Implementing Audits to Improve High-Level Disinfection of Flexible Endoscopes

Flexible endoscopes used in gastrointestinal procedures possess long, narrow channels that complicate decontamination and high-level disinfection. Infections may occur even with proper execution of all reprocessing stages, particularly as the endoscope ages or in the presence of biofilm. Effective reprocessing improves when the nurses and associates handling endoscopes are knowledgeable and well-trained, have sufficient time to complete all steps correctly, and work in a clean environment equipped with the right tools. Audits evaluate endoscope reprocessing to confirm the presence of necessary conditions and verify the correctness of procedures. This article details the implementation of endoscope reprocessing audits in five clinical sites, which resulted in an increase of all audited items being compliant in 296 out of 325 audits to 317 out of 325 audits. A consistent improvement in the audit compliance score through audit and feedback indicates the project's moderate influence on overall endoscope reprocessing, consistent with the anticipated impact described in the literature.