STERILE PROCESSING
or effective point-of-use pre-treatment can add to the downstream workload and effectiveness – for manual cleaning, as well as high-level disinfection or sterilization. An endoscope not effectively precleaned can take that much longer to manually clean and/or may inhibit complete manual or automated cleaning/removal of biobur- den and biofilm, which in turn affects the success of disinfection/sterilization. For certain brands of flexible endo- scopes, there are steps that can only occur at the bedside – while the scope is still con- nected to the processor in the procedure room (e.g., the IFU directed use of the “AW Channel Cleaning Adapter”),” Whelan con- tinued. These steps cannot be reproduced in the processing area.”
lympus Benedict remains sacrosanct.
eglecting pre-cleaning immedi- ately following a patient procedure may increase the risk for infection and could increase processing time,” she said. “Allowing clinical soil to dry on the endo- scope may allow biofilm to form on the device. Pre-treating is critical to ensure subsequent reprocessing steps, includ- ing high-level disinfection or steriliza- tion, can be effective. When performed correctly and with knowledge as to why the process is critical, pre-treating is a cornerstone in high-quality safe patient care. Pre-treating requires minimal time to complete and provides the foundation for effective and efficient reprocessing of medical devices.” As some in the OR may question the workflow changes, pecialtyCares goston
raises the specter of workflow changes not requiring pre-treatment in the . Failure to properly pre-treat instru-
ments in the OR sets up a cascade of possible effects in the SPD,” he insisted. nstruments that are not pre-treated require more time and effort by the SPD staff to clean them. This can lead to excess force being used on the item or tools that could possibly damage the instrument, e.g., wire brushes. We know that the risk of biofilm formation increases the longer the bioburden remains on the instrument. This increases the risk of ineffective cleaning, increasing the risk of [surgical site infec- tions to patients. t is extremely important that the staff perform complete pre- treating prior to returning products to the SPD.” HPN
Alternative options to reusable endoscopes simmering
By 2035, healthcare organizations can expect influx of hybrid products by Rick Dana Barlow
F
rom a reprocessing perspective, Sterile Processing & Distribution (SPD) experts anticipate minimally invasive surgery migration to hybrid rigid and flexible endoscopes by the mid-s but the expected shift seems to be simmer- ing to a slow boil.
Generally, healthcare organizations can choose between three types of flexible and rigid endoscopes – those that are completely reusable, those that are completely dispos- ablesingle-use only and those that are called “hybrid” for infection control pur- poses because they are reusable devices with a select number of disposable components that can be discarded after use (e.g., distal covers and adaptors, etc.).
By and large, two primary issues sparked the emergence of disposable and hybrid models as alternatives to the traditional reusable endoscopes that surgeons have operated since the s The challenges and difficulties in thoroughly cleaning, disinfect- ing and sterilizing these increasingly intri- cate and complex devices and the number of healthcare-associated infections attributed to inadequately reprocessed devices, such as bronchoscopes. Early countermeasures called for more education and training of SPD technicians handling these delicate and expensive instruments, followed by demands for more detailed, but clearly organized and easily understandable instructions for use (IFUs)
from the device manufacturers. Within the last decade, however, the third option of changing the devices themselves emerged as a possibility. Several years ago, Healthcare Purchasing
News began exploring and reporting on the potential shift that generated buzz and quick momentum with radical predictions of a progressive shift in behaviors and habits, but as time progressed, topped by a global pandemic, the early full-speed- ahead approach seems to have settled into a steady, but surefire gait. Once again, HPN reached out to a small
group of executives at manufacturers of endoscope devices and related reprocessing supplies and equipment about their chang- ing forecast of any market shifts through . They were able to choose from among five different potential market scenarios and to share their reasoning. 1.Fully reusable endoscopes will remain. Healthcare organizations will continue to rely on fully reusable flexible and rigid endoscopes for the majority of minimally invasive surgical (MIS) procedures
.Hybrid models will become a minority segment. Healthcare organizations will increasingly shift toward using hybrid flexible and rigid endoscopes that incor- porate disposable components that can be discarded after use, but the hybrid models W T surpass the use of fully reusable models
32 November 2022 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
.Hybrid models will become the majority. Healthcare organizations will increasingly shift toward using hybrid flexible and rigid endoscopes that incorporate dispos- able components that can be discarded after use, and the hybrid models WILL surpass the use of fully reusable models
4.Disposable/single-use only models will become a minority segment. Healthcare organizations will increasingly shift toward using fully disposable flexible and rigid endoscopes, but the disposable models W T surpass the use of fully reusable models
.Disposable/single-use only models will become the majority. Healthcare organizations will increasingly shift toward using fully disposable flexible and rigid endoscopes, and the disposable models WILL surpass the use of fully reusable models ast year, os. and didnt generate support as executives felt remaining with fully reusable models – essentially, the status quo wasnt an option and neither was complete conversion to disposable/ Ds. This year, opinions and predictions seems to have shifted and tempered a bit, retreating to a wait-and-see area on one hand to a gradual acceptance and adoption of hybrids as part of conven- tional practice.
Olympus Corporation of the Americas, one of the worlds leading manufacturers
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