FEATURE
process. They were trained on donning and doffing PPE per CDC protocol.” N95s might provide another level of protection along with the use of a face shield for healthcare workers, Daley says. “Endoscopes can become heav- ily contaminated. Because there are reprocessing steps that may aerosol- ize these contaminants, staff should be made aware that aerosolization occurs in reprocessing and that they strictly follow reprocessing guidelines.” As of mid-June, no changes were recommended to established repro- cessing procedures for endoscopes and associated accessories. ASCs are still expected to complete bedside pre- cleaning followed by manual cleaning and high-level disinfection performed in a designated reprocessing area, notes Fahnhorst. “Decontamination of coronavirus species has been con- firmed with commonly used biocidal agents. There are ample data to sup- port continuation of current endoscope decontamination practices in the con- text of known COVID-19.”
The reason why disinfection prac- tices remain unaffected is that COVID- 19 is an enveloped virus, Daley says. “The detergents and disinfectants ASCs use for reprocessing are highly effective at breaking down the envelope and pull- ing the teeth out of the virus, rendering it essentially harmless.” Allison says her ASC has con- firmed its disinfectant solutions, including those used to clean repro- cessing rooms and storage areas, are effective in eliminating COVID-19 by checking their Environmental Protec- tion Agency (EPA) number. The EPA is maintaining a list of disinfectants for use against the virus.
In addition to appropriate disinfec- tant use, Daley advises ASCs to care- fully monitor the expiration dates of their chemical solutions and enzymatic detergents. “While this is common best practice, it can be a step that is acciden- tally overlooked following a shutdown or reduced operations with fewer staff.
after implementation of new policies and procedures, daily rounding on my staff and immediate correction of any issues are some of the ways I ensure consistency. I also provide positive feedback and recognition when staff are doing the right thing.” During the pandemic, Allison says
her ASC is using email communica- tion and videoconference meetings more frequently to limit the number of staff members physically together in an enclosed area. “I found that send- ing out weekly emails with updates on COVID-19, community COVID track- ing and any policy changes has been very effective.”
Pay really close attention to competencies. Receiving training on reprocessing does not mean you are competent.”
— Jacqueline Daley, Infection Prevention Consultant
When reopening and working to resume normal operations, ASCs should also review guidelines for restarting and using idle equipment, such as auto- mated endoscope reprocessors, water filters and flushing of plumbing lines. Lack of usage can create risks, includ- ing the buildup of biofilm.”
To help ensure her staff follow exist- ing and revised practices, Fahnhorst’s ASC relies on frequent educational in- services, staff meetings and employee observations. “These are imperative for ongoing compliance with all cen- ter policies and procedures. Our pro- cedures are regularly revised based on staff feedback and observations.” Allison says her ASC takes a sim- ilar approach. “Constant follow-up
Lean on your infection prevention- ist for assistance during the health cri- sis, Daley recommends. “Have them run a risk review to determine if you have any gaps in your processes.” As more is learned about the novel
coronavirus, recommended practices might continue to evolve. Fahnhorst is working to keep her staff abreast of important developments and announce- ments. “We will continue to review guidelines, articles and recommenda- tions from gastroenterology and endos- copy societies such as the American Society for Gastrointestinal Endos- copy and American Gastroenterologi- cal Association as well as CDC to iden- tify and determine best practices for all aspects of endoscope reprocessing.” Allison says she is also planning to monitor announcements coming out of the Occupational Safety and Health Administration and her local depart- ment of health. “I stay as current on everything surrounding COVID-19 as I can and keep our physicians and staff up to date as well. That said, you should not expect a single person to do everything required to stay current. I have relied heavily on my endoscopy team to help ensure we did not miss any important updates and will con- tinue to do so for as long as we are combating this virus.”
ASC FOCUS SEPTEMBER 2020 |
ascfocus.org 15
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30
