STERILE PROCESSING Drying the endoscope makes scientifi c sense. Water is needed
for growth of all living organisms. Drying the endoscope as quickly as possible helps prevent bacterial growth. The chal- lenge with the new standard is that fi rst, most facilities do not actively dry the lumens after processing. ost simply hang the endoscope and allow it to drip dry, thus this is a signifi cant change. econd, the requirement for minutes adds signifi cant time to the process and some departments struggle to keep up with the workload without this new requirement. astly, drying takes space and the equipment to perform the function. t is not effi cient for a technician to use an air gun or similar tool to dry lumens. n automated system that connects to the endoscope is
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needed to ensure that the process is effectively administered and timed for the appropriate cycle. Facilities will need to purchase fl exible endoscope drying cabinets or convert to storage systems that actively dry the endoscope. “‘8.2.5.1 The endoscope and its components should be dried after completion of the cleaning and disinfection process. Flexible endoscopes with channels should be dried for a minimum of 10-minutes with pres- sre reglated force instrment air or a minimm of fi ltered air any processing departments do not have medical air or HEP-fi ltered air available, thus this requirement will force those facilities to add this tool. n addition, without automating the process, there is a great chance that staff will not perform this process for the required -minute period. n addition, it will be a signifi cant drain on technicians time if the process is not automated. The extra minutes required for this process, if all manual, could cause delays in reprocessing in busy departments. r with high-level disinfected endoscopes, most endoscopy suites simply hang the endoscopes after processing them in an E. n absorbent towel is placed in the bottom of the storage cabinet to absorb any water that drains from the endoscopes. For sterilized endoscopes, the drying process is now performed primarily to prevent sterilization failure as the machines are very sensitive to moisture and in addition moisture interferes with the sterilization process. To be successful, management will need to implement training, provide the appropriate space and tools needed for the air drying and enforce recording drying times. nless the process is automated, this will be a very challenging task for management. t is important to recognize that both changes impact PD
and endoscopy processing areas as small diameter fl exible endoscopes (e.g., ureteroscopes, cystoscopes, etc.) are impacted by these changes. nother change in T is for the reporting of leak
test failures. lmost every F states that the endoscope should not be used on a patient if it leaks. The reason for this is that only the exterior of the endoscope and the interior of the lumens are rendered sterile or HD through reprocessing. When a leak forms, the interior of the endoscope is exposed, and this space is not clean, and therefore cannot be considered sterile or HD even if it is exposed to sterilant. (Those endoscopes that are sterilized by hydrogen peroxide or ozone gas require a vent port be attached. This vent port allows the sterilant gas to penetrate the interior of the endoscope. The vent cap is used to allow the pressure within the endoscope to equalize during the sterilization process. Without the vent cap, the endoscope cover could tear due to the pressure inside the endoscope. While the sterilant enters the interior of the endoscope, the interior is not considered sterile because it is not an area that is or could be cleaned). eak testing should be performed prior to cleaning. t is also
performed in Es. Both processes occur prior to the use of the endoscope on the patient. Post-case if a leak is detected the endoscope must be immediately taken out of service and sent for repair or replacement. eaks typically are a result of accessory devices used with the endoscope (biopsy forceps, snares, laser fi bers etc.), improper handling (bending, torquing) improper care (sharps, heavy equipment placed on or near the endoscopes and general wear and tear (parts fail due to age condition). n most cases the damage occurs during use. Currently, physicians have no way of telling if the endoscope that they are using has a leak. When a leak occurs, the endoscope can no longer be considered sterile or high level disinfected and should not be used on a patient from that point in time when the leak occurred. otification of a leak post case is not a perfect solution because the patient likely was exposed to a
28 November 2022 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
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