DECONTAMINATION
that take place on one side with cleaning tasks taking place on the other. Why have clean and dirty separation? It reduces the risk of cross contamination.” Summarising, Bradley’s final
presentation slide offered the following tips: Important to ensure:
l Staff receive comprehensive training and are assessed for competency on an annual basis.
l Cleaning takes place prior to disinfection (or sterilisation).
l All surfaces of the endoscope are exposed during the decontamination procedure.
l An effective disinfectant is used at the correct concentration.
l The final rinse does not re-contaminate the endoscope.
l Testing, in accordance with national guidance, takes place and is audited.
Cleaning scopes
The ‘How’ section was covered by Dr Helen Griffiths, advanced nurse practitioner gastroenterology, whose presentation was entitled ‘Pathway to successful manual cleaning of scopes’.
Dr Griffiths, who is also a decontamination advisor to the BSG, outlined the principles of decontamination: l Decontamination – high level disinfection that kills bacteria, viruses, mycobacteria and some spores. Instrumentation has contact with mucous membranes but does not ordinarily penetrate normally sterile areas of the body.
l Essential that ALL reprocessing stages are included after every use of the endoscope.
l Include reprocessing of ALL channels even if they were not used in the preceding patient procedure.
The decontamination of endoscopy equipment is a specialised procedure and should only be carried out by personnel who have been trained for the purpose and who have an understanding of the principles involved.
l NOT even the most modern and sophisticated EWD negates the need for prior thorough manual cleaning of all working channels.
During her presentation, Dr Griffiths covered a number of areas including: training, personal protective equipment (PPE), pre-cleaning, preparation for manual cleaning and manual cleaning. Talking about training, she
noted: “The decontamination of endoscopy equipment is a specialised procedure and should only be carried out by personnel who have been trained for the purpose and who have an
understanding of the principles involved.”
Highlighting the importance of
pre-cleaning of endoscopes, Dr Griffiths noted that this process should start in the procedure room with the endoscopist cleaning external surfaces of the scope. Offering further advice on how to pre-clean scopes, she stated that all scopes channels should be flushed immediately using low foaming medical grade neutral detergent and using air/water adaptor. She also recommended that scopes
Dr Helen Griffiths
should be reprocessed as soon as possible, adding: “I’ve had at least two incidents this year where scopes have been accidentally picked up and reused by another individual. Because they weren’t marked properly and people forgot what was happening. “It shouldn’t happen, but it does happen. When it happens it means a patient has to be offered all sorts of testing for hepatitis, HIV, etc. Be careful and make sure that you’re clearly marking your endoscopes as soon as possible.” When dismantling a scope for the purposes of cleaning, Dr Griffiths advised that reusable detachable parts must be reprocessed together with the corresponding endoscope as a unique set to allow traceability.
Throughout her presentation, Dr Griffiths was keen to stress that staff carrying out decontamination of endoscopes should follow manufacturers recommendations.
As a way of reinforcing the messages delivered through her presentation, Dr Griffiths told attendees to re-think the processes they use when carrying out decontamination. “What are you going to start doing that you’re not doing now?, she asked attendees. “If you can’t change a practice instantly go back and have a discussion with your Trust about what you’re going to do. Also, think about what you’re going to stop doing. Each time we run these events we find more and more good practice.” In the afternoon attendees were invited to participate in a group session where they discussed what they’d learnt throughout the day. When it comes to
Tina Bradley
endoscope decontamination participants discovered that if you deal with the Why, What and How then you should avoid having to answer the sometimes difficult to answer questions of Where, When and Who. Ultimately, the event offered an opportunity to share best practice and those who carry out endoscope decontamination would undoubtedly have taken something away from it. To register for the next study day please
Attendees were invited to participate in a group session. 58 I
WWW.CLINICALSERVICESJOURNAL.COM
visit
www.cantelmedical.co.uk/news-events or
www.bsg.org.uk/events
CSJ SEPTEMBER 2017
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