ENDOSCOPE GUIDE
GI LABS from page 38
In addition, to expe- of expensive, refurbishment-level repairs.
OVERALL MEDIAN AGE OF ENDOSCOPES
dite transport to re- (More information about avoiding fluid inva-
mote reprocessing ar- sion is available at olympusamerica.com/
Overall Median Age of Scopes 2008 2009
eas, staff may be more endoscopecare.)
All endoscopes 2.6 years 3.0 years
tempted to tightly coil Space: The reprocessing room should
Workhorse colonoscopes 3.0 years 3.5 years and stack scopes to- be of adequate size with proper ventila-
gether or scopes and tion. Check the sink and drain and work
Workhorse gastroscopes 3.1 years 3.6 years
accessories together in areas to ensure they are free of sharp
ERCP scopes 3.0 years 4.3 years
the same transporta- edges. Remove all unnecessary objects
®
Courtesy of Olympus EndoSite Consulting, 2009 Q3 Benchmark Data
tion bins. Such short- that might inadvertently damage the en-
cuts make scopes more doscope. The reprocessing room should
have taken into consideration the dynam- vulnerable to kinks, cuts, punctures and leave ample counter space for leak testers,
ics of staff, equipment and workspace. other damage. basins, flushing pumps and so forth so
Below are a few questions to think about Time: In the reprocessing area, allow that there is adequate room to maneuver
with respect to your own facility: staff adequate time to complete all clean- the scopes without stacking or bumping
• Do you have an appropriate number of ing, disinfection and sterilization (CDS) them into other equipment.
prep and recovery bays to meet the steps in accordance with OEM guidelines. Benchmark data indicates that appro-
needs of your case mix and volume? The procedural schedule can often get priately sized reprocessing space is a rec-
• Do your workspaces follow a dirty-to- hectic. Unfortunately, the more rushed the ognized and ongoing issue. In 2009, 20%
clean flow? Is the reprocessing room reprocessing technician gets, the more op- of survey participants agreed that their
close to the procedure room for conve- portunity there is to omit steps, causing workspace was too small.*
nient transport of the dirty scopes and endoscope damage and downtime. Insuf- Sinks: Use a sink large enough to avoid
accessories in a dirty-to-clean path? ficient or improper leak testing can result crimping the instrument during leak test-
• Does the procedure room have adequate in accidentally missing a small leak, ing and manual cleaning. The sink should
space to safely protect endoscopes be- which left unchecked can escalate into a be deep enough to allow full immersion
fore, during and after procedures? major repair. Failure to inspect water-re- of the endoscope to effectively accomplish
• Does your facility have dedicated clean sistant caps before attaching them to the leak testing and manual cleaning. Never
scope storage, separate from accessories? scope or forgetting to attach the water- use sinks to stack scopes waiting for leak
In short, a workspace that enhances ef- resistant cap before immersing the scope testing and manual cleaning.
fective operational throughput may into the basin of water can also cause dam- AERs: If your facility uses automated
mean less rushing and fewer incidents age and additional repair work that could endoscope reprocessors (AERs), make
of damage. have largely been avoided. sure you have the appropriate number
On average, 2009 benchmark repro- and types of machines to adequately pro-
Rearrange your reprocessing cessing time data showed that 8.9 min- cess your volume of scopes. Benchmark
Equally as important as a well-designed utes were required for leak testing and data for 2009 shows that on average, 1.8
facility, GI labs should effectively struc- mechanical cleaning, 32.3 minutes for scopes wait for 14.3 minutes during peak
ture reprocessing protocols and pro- AER cycle time and 5.2 minutes for post- times to be reprocessed.*
cesses as well as the workspace. Their automated time, for a total of 46.3 min- Make sure you are using an AER that
goal should be to maximize the through- utes from start to finish.* Compare your is appropriate for the types of scopes at
put of scopes while minimizing the risk average scope turnaround time from your facility. Use caution and care when
of scope damage. patient scope extraction until the scope placing and removing scopes from
Location: As stated in the Society of is once again patient ready. This is one AERs. Follow the scope manufacturer’s
Gastroenterology Nurses and Associates, benchmark whereby faster is not neces- instructions for use of the AER and for
2008 Standards of Infection Control in Re- sarily better. Factor in sufficient time to approved protocols for high-level dis-
processing of Flexible Gastrointestinal cover all of the necessary reprocessing infection or sterilization. Also, use only
Endoscopes, “Reprocessing of contami- steps based on your staff and equipment FDA-approved liquid chemical germi-
nated patient equipment should be done requirements. cides (LCG) recommended by the endo-
in an area designated and dedicated for Protocols and Processes: Make sure scope manufacturer to protect your
this function. This should be a room to complete pre-cleaning in the procedure equipment from chemical damage. LCG
separate from where endoscopic proce- room. Pre-cleaning removes bioburden potencies should be tested and recorded
dures are performed.” before it has a chance to harden, avoiding prior to every cycle. Staff can avoid un-
Failure to properly clean endoscopes the need for more aggressive cleaning and due chemical damage to the scope as well
produces a host of avoidable consequences potential damage to the scope. Check the as cross-contamination risks by adher-
that drain resources from safe, effective integrity of the water-resistant cap, mak- ing to the detergent and/or disinfectant/
delivery of GI endoscopy services. This ing sure it is dry and attach it to the scope sterilant OEM’s instructions for repro-
dedicated area ideally should be located at bedside. Transport scopes to the repro- cessing times, temperatures, dilution,
close to the procedure rooms. Additional cessing area in covered containers. Then shelf life and expiration. HPN
time spent moving scopes to remote sites in the reprocessing room, always perform
may inadvertently encourage infection leak testing prior to moving on to manual Nancy Vacante, R.N., BS, is the director of
control risks associated with delayed re- cleaning and high-level disinfection. Con- R&D for Olympus’ Clinical Shared Services.
processing. Always check with your origi- sistent leak-testing practices can help you Visit the HPN website for more GI lab tips.
nal equipment manufacturer (OEM) for largely avoid fluid invasion damage to
* 2009 Q3 benchmark survey data, Olympus EndoSite

Consulting.
instructions on delayed reprocessing. the scope, which is the number one cause
SCOPES continues on page 42
40 November 2009 • HEALTHCARE PURCHASING NEWS www.hpnonline.com
0911-Scope Guide-shorrt.pmd 40 10/13/2009, 4:38 PM
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