STERILE PROCESSING
gauges, suctions and certain laparoscopic instruments like graspers. The internal complexities and differences between
endoscopes must be understood to ensure proper drying of the internal channels, according to Solaire’s Champion. “Not all channels are interconnected within some endoscope models, meaning that direct- ing air through one port does not necessarily mean all residual moisture is being removed from the endoscope,” he indicated. “The length of the endoscope and size of the lumens may contribute to the amount of residual moisture left in the endoscope after the AER cycle. Failure to leave the endoscope in a drying cabinet for a suf- ficient length of time may result in an incomplete drying cycle, thus allowing for residual moisture to promote bacte- rial growth. Additionally, environmen- tal factors like water quality, ambient temperature and humidity and atmo- spheric pressure can have an impact on the effectiveness of a drying cycle within an endoscope drying cabinet. “Each facility should perform a risk
assessment to verify that a standard drying cycle is sufficient to remove moisture and minimize the potential for contamination in endoscopes,” Champion added. Healthmark’s Elammari warns about improper storage as well as storage tech- niques that may seem harmless enough. “The manner in which extra instru- ments are stored can be damaging to the instrument and in turn does not
stress on the box lock of the instrument and with time can diminish its ability to function correctly. An additional example would be with light cords. According to most light cords’ IFUs they should be stored coiled no less than six or eight inches. Coiling less than this will cause the light fibers in the cord to break and reduce the amount of light produced. This translates to a dark operating view for the surgeon.”
Olympus’ Kunsman stresses the innate importance of aeration, dry- ing and storage of surgical devices for the durability and lifecycle of the devices.
“Even with the proper drying meth-
ods and devices, whether sterilizing or high-level disinfecting, verifying dryness can be a challenge,” she said. “This is because there are no broadly available methods for determining if a device is dry. Ensuring proper care and handling of equipment during reprocessing and transport should be managed because this can directly impact drying effectiveness and device longevity. Finally, checks and balances should be implemented to ensure proper reprocessing and drying steps are performed.” HPN
References
1. Association of periOperative Registered Nurses. Guideline for Processing Flexible Endoscopes. Revised February 2016 for publication in Guidelines for Periop- erative Practice, 2016 edition
Photos courtesy Malinda Elammari, Healthmark Industries
allow for proper functionality during surgical procedures,” she noted. “For example, when placing ringed instruments on a peg board, some facilities clamp the ratcheted instruments closed in an effort to utilize one peg and save space. This practice places
2.
“ANSI/AAMI ST91:2021: Flexible and Semi-rigid Endoscope Processing in Health Care Facilities.” As-
sociation for the Advancement of Medical Instrumentation. Published March 1, 2022
3. Society of Gastroenterology Nurses and Associates. Standard of Infection Prevention in the Gastroenterology Setting. 2016.
4. Multisociety Task Force Article. Guideline on reprocessing flexible GI endoscopes and acces- sories. 2021.
Tips, tools, tricks for device aeration, drying and storage
Maintaining standard, traditional and minimally invasive surgical devices – particularly during peak demand or elective and scheduled procedural demand spikes – can escalate to pressure cooker situations for sterile processing and distribution (SPD) professionals. SPD experts share some relevant and useful recommendations to help relieve some of the pressure once the devices exit the high-level disinfector or sterilizer. Note that some overlap or may be repetitive for emphasis.
• Make sure to consult your endoscope’s Instructions for Use (IFU) for proper aera- tion and drying methods (such as blowing air and/or using alcohol) as well information on the proper way to store the scope. There is no one-size-fits-all way of cleaning that applies to all endoscopes, so it is important to know what specific steps need to be taken to ensure proper cleaning and storage for your scopes.
• Scopes also should be hung and stored as soon as possible after cleaning is finished to allow for adequate drying. Documentation that contains the date of reprocessing and initials of who cleaned it is important to help
identify scopes that have reached your facil- ity’s identified storage time.
• Make sure your endoscope storage cabi- nets are clean. Storage cabinets should be cleaned according to the manufacturer’s IFU. However, doing visual inspections of the cabinet whenever storing or retrieving endoscopes can help ensure the cabinet’s cleanliness is maintained between scheduled cleaning times.
Kayla Ostrander, Application Engineer, Device Reprocessing, 3M
Health Care Business Group, Medical Solutions Division
32 December 2022 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
The below useful tips stem from some of the main issues that I have seen at differ- ent facilities. • The cloth that is being used to dry the outside of the scope should be changed with each scope.
• Scopes that come out of the [automated endoscope reprocessor] should be tagged as clean and with additional information per AAMI ST91
• Handheld air guns do not allow for proper drying of scopes internal lumens; invest in an automated system or drying cabinet.
• Ensure your leak tester’s pressure is being tested each day it is in use. This is different
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