Hanging endoscopes

Patient Safety

Advice from Endoscope Reprocessing Experts

One benefit of the single-use endoscope is the ability to reclaim crowded, valuable hospital space for more efficient use. Single-use devices also eliminate the potential for cross-contamination when properly utilized.

When you ask nine experts in the endoscopy field for tips on safely preparing devices for the next patient, you get a full range of answers.

That’s just what Healthcare Purchasing News did in a recent article examining the best practices for getting endoscopes back into surgical suites after use. The topics covered everything from endoscope hang times to proper care of drying cabinets to cutting out reusables entirely by going to single-use devices.

There’s no doubt that having adequate storage and reprocessing space is essential for a quality reusable operation, says Christian Escobar, director of marketing for visualization at Ambu Inc. He also advocates trying single-use devices.

“One benefit of the single-use endoscope is the ability to reclaim crowded, valuable hospital space for more efficient use,” he says. “Single-use devices also eliminate the potential for cross-contamination when properly utilized.”

Ambu plans to add a single-use colonoscope and single-use gastroscope to its portfolio later this year after winning 510(k) approval from the U.S. Food and Drug Administration in 2020 for its cystoscope and duodenoscope.

The experts agree on the importance of drying reusable endoscopes both inside and out. Here are some of their tips:

  • Allow time for proper drying. The drying cycle of many automated endoscope reprocessors, or AERs, and simple alcohol flushes do not produce completely dry endoscopes for use or storage.
  • Air, whether at a workstation or in forced air-drying cabinets, produces better results than syringe flushing or hang drying.
  • Choose endoscope storage cabinets that meet current society guidelines and provide for future upgrades that may be needed.
  • Automated drying cabinets that force a constant flow of air through scopes may extend time before another reprocessing is needed for up to 30 days.
  • Vertical storage is vital to enable channels to drain properly and to maintain the integrity of the scope’s shape.
  • Evaluate the cost of resources and personnel to adequately dry the endoscopes vs. the cost of constant reprocessing due to short hang times.
  • Clean drying cabinets thoroughly and monitor them for chips and damage.
  • Endoscope storage cabinets should be housed in a designated room or a low-traffic area.  They should never be kept in a procedure room.

     “The wet environment inside of an improperly dried endoscope is the perfect breeding ground for water-loving bacteria,” says Seth Hendee, clinical education coordinator SPD at Healthmark Industries Co. “Thoroughly drying endoscopes between uses and before storage will remove that risk from the process.”

A lack of clarity in industry standards leaves many procedures open to interpretation, says Natalie Reece, clinical educator with Key Surgical.

“If you are hanging your scopes, there will absolutely be residual moisture left over,” she says. “Test how many of your ‘patient-ready’ scopes have microbial contamination. Test for residual moisture in your scopes.”

We’ve written here at Single-Use Endoscopy about studies showing that scopes believed to be patient-ready were not.

Alison Sonstelie, lead sterile processing coordinator at Sanford Health and affiliated with OneSOURCE in Fargo, N.D., recommends consulting the endoscope manufacturer’s instructions and preventive maintenance documents and staying abreast of current AAMI, AORN and SGNA standards.

“A controversial topic for endoscopes has been ‘hang time’, which is the amount of time a scope can be stored before it should be reprocessed,’ she says. “Depending on the standard or guideline, you may get different guidance for hang time.”

More Infection Prevention Articles
Endoscope-Related Infection: A Look to the Future
Prevention Strategies
Exogenous infections relating to contaminated endoscopes have been historically difficult to quantify. A recent systematic review offers a look at potential solutions to reducing the risk of patient infection from cross-contamination.
PPE in Reprocessing: Vital for Safety and Eliminating Endoscope Contaminants
Prevention Challenges
Endoscope reprocessing involves a complicated series of between 50 and 100 steps depending on the device instructions for use and society guidelines adopted by the institution. Among the dozens of steps needed are several PPE changes to protect the integrity of the cleaning process.
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