Access Now: AORN COVID-19 Clinical Support

Archive August 2020 XXI, No. 8

How Does COVID-19 Impact Endoscope Reprocessing?

Now's the time to reemphasize the importance of meticulous cleaning and high-level disinfecting.

Joe Paone

Joe Paone

BIO

TOUGH JOB
Penn State Milton S. Hershey Medical Center
TOUGH JOB Manual cleaning of endoscopes is more critical than ever in the COVID-19 era.

The proper cleaning and high-level disinfecting of flexible endoscopes has been under increased scrutiny because their long, narrow channels make it difficult for reprocessing techs to access or see contaminants stuck deep inside lumens during manual cleaning. If bacteria remain in scopes after manual cleaning, high-level disinfecting won't be effective and the risk of cross-contamination increases.

Right now, however, the only infection on most people's minds is COVID-19, which can reside in both the respiratory and the gastrointestinal tracts — where endoscopes travel. If a patient is COVID-19 positive, the virus can very likely be present in the scope used during the procedure. The pandemic has caused many patients to postpone colonoscopies, among other elective procedures, for fear of being exposed to the coronavirus.

It's a legitimate concern. Or is it?

"Standard cleaning and disinfection should eliminate any viral particles," says Robert Lim, MD, FACS, FASMBS, vice chair of education at Oklahoma University School of Medicine in Tulsa. Other experts express similar sentiments. "Our reprocessing has stayed pretty much the same," says Muriel Moyo, MS, BSN, RN, CCRN-K, NE-BC, clinical director of OPSC, PACU & Endoscopy at PIH Health Downey (Calif.) Hospital, which regularly cultures its scopes to check for residual contaminants. Monjur Ahmed, MD, an assistant professor of gastroenterology at Jefferson University in Philadelphia, told us that after speaking with his scope vendor, he's satisfied that current cleaning and HLD processes with proper adherence to instructions for use (IFUs) will eliminate traces of the coronavirus in scopes.

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