Archive December 2017 XVIII, No. 12

Is It Time to Sterilize Endoscopes?

A much-needed higher standard may be on the horizon.

Jim Burger

Jim Burger

BIO

endoscopes FALSE CONFIDENCE? Evidence suggests that current IFUs and standards aren't rigorous enough to ensure that endoscopes are adequately reprocessed, say experts.

Has the time come to acknowledge that sterilization, and not just high-level disinfection, is what's called for in endoscope reprocessing? "The evidence suggests that current IFUs and standards aren't rigorous enough," says Cori Ofstead, MSPH, president and CEO of healthcare research company Ofstead & Associates in St. Paul, Minn. "And we now know that they weren't based on real-world evidence of effectiveness."

When we asked a panel of more than 200 Outpatient Surgery Magazine readers how confident they were that their facility will never be the source of an endoscopy-related outbreak, 29% said they were "extremely confident," and 11% admitted they were "not as confident as [they'd] like to be." The other 60% are confident, just not extremely so, perhaps because reprocessing is such a difficult chore.

To wit, one-third of our respondents agreed with this statement: "The large number of tasks involved in high-level disinfection of endoscopes is so complex that it's difficult to be confident that it's being done right every time."

But lack of confidence in the specifics doesn't seem to translate into a lack of confidence overall. "This indicates a misunderstanding of the nature of risk," says Ms. Ofstead, who reviewed our survey results. And the risks, she adds, go well beyond the complexity of the process, no matter how diligent your employees are.

"Human factors and skipped steps are only part of the problem," she adds. "Clinicians often continue to use scopes that have critical defects, and residual contamination is more common when scopes are damaged. Furthermore, outbreaks have occurred even in cases when no breaches were identified."

Cutting it close?
We also asked whether respondents see themselves in this statement: "We place a high value on efficiency and throughput in our facility, which means that we may occasionally be in danger of cutting it a little too close when it comes to endoscope reprocessing."

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