STERILE PROCESSING


from pushing the pin prior to processing a scope. This involves testing the actual unit and cord.


• Transportation of dirty scopes should be in a biohazard-marked containment device that has an IFU for proper care and handling.


Malinda Elammari, CST, CSPM, CSPDT, CFER, CSIS, CRCST, CIS, CHL,CER,


CLSSGB, Clinical Education Specialist, Healthmark Industries Co.


The mindset needs to shift to active drying prior to scopes being released by processing professionals. It becomes the last formal step of processing – prior to storage or as part of storage. Key points: • The drying cycle in an AER is a purge, not a validated drying cycle.


• Both the exterior of the scope and accessible channels need to be actively dried.


• Low-linting wipes need to be used for external drying.


• Instrument air or HEPA-filtered air needs to be used for channel drying.


• Based on research to date, channel drying should occur for at least 10 minutes.


• Holding an air gun to the proximal work- ing channel does not ensure drying of the entire channel.


• Scopes need to be dried before storage in a conventional vertical storage cabinet or they need to be placed in a dedicated channel drying cabinet.


• Conventional storage cabinets need to have active filtered air circulat- ing through the cabinet.


• Embedded QC for active drying would include the use of periodic drying verification testing.


John Whelan, Clinical Education Specialist, Healthmark Industries


AAMI ST91 addressed this issue rather nicely: • Endoscope channels be dried for a minimum of 10 minutes with pressure-regulated forced instrument air (or, at minimum, HEPA-filtered air). If moisture is still observed, the drying time should be extended until no moisture is visible. The endoscope manufacturer’s writ- ten IFU should be reviewed for the maximum PSI. Note: Manual drying should occur even if an AER is used, and it has an air purge or extended dry time feature. They also looked at the use of alcohol and came up with the following recommendation: • The use of alcohol has long been recom- mended in the drying process after disinfec- tion is completed; however, some studies have shown that alcohol can be a fixative agent. For that reason, ST91 now


recommends that a multidisciplinary team (with representation from infection preven- tionists, endoscopy and perioperative nurses, endoscope processing personnel, endosco- pists, and other involved personnel) conduct a risk assessment to determine whether endoscope lumens should be flushed with 70% to 90% ethyl or isopropyl alcohol. Since no two facilities are alike, the use of a risk assessment makes perfect sense.


Sharon Ward-Fore, BS, MS, MT(ASCP), CIC, FAPIC, Infection Prevention Advisor, Envista


• Using a drying cabinet that directly con- nects to the endoscope lumens and forces air through the internal channels is preferred over simply hanging in a cabinet.


• Facilities should conduct a risk assessment to determine the appropriate length of dry- ing cycle and appropriate maximum storage time for their endoscopes.


• Place the endoscope into a drying cabinet and initiate the drying cycle as soon as possible after the endoscope is removed from the AER.


• Conduct periodic inspections of the internal channels of endoscopes to ensure moisture is completely removed through a standard drying cycle.


• Follow manufacturer IFUs for endoscopes, reprocessing equipment and drying cabinets.


Aaron Champion, Vice President, Endoscopy Sales, Solaire Medical


• Ensure endoscope manufacturer instructions for use (IFUs) are followed for maximum psi allowed for endoscope channels.


• If possible, dry in a controlled environment such as a drying cabinet with instrument air or a minimum of HEPA-filtered air. This helps limit exposure of the clean endoscope to airborne contaminates.


• Designate a defined drying space in your reprocessing/sterilization flow. Ensure the drying space does not cross over into the dirty space. Keep the reprocessing flow unidirectional.


• To protect the integrity of the endoscope, vertical hanging is best for long-term stor- age. The use of a drying cabinet for storage is preferred. If a drying cabinet is not avail- able, endoscopes may be completely dried, and then stored in a standard cabinet with HEPA filtration, ventilation and air flow.


• Follow drying cabinet or drying device manu- facturer instructions for use (IFUs) for filter changes. This is critical to ensure the quality of air that is exposed to clean endoscopes.


Theresa Kunsman, Senior Product Manager, Cleaning/Disinfection/


34 December 2022 • HEALTHCARE PURCHASING NEWS • hpnonline.com


Sterilization, Olympus Corporation of the Americas


Endoscope drying and storage play a key role in endoscope reprocessing. It is important to stress that preventing the introduction of contaminants after disinfection is also pivotal to patient safety. Here are a few tips on drying and storing reprocessed endo- scopic devices: • The quality of compressed air used to dry endoscopes is important. Inadequately fil- tered air could introduce contaminants to a clean endoscope. Societies are moving toward the use of instrument-quality air. The AORN guidelines state, “The exterior surfaces of the endoscope should be dried with a soft, lint-free cloth or sponge and all channels purged with instrument air.”1 AAMI has also noted that endoscopes that have completed an HLD cycle should undergo additional drying internally with instrument air.2


SGNA indicates that step


#8 in endoscope reprocessing is drying, “which requires an alcohol flush, followed by forced-air drying with instrument-quality compressed air.”3


• Heath care facilities should avoid the use of oil-based compressors for drying endoscopes.


• When drying endoscope channels, be sure the maximum air pressure introduced does not exceed manufacturer IFU requirements. The latest Multisociety Guidelines recom- mend, “Endoscopes should be completely dried after reprocessing and before use.”4 AAMI ST91 2021 guidelines have taken this a step further and recommend that endoscopes with channels should be dried for a minimum of 10 minutes with pres- sure-regulated forced instrument air or a minimum of HEPA-filtered air. If moisture is still observed after 10 minutes, drying time should be extended until no moisture is visible.2


• Whenever possible, store the endoscope in a drying cabinet. If a drying cabinet is not available, dry the endoscope (exterior and lumens) and hang it in a well-ventilated HEPA cabinet that provides positive pressure.


• Once disinfected, endoscopes should be dried and stored in a way that will protect them from external contaminants. Hang the endo- scope in a vertical posi- tion to enable drying and maintain scope integrity. Remove caps, valves, and other detachable parts per IFU instructions.


Melinda Benedict, Director, Infection Prevention and Control, Olympus Corporation of the Americas


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