ENDOSCOP E R E P ROCES S ING
Enhancing IP&C in endoscopy services
Debbie McKinney explores innovative approaches to infection prevention in endoscopy services, and the knock-on impacts for cost and efficiency savings.
A Lancet review in 2018 noted that while there had been only 32 infection outbreaks associated with endoscope pathogen transmission between 2002 and 2007, the increased frequency and complexity of endoscope procedures; alongside the growing threat of antimicrobial resistance, represents a matter that requires urgent attention.1 Reusable endoscopes represent a potential infection risk for the busy endoscopy or decontamination department, and design features of the devices can complicate the disinfection process; for example, non-disposable valves or heat sensitive surfaces. Endoscopes undertake a complex decontamination journey, and with Trusts battling growing procedure waiting lists, many are losing time and money through inefficiencies in the infection prevention process.
While COVID-19 has placed new pressures on Trusts, does this also represent a moment of opportunity to adapt and improve the approach to infection prevention? This article looks at some of the Trusts exploring innovative solutions to prioritise patient safety.
The reprocessing journey In recent years, the ‘mishandling’ of flexible endoscopes and errors in cleaning, disinfection, storing and transporting these
have featured in the ECRI Institute’s top 10 technology hazards, given the associated infection risks.2-3
by COVID-19, with the 2021 report highlighting ‘pandemic preparedness’ as a patient safety factor in relation to infection prevention and control.4
Given the contaminants endoscopes are
exposed to, thorough cleaning and proper storage are key to reducing infection spread risks. The reprocessing journey, in brief, typically consists of the following stages: bedside pre-clean, leak tests, manual clean,
Contaminants pose a significant risk during storage and transport, and the final two stages of reprocessing are therefore particularly important. In fact, a review found that many outbreaks of HCAIs, such as P
. aeruginosa,
S. marc-escens, M. tuberculosis, and M. chelonae, were associated with contamination due to a lack of proper drying procedure.
DECEMBER 2021
This has been exacerbated
rinsing, purging, disinfection, rinsing, drying, storage, transport. It is a complex, but necessary, process that takes time and effort to deliver properly. However, recognising these risks, some Trusts are trialling alternative systems and solutions to help reduce time and spend, while maintaining the highest possible hygiene levels – from storage and transport solutions to digital scope tracking.
Drying and storage solutions Contaminants pose a significant risk during storage and transport, and the final two stages of reprocessing are therefore particularly important. In fact, a review5 found that many outbreaks of HCAIs, such as P. aeruginosa, S. marc-escens, M. tuberculosis, and M. chelonae, were associated with contamination due to a lack of proper drying procedure. As a result, approaches to minimising drying and storage-associated infection risks have evolved over the years. Previously, many units would hang scopes to dry. Recent studies have shown that hanging in an ambient storage cabinet may not actually be that effective to dry
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