1. Pre-Purchase Evaluation .............................................................................................................. 218 2. Selection of a Processing Method ............................................................................................... 223 3. Sterile Processing Area ................................................................................................................. 226 4. Personal Protective Equipment .................................................................................................. 228 5. Point-of-Use Treatment................................................................................................................ 229 6. Transport to the Decontamination Area ................................................................................... 230 7. Leak Testing ................................................................................................................................... 232 8. Cleaning ......................................................................................................................................... 233 9. Cleaning Verification and Inspection ......................................................................................... 237 10. Sterilization ................................................................................................................................. 239 11. High-Level Disinfection .............................................................................................................. 240 12. Drying ........................................................................................................................................... 241 13. Storage ......................................................................................................................................... 242 14. Transport to the Point of Use .................................................................................................... 245 15. Water Bottles ............................................................................................................................... 246 16. Endoscope Sheaths ..................................................................................................................... 246 17. Prion Disease Transmission Precautions ................................................................................. 247 18. Processing Records ..................................................................................................................... 248 19. Leadership ................................................................................................................................... 249 20. Education ..................................................................................................................................... 250 21. Policies and Procedures ............................................................................................................. 252 22. Quality .......................................................................................................................................... 254 23. Microbiological Surveillance ...................................................................................................... 255
MEDICAL ABBREVIATIONS & ACRONYMS
AER – Automated endoscope reprocessor CDC – Centers for Disease Control and Prevention CRE – Carbapenem-resistant Enterobacterales ED - Emergency department ERCP – Endoscopic retrograde cholangiopancreatography FDA – US Food and Drug Administration HEPA - High-efficiency particulate air HLD – High-level disinfection HVAC - Heating, ventilation, and air conditioning ICU - Intensive care unit IFU – Instructions for use
ILD - Intermediate-level disinfection LCS – Liquid chemical sterilant MAUDE – Manufacturer and User Facility Device Experience
MDRO – Multidrug-resistant organism OR – Operating room PPE - Personal protective equipment RCT – Randomized controlled trial RLU - Relative light units RN - Registered nurse