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Archive Surgical Construction 2020

Gearing Up for GI

Build your program on the essential elements found in leading endoscopy centers.

Keith Mignault

Keith Mignault, BS, MS


Pamela Bevelhymer, RN, BSN, CNOR
CLEAN START The reprocessing department is key to a successful new endo center, and shouldn't be given short shrift during the design phase.

We’ve helped plan and build numerous GI centers and know from experience the amount of time and resources top-performing facilities have invested in smart procedure room designs, the latest flexible endoscope technology and reprocessing areas outfitted with patient safety in mind.

1. Prioritize reprocessing

Endoscopes are difficult to properly disinfect and preventing infections during endoscopies and colonoscopies is paramount, so the design of the reprocessing department might be the most important place to start when planning a new space. With that in mind, best practice is to frame out 3 different rooms: one for decontamination; one for scope washing and one for drying. At a minimum, there should be 2 rooms with a pass-through automated endoscope reprocessor (AER) between them. A pass-through AER costs about $120,000 — 4 times the price of a traditional unit — but it eliminates the need for a third room. The amount of space you have in the new facility and your budget will guide your choice, but either is preferable to washing and drying instruments in a single open space.

Some AERs include barcode-scanning technology that provides the ability to trace the entire life cycle of the scope. It logs which patient the scope was used on, when it was used, when it enters each phase of the high-level decontamination process, which staff member cleaned and disinfected the scope, when it’s placed into a storage cabinet and when it gets used on the next patient. We suggest investing in one of these reprocessors, at about $60,000 each, for every 2 procedure rooms.

Standard endoscope storage cabinets cost $4,000 or $5,000, but we always advocate that new suites be outfitted with cabinets that have automated air circulating technology, even though they’re twice the cost. When you wash and decontaminate scopes, even though the water is filtered and you’re using a highly disinfecting scope washer, it’s possible to turn the scopes around before they’re dry. When that happens, there’s a risk that chemical and water residue will remain in the internal lumens to increase cross-contamination risks. Storage cabinets with air circulating inside ensures scopes return to the procedure room bone dry.

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