological surveillance for the testing of reprocessed endoscopes and scope longevity and durability from an infection prevention standpoint.
The recommendations are available in the June issues of GIE: Gastrointestinal Endoscopy and Infection Control and Hospital Epidemiology.
Irene Tsikitas
