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How clean is your scope? A completed audit cycle of the disinfection of nasendoscopes
Raj Lakhani1, Abigail Smithard, Nigel Bleach
1ENT Department, Wexham Park Hospital, Slough, UK. drlakhani@doctors.net.uk
Introduction:
Correct disinfection of nasendoscopes is essential to address both the potential iatrogenic transmission of infection and to avoid injury from the chemicals used.
Materials And Methods:
Standards-based audit of the disinfection of nasendoscopes against the ENT UK guidelines.
Intervention:
instructional poster and staff training session. The disinfection process was re-audited one month later.
Results:
A total of 10 sessions and 31 cleaning episodes were audited in the first cycle (C1). A total of 12 sessions and 36 cleaning episodes were re-audited in the second cycle (C2). Clinic set-up results: there was a marked improvement in the checking of the expiry date (C1=5/10; C2=10/12; P≤0.001) and recording the date for the solution to be discarded (C1=0/10; C2=10/12; P≤0.048). Each cleaning episode results: an improvement in transportation in a 'dirty bag' (C1=0/31; C2=19/36; P≤0.001), washing of the scope (C1=0/31; C2=36/36; P≤0.001), adequate disinfection time (C1=16/31; C2=33/36; P≤0.001), rinsing and drying with alcohol swab (C1=0/31; C2=35/36; P≤0.001) and placing of the scope in a 'clean bag' for storage (C1=0/31; C2=35/36; P≤0.001) was seen after the intervention.
Conclusions:
The introduction of a poster and training in the disinfection of nasendoscopes proved successful in improving compliance with the published guidelines. These simple measures were simple, cheap and effective to institute. The benefit of improving the disinfection of nasendoscopes to patients, doctors and the organisations that they work in is clear.
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