ENDOSCOP E R E P ROCES S ING


the load on some other local hospitals by helping to wash and package endoscopes.


Trusts turning to digital solutions Another important aspect of the endoscope reprocessing process is the track and trace of scopes. It helps departments stay on top of equipment lifecycles, identify broken scopes or errors, manage resource, and minimise the risk of infection spread between scopes. Traditionally, these systems have been paper based – creating endless physical admin challenges along the way. However, in recent years, the move has been to electronic systems. Recent guidance on equipment decontamination7


recommends recording


serial numbers for all equipment pre- examination, using this to follow the scopes throughout the decontamination process, as well as electronically tracking the personnel and patient associated with each scope. Furthermore, it states that electronic tracking and traceability systems are mandatory for endoscope units that rely on remote decontamination facilities.8


of Health’s HTM 01-06 guidance9


The Department also


advocates for computerised track and traceability systems as best practice. While many endoscopy units now deploy an electronic track and trace system, these often still require manual input, which introduces the risk of user error, alongside the time and cost associated with requiring staff to input individual serial numbers for every piece of equipment. Some Trusts have therefore started to move to more intelligent automatic systems,


to eliminate manual input errors, improve record sharing within the hospital’s digital ecosystem, manage equipment and, most importantly, reduce infection risks. Cantel has spent considerable time working with NHS clinicians to develop and progress such a system, in the form of the Canexis Integrated Workflow Solution. Barcodes or radio-frequency identification (RFID) tags are applied to each piece of endoscope equipment, connected to a software system that automatically catalogues all tagged items. It enables staff to monitor a scope’s journey from patient appointment to storage, monitor usage history, decontamination, and disinfection status, and note any repairs or replacements that might be due.


This system also enables the simple integration with patient electronic health records (EHRs), feeding into a centralised hospital information system. It means track and trace records can be accessed between departments and a patient’s medical history can also be quickly pulled up if needed. NHS Lothian, the health authority which


services Edinburgh, East Lothian, Midlothian and West Lothian, was one of the first in the country to commission the Canexis Solution across endoscopy, surgical and sterilisation. The authority was looking for one system that could streamline its infection prevention systems, which synchronised across departments; it opted for an integrated platform due to its compatibility with electronic equipment, such as disinfection machines and endoscope washers, and third- party technology, such as the RFID tracked equipment NHS Lothian uses.


Embracing innovative solutions As endoscope and decontamination units continue to navigate the aftermath of the pandemic, it has never been more important to take a proactive approach to processes and systems that could enable considerable efficiency savings. Embracing solutions, such as digitally tracking scopes or aseptic wet storage, could help reduce infection spread risks, and empower staff to improve the safety of endoscopy procedures, while delivering services more efficiently – ultimately prioritising the patient experience at every stage.


4 ECRI. Special Report: Top 10 Patient Safety Concerns 2021. Retrieved from ecri.org: https://assets.ecri. org/PDF/White-Papers-and-Reports/ECRI_Top10_ Patient-Safety-Concerns_2021_v2.pdf


5 Julia Kovaleva, F. T. Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy. Clinical Microbiology Reviews, 231- 254, 2013.


6 Michelle Nerandzic, B. K. Efficacy of flexible endoscope drying using novel endoscope test articles that allow direct visualization of the internal channel systems. American Journal of Infection Control, 614-621, 2020.


7 British Society of Gastroenterology. Guidance on decontamination of equipment for gastrointestinal endoscopy, 2017.


8 British Society of Gastroenterology. BSG Guidance for Decontamination of Equipment for Gastrointestinal Endoscopy, 2016. Retrieved from bsg.org.uk: https://www.bsg.org.uk/wp-content/ uploads/2019/12/Guidance-for-Decontamination- of-Equipment-for-Gastrointestinal-Endoscopy_- 2017-Edition-3.pdf


9 Department of Health. Health Technical Memorandum (HTM) 01-06: Management and decontamination of flexible endoscopes. 21 May 2021. Retrieved from england.nhs.uk: https:// www.england.nhs.uk/publication/management- and-decontamination-of-flexible-endoscopes- htm-01-06/


10 NICE. Healthcare-associated infections: prevention and control in primary and community care, 28 March 2012. Retrieved from nice.org.uk: http:// www.nice.org.uk/guidance/cg139/chapter/1-guidance


About the author CSJ


References 1 The Lancet. (2018, July). Scoping the problem: endoscopy-associated infections. Retrieved from thelancet.com: https://www.thelancet.com/journals/ langas/article/PIIS2468-1253(18)30168-7/fulltext


2 ECRI. 2019 Top 10 Health Technology Hazards: Executive Brief. Retrieved from ecri.org: https:// www.ecri.org/2019hazards


3 ECRI. Special Report: Top 10 Health Technology Hazards for 2020, Retrieved from ecri.org: www.ecri. org/2020hazards


DECEMBER 2021


Debbie McKinney is the UK sales director at Cantel (UK), a provider of infection prevention products and services for private and public healthcare professionals. Having worked in endoscopy and medical device sales for over 15 years, Debbie has full responsibility for the field sales division. Debbie has focused on creating a culture of quality service and education, to assist customers in improving the safety and efficiency of their endoscopy procedures. Her team prides themselves on always being mindful that there is a patient at the end of everything they do, prioritising the patient experience at every stage.


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