Decontamination
presented on Microbial Contamination of Final Rinse Water for Endoscope Washer-Disinfectors. This presentation discussed the lessons learned following an incident, starting in December 2019, relating to a sudden rise in Total Viable Count (TVC) levels in water samples from the endoscope washer-disinfector. A complete site audit was conducted to determine the root cause of the problem. This audit identified that the design of the pipe and break-tank of the endoscope washer-disinfector were an open circuit exposed to air, allowing for potential bacteria ingress and growth. Following this, the manufacturer issued an SOP for break tanks, which was implemented by the facility and a significant reduction in TVCs was recorded. The lessons learned from this incident was the need for improved communication between health boards regarding any issues encountered and the actions taken to remedy these.
Clinical impact of incidents of final rinse water for endoscopes Dr. Vanda Plecko, Consultant Microbiologist & Infection Control Doctor, NHS Highland, presented on the clinical impact of incidents of final rinse water for endoscopes. There is a regulatory requirement for endoscope decontamination units to collect final rinse water samples from endoscope washer-disinfectors. The presentation outlined the microbiological method used for this process including that required in Scottish Health Technical Memorandum 01-06, Part D. Also discussed were the actions taken following high TVC results, offering a clear insight into the actions that are discussed following such an incident. Dr. Plecko shared learning regarding the clinical impact assessment following this, including:
An audit identified that the design of the pipe and break-tank of the endoscope washer-disinfector were an open circuit exposed to air, allowing for potential bacteria ingress and growth.
l Risk for infection versus risk of delaying procedures
l Assessing patients/ contacting patients – significant impact
l Stopping elective procedures (no available machines/ high TVC as unknown high risk for further procedures)
l There are always exposed number of patients (retroactive reports) – anxiety
l Surveillance/ follow up of patients
RMD decontamination policy and guidance in NHSScotland This presentation was from Anne Campbell, Technical Advisor (Decontamination) at NHSScotland Assure. The presentation discussed the available guidance for
Central Decontamination Units, Endoscope Decontamination Units and Local Decontamination Units and the range of different guidance published by the organisation, including: l Scottish Health Technical Memorandums (SHTM)
l Scottish Health Technical Notes (SHTN) l Scottish Health Planning Notes (SHPN) l Logbooks l Compliance documents
Anne’s presentation highlighted a number of reasons the guidance requires to be revised: l Exit from the European union l New legislation l New British Standards l Creation of NHSScotland Assure l Introduction of accessibility requirements l Evidence and lessons learned l New technology and innovation
There are several new publications in the last two years and there are expected to be several more in 2025.
Case Study - Collaboration to deliver a safe endoscope for every patient James Doherty, National Sales Manager from Wassenburg presented the first case study of the day on the collaboration to a deliver a safe endoscope for every patient. The presentation discussed a situation whereby an NHS Trust in England had experienced significant issues with their endoscope washer-disinfectors rendering them unusable. Three different
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www.clinicalservicesjournal.com I September 2025
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