From the April 2017 issue of HealthCare Business News magazine
Surveillance culturing
Health care facilities may perform microbiologic culturing, which involves sampling endoscope channels to identify any bacterial contamination that may be present on the scope after reprocessing. International guidelines have recommended intervals ranging from every four weeks to annually. Although numerous health care facilities have successfully implemented routine or periodic microbiological culturing, the CDC encourages that additional data and validation testing is needed to demonstrate the robust methodology and reliable culturing results before health care facilities can incorporate it as a best practice.
Competency
To ensure that manual cleaning is performed consistently and accurately, the FDA panel recommends strengthening competency training for reprocessing staff in health care facility reprocessing units and incorporating human factors testing when developing reprocessing instructions. Additionally, to prevent the risk of infection, single-use or autoclavable accessories should be used wherever possible. Do not reuse accessories labeled for single use.
Recordkeeping
Health care facilities should develop procedures and responsibilities for tracking the useful life of endoscopes and accessory equipment, including equipment and supplies for reprocessing. These procedures should address specification evaluation, scheduled maintenance and removal of equipment from use. Identify all endoscopes, endoscope accessories and endoscope reprocessing equipment used in your facility, including manufacturer, models, serial numbers or hospital-specific equipment tag numbers and unique device identifiers (UDIs). It is important to also include the location within the facility where the equipment is reprocessed and stored, and the status or maintenance schedule of the device.
Infection preventionists play an important role in endoscopy leadership and quality reporting to further reduce the risk of infection and increase the safety of endoscopes. It is critical that health care organizations include endoscope-related infections in surveillance activities in the event that an environment-to-patient infection is acquired, also referred to as a health care associated infection (HAI). Although conducting surveillance for HAIs is part of every infection preventionist’s job, there is not a standard definition set for determining if a patient acquired an infection from an endoscope. Therefore, it is critical to examine all aspects of the endoscope reprocessing programs to ensure that staff are meticulously adhering to the cleaning and reprocess instructions.
