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Archive April 2019 XX, No. 4

On the Road with Dirty Scopes

How you get scopes to and from the cleaning room is just as important as what happens there.

Joe Paone

Joe Paone


Pamela Bevelhymer, RN, BSN, CNOR
CARRY ON MY WAYWARD SCOPE Safely handling and transporting both dirty and clean scopes is a critical infection control function that sometimes doesn't get enough attention at surgical centers.

Cleaning dirty endoscopes is a high priority, but the equally critical process of getting dirty scopes safely to the cleaning area — and keeping them clean on the way back to storage or the next procedure — is an area where most facilities can improve. The fact is, if you don't lock down the process of handling and transporting dirty scopes from the moment of withdrawal to the decontamination area, and then handling and transporting processed scopes to storage or directly to the next patient, you're introducing all kinds of opportunities for something in the chain to go wrong, and increasing the possibility of infection.

Incidences of infection from dirty scopes are distressingly prevalent, so much so that the FDA has made it a priority area. According to a recent report, the problem could be even worse at ASCs and outpatient facilities — which often don't have dedicated infection control units — than it is in hospitals. A September 2018 study by Johns Hopkins researchers published in the British Society of Gastroenterology's Gut journal ( investigated infection rates after colonoscopies and osophagogastroduodenoscopies performed at same-day surgery centers. It found that "postendoscopic infections (those present within 7 or 30 days after the procedure) are more common than previously thought and vary widely by the ASC facility," and that "observed postendoscopic infection rates at some ASCs are over 100 times higher than their expected rates."

The Association of periOperative Registered Nurses (AORN) has published highly detailed, heavily vetted, evidence-based, end-to-end guidelines for processing flexible endoscopes, which represent the most up-to-date science on this issue. To hit on all the main points in handling and transporting scopes, we consulted Erin Kyle, DNP, RN, CNOR, NEA-BC, perioperative practice specialist with AORN in Denver, Colo.

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