ENDOSCOPE GUIDE
Opting for an oxidizing chemistry
Nurse recounts her journey to endoscope reprocessing upgrade
by Marcia Hardick, R.N., CSPDT, STERIS Corp.
I
started my nursing career working This problem led to the acquisition of used only once that day. We were a busy
in the endoscopy lab. When we first a newer mechanical disinfector. After us- academic center, so our schedule was full
started using glutaraldehyde for re- ing it for one-to-two years we were told and the turnover demand for disinfected
processing scopes, we didn’t know the it had “bacteria” (referred to as biofilm scopes was high.
dangers of inhaling the fumes. The soak- nowadays) within the processor and wa-
ing pan sat next to a window, which we ter lines. We tried to self-disinfect the A glimmer of hope?
would open during warmer weather to processor, but the procedure was so cum- With the assistance of our director of ster-
vent the fumes, never realizing that the bersome that we actually went back to ile processing, we found a new technol-
glutaraldehyde vapors were heavier manual soaking. ogy on the market that was
than air. When the operating room ma- going to meet our require-
terials manager offered us a product that Safety issues arise ments of providing consis-
didn’t smell, I immediately told her we While these processing tently safe endoscopes for
were not interested. We stayed with the issues were going on, use on our patients. We
“smelly” stuff and continued to process one of my nursing col- were the first center in the
our endoscopes in the same room where leagues developed a se- northeastern U.S. to pur-
we performed endoscopic procedures. vere sensitivity to glut- chase a low-temperature
araldehyde and latex sterile processing system
Automation changes gloves. We had a dedi- that used an oxidative chem-
reprocessing – right? cated endoscopy techni- istry. We were pleased be-
Over the next several years we advanced cian by then, but we were
Photo courtesy STERIS Corp.
cause having this new op-
to using an “auto-disinfector.” This elimi- in a tough spot because we were still tion meant that we didn’t need to use the
nated the pressure from physicians to re- using this chemistry in the department glutaraldehyde or ethylene oxide as
lease scopes faster for use because the for reprocessing. much. We used this oxidative chemistry
scope couldn’t be released until the auto- In the late l980s we renovated to create processor as often as we could.
mated cycle was complete. However, we a new bronchoscopy area for our AIDS The ’80s represented the dawn of new
discovered that the “auto-disinfector” was patients. Because of our bad experiences endoscopic technologies and minimally
diluting the glutaraldehyde to such a de- with the two previous processors, we invasive therapies, and everyone was
gree that it was no longer effective after decided to look for new technologies that trying to develop the best ways to re-
six cycles. Since we had no chemical strips might be available. Also, we didn’t like process these very expensive reusable
to test glut’s efficacy in those days, we soaking scopes overnight. We used eth- devices. My story illustrates both the fear
used the same glutaraldehyde solution ylene oxide sterilization when we could, of change and the halting progress many
for the full two weeks. but it always meant the scopes could be departments have made in trying new
technology and developing best practices
in such a new medical environment.
Why oxidizing chemistries?
There are a number of practical benefits
to be gained by switching to an oxidiz-
ing high-level disinfectant. For example:
• When used properly, oxidative formu-
lations help protect workers, patients,
endoscopes, and the department. The
endoscopy staff is protected because
there are no inhalation risks and less
fear of anyone developing asthma or
sensitivity. Patients are protected be-
cause the chemistry is active in the
presence of soil, so any residual debris
is cleaned away.
• Oxidizing high-level disinfectants ef-
fectively remove even adherent resi-
dues that have had prolonged expo-
sure to cross-linking chemistries (dial-
dehydes). They will extract residues
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46 November 2009 • HEALTHCARE PURCHASING NEWS
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0911-Scope Guide-shorrt.pmd 46 10/14/2009, 8:37 AM
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