ASGE Masterclass: Infection Control (Live Virtual) | June 2021-03-Muthusamy_ASGE Enhanced Endoscope Reprocessing Talk

03-Muthusamy_ASGE Enhanced Endoscope Reprocessing Talk

Pdf Summary

This document discusses the challenges and potential solutions for the reprocessing of endoscopes, with a focus on duodenoscopes. The first section highlights the complexity of the reprocessing process, which includes multiple steps such as pre-cleaning, leak testing, manual cleaning, high-level disinfection, and storage. Inadequate cleaning protocols and user error are identified as potential mechanisms for reprocessing failure.<br /><br />Manual cleaning is emphasized as a critical step, as residual bio burden after manual cleaning may impede high-level disinfection and increase the risk of infection. However, there are challenges associated with manual cleaning, such as the time-consuming nature of the process and staff turnover.<br /><br />It is noted that high-level disinfection has a low margin for error, as endoscopes can be heavily contaminated with bacteria. The document compares the margin of safety for endoscope reprocessing to the sterilization of surgical instruments, highlighting the greater risk in reprocessing endoscopes.<br /><br />The rise of "superbugs" is also discussed as a concern, further emphasizing the need for effective reprocessing practices. The FDA has recommended enhanced reprocessing methods, including double high-level disinfection, ethylene oxide sterilization, liquid chemical sterilization, and culture and quarantine.<br /><br />The document provides data from a national survey on the utilization of enhanced reprocessing methods, as well as attitudes towards different solutions. It also discusses the effectiveness of remote video auditing as a process improvement strategy.<br /><br />Other topics covered include the assessment of reprocessing adequacy through ATP testing, the comparison of double high-level disinfection to ethylene oxide sterilization, the efficacy of microbial surveillance in detecting bacterial contamination, and the potential use of protective attachments for endoscopes.<br /><br />The document concludes with recommendations for improving reprocessing practices, ensuring safe storage and maintenance of devices, and following FDA guidance. It emphasizes the need for further research on efficacy and cost-effectiveness and recognizes the role of patient preference in determining appropriate solutions.

Keywords

reprocessing

endoscopes

duodenoscopes

challenges

solutions

manual cleaning

high-level disinfection

superbugs

FDA recommendations

patient preference