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The utility of lighted magnification and borescopes for visual inspection of flexible endoscopes
Cori L Ofstead1, Abigail G Smart1, Krystina M Hopkins1
1Ofstead and Associates, Inc.; St. Paul, MN.
Introduction:
Infections have been linked to damaged or contaminated endoscopes with visible defects. Endoscope processing standards and guidelines state endoscopes should be visually inspected every time they are used. This study evaluated a new visual inspection program using magnification and borescopes in an endoscopy department that had not previously utilized these tools.
Methods:
Site personnel were given visual inspection tools and training before systematically examining fully processed endoscopes twice during a 2-month period. A risk assessment protocol was used to determine whether endoscopes required recleaning, repair, or other action. Findings were documented using log sheets, photographs, and videotapes.
Results:
Visible damage and residue or debris were observed in 100% of 25 endoscopes at both assessments, and 76% required repair. Defects at baseline included scratches (88%); channel shredding or peeling (80%); adhesive band disintegration (80%); residual soil or debris (white 84%; black 68%; brown 40%; yellow/green 36%; and orange/red 8%); retained fluid (52%); and dents (40%). Findings were similar at follow-up.
Discussion/Conclusions:
Visual inspection with magnification and borescopes identified actionable defects that could interfere with processing effectiveness in 100% of endoscopes. Infection preventionists have a critical role to play in supporting processing personnel now that standards, guidelines, and manufacturer instructions recommend enhanced visual inspection of every endoscope, every time.
Insights
Enhanced visual inspection using magnification and borescopes revealed defects in 100% of endoscopes. This highlights the critical need for improved endoscope reprocessing to prevent infections.
Area of Science:
- Medical device reprocessing
- Infection prevention and control
- Gastroenterology
Background:
- Endoscope reprocessing is crucial for preventing healthcare-associated infections.
- Damaged or contaminated endoscopes pose a significant infection risk.
- Current guidelines mandate visual inspection of endoscopes after each use.
Purpose of the Study:
- To evaluate a novel visual inspection program for endoscopes.
- To assess the effectiveness of magnification and borescopes in identifying endoscope defects.
- To determine the prevalence of actionable defects in processed endoscopes.
Main Methods:
- A new visual inspection program using magnification and borescopes was implemented.
- Endoscope processing personnel received specialized training.
- Fully processed endoscopes were systematically examined twice over two months.
- A risk assessment protocol guided decisions on endoscope recleaning or repair.
- Findings were meticulously documented using logs, photographs, and videos.
Main Results:
- 100% of endoscopes exhibited visible damage or residue at both assessments.
- 76% of endoscopes required repair due to identified defects.
- Common defects included scratches, channel damage, adhesive disintegration, residual soil, retained fluid, and dents.
- Similar defect rates were observed at follow-up assessments.
Conclusions:
- Enhanced visual inspection with magnification and borescopes is highly effective in detecting actionable endoscope defects.
- The findings underscore the importance of rigorous endoscope inspection to ensure patient safety.
- Infection preventionists play a vital role in supporting enhanced endoscope reprocessing protocols.
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