The American Society for Gastrointestinal Endoscopy has issued new, endoscopy-specific guidelines to establish accepted practices at GI facilities.
Their publication comes in response to CMS's Ambulatory Surgical Center Conditions for Coverage, which had accreditors holding endo suites to the same standards as sterile ORs, even though clinical and staffing requirements for surgery aren't necessarily applicable or necessary in endoscopy settings.
Here's a list of the ASGE's new recommendations:
- Have a designated flow for the safe physical movement of dirty endoscopes and other equipment.
- Assign more complex procedures to larger procedure rooms with space for more specialized equipment and, in some cases, additional staff.
- Before starting an endoscopic procedure, the patient, staff and performing physician must verify the correct patient and procedure to be performed.
- A qualified staff member must implement a specific infection prevention plan.
- Staff engaged in direct patient care must wear gloves and impervious gowns.
- Have a terminal cleansing plan that includes methods and chemical agents for cleansing and disinfecting the procedural space at the end of the day.
- In addition to the performing physician, a single nurse is required in the procedure room during routine endoscopy involving moderate sedation.
- Complex procedures may require additional staff for efficiency, but not necessarily for safety.
- At a minimum, perform patient monitoring before the procedure, after administration of sedatives, at regular intervals during the procedure, during initial recovery and before discharge.
- For cases involving moderate sedation, the individual responsible for patient monitoring may perform brief, interruptible tasks.
- Current data does not support the routine use of capnography during cases involving moderate sedation.
For full explanations of the recommendations, including the ASGE's position and rationale for each, check out the complete document.