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Reprocessing of flexible endoscopes
1Division of Gastroenterology, UC Davis Medical Centre, Sacramento 95817, USA. jwleung@ucdavis.edu
Abstract:
Proper reprocessing of endoscopes prevents the risk of transmission of infection between patients. Meticulous mechanical cleaning is the most important step as it removes the majority of the contaminating bacteria. It should be performed before manual or automatic disinfection. High-level disinfection involves total immersion of the endoscope in a liquid chemical germicide (LCG) at a preset temperature and concentration for a pre-determined period of time. Subsequent rinsing and drying are essential steps to remove the chemical solution and prevent bacterial colonization during storage. Endoscopy units that are used for more than 50 procedures per week may benefit from cleaning in an automatic endoscope reprocessor (AER). This allows automated exposure of the endoscope to the LCG with subsequent flushing and drying of the channels, and minimizes staff exposure to the LCG. Reprocessing should be performed by trained and accredited personnel according to written guidelines or standards of practice as defined by professional societies. Regular monitoring of the reprocessing process is important for quality control and in ensuring patients' safety.
Insights
Proper endoscope reprocessing, starting with meticulous cleaning, prevents patient infection transmission. High-level disinfection using liquid chemical germicides (LCGs) and proper drying are crucial steps for safe endoscopy procedures.
Area of Science:
- Infection control in healthcare settings
- Medical device reprocessing
- Patient safety in endoscopy
Background:
- Endoscope reprocessing is critical to prevent patient-to-patient infection transmission.
- Meticulous mechanical cleaning is the foundational step, removing most bacterial contaminants before disinfection.
- High-level disinfection (HLD) requires specific parameters: liquid chemical germicide (LCG), temperature, concentration, and time.
Framework:
- HLD involves complete endoscope immersion in an LCG.
- Post-disinfection rinsing and drying are essential to remove residual chemicals and prevent microbial growth.
- Automatic endoscope reprocessors (AERs) offer benefits for high-volume endoscopy units (over 50 procedures/week).
Implementation:
- AERs automate LCG exposure, channel flushing, and drying, reducing manual labor.
- AERs minimize healthcare staff exposure to potentially harmful LCGs.
- Reprocessing must be conducted by trained personnel following established guidelines and professional standards.
Implications:
- Consistent adherence to reprocessing protocols ensures endoscope safety and efficacy.
- Regular monitoring of the reprocessing workflow is vital for quality assurance.
- Effective reprocessing directly contributes to enhanced patient safety and reduced healthcare-associated infections.