FEATURE
BY ROBERT KURTZ
C
OVID-19 has not changed the importance of proper disinfec- tion, handling and storage of endo- scopes to ensure patient and staff safety. What the virus has done, says Shelley Allison, RN, director of nurs- ing at EndoCenter in Covington, Loui- siana, is further underscore it. “These processes have always played a critical role in preventing the spread of all types of infections in the ASC,” Allison says. “We know that ribonucleic acid from SARS-CoV-2— the virus that causes COVID-19— has been detected in gastrointestinal secretions and stool. This means any improper disinfection, handling and storage of endoscopes can potentially lead to transmission of the virus from an infected person.” To help reduce the potential for transmission, gastroenterology societ-
ies and the Centers for Disease Con- trol and Prevention (CDC) have issued recommended practices and guidelines concerning endoscope reprocessing and management during the pandemic. “ASCs should familiarize them-
selves with the new guidance and try to ensure staff are following these best practices correctly and consistently,” says Jacqueline Daley, an infection prevention consultant based in San Clemente, California. “It is impor- tant to note that most processes have not been changed. Centers may want to view this as an opportunity to verify that staff are continuing to complete them appropriately.”
At San Antonio Gastroenterology Endoscopy Center North in San Anto- nio, Texas, two of the most significant
14 ASC FOCUS SEPTEMBER 2020 |
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changes undertaken in response to COVID-19 involve staff, says Rebecca Fahnhorst, RN, the center director. To follow published recommenda- tions, the ASC is permitting only those employees with extensive experience and documented competencies to per- form reprocessing. The center also has temporarily halted the training of new reprocessing staff. Daley says such actions serve mul- tiple purposes. ASCs are expected to maintain social distancing between staff members, which will likely require limiting the number of people in a reprocessing room at a single time. “Staff are under increased stress and pressure due to COVID-19,” Daley says. “You will want the staff in the room to focus on completing their reprocessing work, and you want those staff to be competent. Pay really close attention to competencies. Receiv- ing training on reprocessing does not mean you are competent.” Staff will likely have many endo- scopes that need to be reprocessed, and each one can have features that are slightly different than others. “If staff are used to working with other people, reducing the numbers can be quite a change in process flow and scope turn- over,” she says. If your ASC modifies its staff-
ing levels, be cognizant of reprocess- ing fatigue, Daley says. “Do not have one person standing there for 12 hours. Make sure you have enough people on staff to rotate through your reprocess- ing room efficiently and provide them with the required personal protective equipment (PPE).” Prior to COVID-19, endoscopy technicians were not expected to wear masks, Allison says. Recommendations now advise that reprocessing staff use masks, specifically N95 respirators if available. “We require our technicians to wear N95s to help reduce the poten- tial transmission of the virus,” Allison says. “Technicians must wear their complete PPE throughout the cleaning
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