employee’s errors can help guide conversations with individuals about work performance. More im- portantly, an accountability system can be used to recognize trends in your facility that can help identify areas that might need more atten- tion with education and training.

to make sure you have the cor- rect reprocessing equipment and chemistries available. This also is a good time to determine wheth- er you have the labor resources available

to perform the work

correctly. Examine the clean- ing instructions to see if they fit with your current practices for processing other endoscopes. Develop a standard operating procedure or policy employees can use when performing the re- processing steps. Checklists are a reliable tool that helps ensure all steps are performed correctly and in the proper sequence, which is critical when reprocessing en- doscopes. Before using the new device, employees should under- stand the new procedure and how the endoscope and any associated supplies are intended to work. If necessary, contact the device company’s representative to veri- fy that your processes are compli- ant with the instructions for use.

24 ASC FOCUS MAY 2021 |

2. Create a plan for education and training. Schedule enough time so employees can ask questions if steps are not clear. Work with your device company’s represen- tative to have them available for training in both reprocessing and using the device. They should be able to answer any questions your team might have.

3. Perform competency testing. You can observe the employee per- forming the task or you can ask them to verbally walk you through the steps. Endoscopes are notori- ously difficult to reprocess, so the competency testing should re- flect the complexity of the task. Documenting competency for use could consist of recording the names of those present for the in-service provided by the device company representative.

4. If you do not already have a system set up for tracking accountability, now is a good time to start. De- veloping a system that records an

5. Incorporate this new process into your quality control system. If you do not have a quality control system in place, many resources that can help are available, such as ANSI/AAMI ST90: 2017 Pro- cessing of health care products— Quality management systems for processing health care facilities. Examples of ways to track quality with endoscopes can include hav- ing the reprocessing technician record if the endoscope was pre- treated and contained appropri- ately before it was sent to the re- processing area, having someone in the operating room document issues with how the endoscope was received in the procedure area, and performing an audit to see if endoscopes are stored prop- erly. Information gathered about quality should be shared with the teams performing the work, used to perform a root cause analysis, and collected after any changes are made to measure outcomes. Incorporating these elements into new and existing processes can help measure compliance. It also helps cre- ate predictable results, simplifies train- ing and reduces waste. Ultimately, improving compliance with infection prevention best practices will positively impact patient safety and outcomes.

Alison Sonstelie is a lead sterile processing coordinator at Sanford Health in Fargo, North Dakota, and a consultant at OneSource in Salt Lake City, Utah. Write her at

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