CS CONNECTION
“Cabinets need to be maintained for clean- liness and inspected for chips or damage. There are numerous choices of available cabinets with built-in positive pressure or filtered circulated air. here is one caution- ary note when choosing one of these options. Historically, drying has not been heavy with oversight. Many of the cabinet options con- tain tubing with permanent metal end fittings that do not have clear cleaning instructions. Some [companies] may say wipe down with use, then high-level disinfect weekly. All trends lead to restricting shared connections between endoscopes once cleaned without the attachments being, at minimum, high- level disinfected. Currently, these reusable cabinet hook-ups are not validated to be run in any . It would be unfortunate to find out down the line that the reusable tubing and connectors need to be processed with each use as well. Only time will tell. In a nutshell, drying of endoscopes exter- nally and internally is necessary, and it should involve at minimum safe filtered air sources, clean connections and storage cabinets that either facilitate internal drying or promote the sustaining conditions for endoscopes dried prior to storage.”
Carolyn Klimas, Olympus America Inc.
• “Storage cabinets should be located in a designated room when possible, or at minimum in low-traffic areas. ndoscope storage cabinets should not be located in procedure rooms.
• “Preferred storage for endoscopes is a dry- ing cabinet that dries both the outside of the endoscope as well as endoscope channels. Recommended channel air options for dry- ing cabinets include nitrogen, instrument air, medical air or at minimum, HEPA- filtered air.
• “If a drying cabinet is not available, a ven- tilated storage cabinet may be used that features -filtered air, a built-in fan and positive pressure inside the cabinet.
• “All cabinets should include doors that can be closed and secured, hangers to safely hold the endoscope, and adequate space to ensure scopes hang freely without con- tacting other scopes or any surface of the cabinet (top, sides or bottom).
• “Vertical storage is preferred to enable endoscope channels to drain and maintain the shape integrity of the scope.”
Alison Sonstelie, oneSOURCE & Sanford Health, Fargo, ND
“First, you should consult the endoscope manufacturer’s IFU. Using a platform like oneSOURCE makes it incredibly easy to access the most updated IFUs and preven- tive maintenance documents needed to effectively decontaminate and sterilize. It
Ergonomics in endoscopy reprocessing requires rigid flexibility
When you have to clean, disinfect, sterilize, store and handle very delicate, sensitive and complex devices like endoscopes, it can be easy to over- look some of the obvious issues in the process. That’s because the intricate process of re-
processing endoscopes and other endoscopic devices involves disassembling the devices to a degree, as well as conducting detailed inspec- tions of products along the way. Performing these tasks can be stressful on
Sterile Processing and Distribution (SPD) techni- cians, particularly in the physical areas of gait between stations, posture at workstations and standing for long periods of time. As a result, ergonomics should be considered
a serious factor. “Ergonomics play a distinct role in the re-
processing arena,” insisted Betty McGinty, RN, CGRN, CER, Fellow, Clinical Education Services, Boston Scientific Corp., who cited the Society of Gastroenterology Nurses and Associates’ “Ergonomics in the Gastroenterology Setting,” a 2020 Position Statement. “Potential injury op- portunities include repetitive motions as well as sustained awkward positions. Supportive correc- tive responses include education about, as well as adherence to, proper body mechanics, rest and use of assistive devices. Reprocessing room design that includes attention to sink depth and counter height (adjustable if possible) as well as use of anti-fatigue mats in the front of the sink (to increase lower extremity blood flow) are ergonomic suggestions. Assistive devices include channel flushing aids.” Much depends on the departmental footprint
and workspace design, according to Melissa Ku- bach, Clinical Education and Training Manager, Mobile Instrument Service & Repair. “People do jobs well when they are well
trained, practice the process regularly and have the resources to make the job easy to do,” she noted. “Installing sinks and working counter space that can adjust to accommodate the re- processing technicians’ height is a big help. Also, cleaning is improved with the use of automated flushing devices to limit repetitive motion.” SPD technicians who reprocess endoscopes handle a variety of devices that require certain equipment, according to Jahan Azizi, Special Projects Manager, Healthmark Industries Co. “The long scopes require large, deep sinks that
the height needs to be adjusted to accommo- date a wide range of individuals,” Azizi indicated. “The high-demand, fast-paced department could [and] will cause additional stress.” Azizi specified the need for height-adjustable sinks and tables, an “assembly line approach” to reprocessing for high-demand departments and
“a quality control person to verify 100 percent enhanced visual inspection after cleaning.” Proper tools of the trade can make a monu- mental difference, according to Gregg Agoston, Vice President, Business Development, SPD Transformation Services, SpecialtyCare. “Newer cleaning equipment and aids, such
as trough-type sinks that allow the flexible endoscope to be stretched out versus coiled and flush/suction devices like Scope Buddy Plus, greatly assist the technician handling and processing of flexible endoscopes,” Agoston said. “Pass-through AERs that allow for separa- tion between the dirty and clean area are a great help as well as the Medivators horizontal storage cabinets that automate the tracking of the endoscopes [and] extend hang time to 30 days are a great benefit. Advances like these greatly enhance the likelihood that endoscope reprocessing will be done correctly.” But Ron Banach, Director, Clinical Training, Ruhof Corp., calls for deeper efforts earlier. “The device manufacturers must work with end users to design products that meet all the necessary guidelines to allow for cleaning and safe use,” he said. “Unfortunately, it comes down to the analysis of costs versus the quality of the outcome.” Several manufacturers contend they already
are working with end users by designing and de- livering a different kind of product that doesn’t involve such detailed and intricate cleaning. “For the last 20 years, hospitals have been
trying to meet increasing patient procedure demand – and the corresponding increase in reprocessing protocols – with more people, time and financial investment in reusable equipment,” said Christian Escobar, Director, Marketing – Vizualization, Ambu. “Reusable endoscope ergonomics and design may improve incremen- tally to address a contamination challenge, but the overall ergonomics (size, length, etc.) are not expected to dramatically change. Utilizing more single-use endoscopes is a way to alleviate the overall volume of reusable scopes that require reprocessing, storage, transport and handling.” Rob Cripe, Chief Commercial Officer,
Inte-
grated Endoscopy, concurs. “As a manufacturer of single-use rigid scopes,
we put a lot of energy into ergonomics relative to the user,” Cripe said. “Many times these ‘hu- man factors’ are the most important in driving adoption and can be a significant challenge to incorporate the right combination of function and form. As it relates to cleaning/sterilization, this obviously is not considered since all single- use products are sterilized during the manufac- turing process.”
hpnonline.com • HEALTHCARE PURCHASING NEWS • November 2020 43
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 |
Page 65 |
Page 66
