sterile processing
sterile processing
By David Taylor , MSN , RN , CNOR
High Cost of Improper Scope Handling and Transport
Proper handling and transporting of flexible endoscopes between the examination room and processing areas is crucial for minimizing infection risks and preventing costly instrument damage . Achieving high reliability , consistency and safety when managing flexible endoscopes from user areas to processing departments requires a strong infrastructure that supports staff training , competency development , quality assessments , and active management .
The repercussions of poor endoscope handling , processing and transport procedures can be significant , impacting both patient health and the organization ’ s bottom line . Patients who develop infections due to inadequate processing and unsafe transport may require prolonged treatment and hospitalization , costing the facility thousands of dollars .
Legal fees , settlements and compensation for damages can result in further financial loss , from thousands to millions of dollars depending on the severity of the case . In addition , regulatory bodies may impose fines and penalties on healthcare organizations that fail to adhere to proper processing protocols . HAIs and other negative patient outcomes stemming from improperly processed and managed devices can tarnish a healthcare organization ’ s reputation by diminishing patient and community trust , often leading individuals to seek care elsewhere . Further , endoscopes are costly purchases , and inappropriate handling , transport and processing practices can contribute to exorbitant repair and replacement costs that could have been prevented . Never rush ( or ignore ) critical steps . Endoscope processing is a collection of crucial and , often , complex steps that should result in a device that is free from microbial contamination and rendered safe for patient use . Every step is inextricably linked , with the success of each preceding step required for subsequent processes to be effective . Although there is understandably strong emphasis on the cleaning and disinfection phases , all processes occurring before and after those stages must never be underestimated , rushed or skipped . Any compromise or breach in any process can potentially re-contaminate the endoscope or damage components , rendering the device unsafe for patient use .
Point-of-use treatment is an essential step of proper endoscope care and handling ; as the name implies , it should be performed in the procedure area , before the endoscope is sent to the decontamination area . The treatment involves using an approved solution ( enzymatic or nonenzymatic ) to wipe the insertion tube of the device and flushing the solution through each channel immediately after use . Dried soils are a challenge to remove , compromising the effectiveness of subsequent cleaning steps , and potentially damaging the endoscope .
The repercussions of poor endoscope handling , processing and transport procedures can be significant , impacting both patient health and the organization ’ s bottom line . Patients who develop infections due to inadequate processing and unsafe transport may require prolonged treatment and hospitalization , costing the facility thousands of dollars .”
Safe transport processes should also be emphasized to any employees who transfer endoscopes to and from Endoscopy suites and Sterile Processing areas . Again , endoscopes are very delicate medical devices , and improper handling during transport can lead to infection transmission , damaged components , and shortened instrument lifespan . To mitigate these risks , endoscopes should be placed horizontally in puncture-resistant , enclosed and leak-proof containers labeled for clean or hazardous transport ( approved disposable , sealable transport bags may also be used , but they should still be placed in a secure container for protection ). Staff should be trained about the importance of never transporting endoscopes with sharps , which could puncture or scratch the delicate components , and they should never coil endoscopes tightly , which could result in severe device damage . Endoscope attachments should always remain with the endoscope but must be placed carefully in the transport container to prevent damage .
Leak testing is crucial before manual cleaning begins . This step helps verify the functionality of the device and whether damage to the external surfaces or internal channels occurred during its most recent use . Detecting damage early can prevent inadequate disinfection and further damage to the device . This helps improve patient safety and avoid costly repairs or replacements by addressing issues before they worsen .
Manual cleaning requirements can vary by manufacturer ; therefore , it is vital to follow the manufacturer ’ s instructions for use ( IFU ) for each step in the process ( including ensuring each of the channels and ports are brushed and flushed the appropriate number of times before the device undergoes high-level disinfection ( HLD ) or sterilization ). The brushing and flushing steps are essential because residual organic material can harden and become difficult to remove . Failure to remove bioburden will reduce the effectiveness of HLD and sterilization and render the device unsafe for patient use . Manual cleaning should begin within one hour of a procedure ’ s completion to prevent extended processing times .
Visual inspection under lighted magnification is another critical step that must never be rushed or skipped because it helps ensure the endoscope and its accessories are free of debris and defects . Ideally , this step will also involve the use of a borescope to inspect internal channels for damage .
High-level disinfection ( HLD ) of endoscopes remains a widespread practice , but some manufacturers now recommend sterilization as the final step . Adhering to the manufacturers ’ IFU for the disinfectants , sterilants , equipment and supplies used for processing is imperative . Proper drying is another vital step because it minimizes the risk of recontamination from waterborne microorganisms . Drying can be achieved by flowing air through
november 2024 • www . healthcarehygienemagazine . com •
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