ENDOSCOPY
Balancing safety with sustainability
Could we see a wholesale move to single-use scopes, in the future, or is the cost to the environment just too great? Could there be a middle ground, and how can we achieve a balance between protecting patients and protecting the planet? These were just some of the questions debated by experts at a recent online event, hosted by Pentax Medical. Louise Frampton reports.
Significant progress has been achieved in improving patient safety in endoscopy over the years – the sector has seen significant innovation in device design, improvements in processes and collaboration between healthcare providers and industry. However, infection prevention remains a crucial topic in endoscopy. While single-use solutions are now coming on to the market to tackle issues around infection risk, balancing patient safety and sustainability is a challenge that continues to be debated in the healthcare sector. With this in mind, Pentax Medical hosted an online discussion exploring these challenges – featuring international experts from both healthcare and industry. Opening the discussion was Professor Rocco Trisolini, director, interventional pulmonary unit, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy. He outlined the risk of infection from bronchoscopes.
In September 2015, a communication from the FDA highlighted 109 medical device reports regarding infection or contamination from flexible bronchoscopes for the period of 2010-2014 – 50 of these reports were in 2014. In June 2021, the FDA issued another communication outlining that, between 2015 and 2020, there were 857 reports regarding infection or contamination from flexible bronchoscopes and seven associated deaths. In response to these reports, the FDA issued some key recommendations, including that healthcare facilities/staff should: l Prefer sterilisation to high level disinfection when feasible.
l Do not use damaged scopes (loose parts; damaged channel walls; kinks or bends in tubing; imperfections, holes or cracks in the distal end).
l After reprocessing, store the scope in a manner that reduces risk of contamination or retention of moisture.
l Follow the manufacturer’s instruction for maintenance and repair, as well as develop schedules for routine inspection and periodic maintenance.
It also recommended that healthcare providers should: l Discuss benefits and risks of procedures involving reprocessed bronchoscopes.
l Discuss signs of potential infection after a bronchoscopy procedure and when patients should seek medical attention.
l Consider using single-use bronchoscopes when there is increased risk of transmission (multi-drug resistant organisms, immunocompromised patients) or when an immediate reprocessed device is not available.
58 l
WWW.CLINICALSERVICESJOURNAL.COM
When it comes to the infection risks, we are “burying our heads in the sand,” Prof. Trisolini commented, pointing out that this was both a cultural and organisational problem.
He explained that many bronchoscopists are unaware of the reprocessing guidelines, non-adherence to the reprocessing guidelines is common, and pseudo- infections and infections caused by contaminated bronchoscopes are often “unrecognised events”. Reprocessing is also a very complex, multi-step process and mistakes can happen at every step. However, outbreaks have even been reported even in centres where reprocessing is carried out according to the guidelines. Defects in the scope – developed during use – may be a contributing factor in these instances, he pointed out. Prof. Trisolini highlighted a study
JUNE 2022
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 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
