ENDOSCOPY
Effective management of rigid endoscopes
County Durham and Darlington NHS Foundation Trust recently trialled an automated testing unit to check the integrity of rigid endoscopes. The system has helped enhance patient safety, while improving the management and traceabiity of the Trust’s scopes.
County Durham and Darlington NHS Foundation Trust is a large integrated care provider in the North East of England, employing around 8,000 staff. The Trust serves a population of around 600,000 people. On average the Trust processes 500 scopes per month from a pool of over 270 devices.
Rigid endoscope stock and its reliability is vitally important to organisations performing minimally invasive surgery and represents a significant investment for the Trust. A need was therefore identified to understand the condition of the stock. By doing this, the Trust hoped to be able to fulfil the following objectives: l Increase patient safety, by ensuring only rigid endoscopes that were fit for use
entered the operating theatre environment.
l Aid budgetary planning, to identify the scopes that need repairing or replacing, and plan ahead with a timeline for scope maintenance by means of a reliable, repeatable testing system.
l Have complete visibility and full traceability of the scopes in circulation, enabling better management, reduced operating costs and improved return on investment.
The key challenges
The only testing method undertaken on rigid endoscopes during processing was a visual check, which was subjective and dependent upon what the SSD technician could see when looking into an endoscope and how
they translated this into a ‘pass’ or ’fail’. Decontamination services manager, James Brown highlighted the key problem areas as: l Lack of traceability for individual rigid scopes.
l Limited testing log maintained. l Absence of a consistent means of identifying faulty rigid scopes.
l No accurate data available on the condition of rigid scopes in circulation.
l No single source of data available, such as inventory types, serial numbers etc.
l Theatre time wasted when a scope is opened and found to be unfit for use.
l Last minute scope and/or procedure changes resulting in additional costs.
l Risk that an open procedure may present difficulties for the patient.
The trial
The data produced from the 50 day trial has allowed the Trust to take a ‘snapshot’ view of current inventory
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Bolton Surgical was invited to perform a trial of ScopeControl to determine whether it could assist in resolving and/or improving key problems and issues associated with the use, processing and inventory management of rigid endoscopes. The automated testing unit checks and records six key optical parameters that are critical to the fitness for use and functionality of rigid endoscopes. Prior to the development and introduction of ScopeControl, there was no set standard to which the functionality of the light fibres could be assessed. If a scope reaches theatres and is not performing adequately, it is common practice for the surgical team to attempt to improve illumination by turning the light source up during surgery. However, while providing a short-term improvement, this can damage the fibres irreversibly, meaning a costly new fibre bundle is needed to restore the scope to a useable condition again.
It was agreed that ScopeControl should be used for a period of time within each of the Trusts two decontamination units, sufficient to enable maximum repeated testing of the rigid scope inventory before and after use, at the pre-determined parameter thresholds
MARCH 2017
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