Improving Quality and Safety in the Endoscopy Unit (On-Demand) | October 2024-15_Case Studies

15_Case Studies_Exploring Safety Issues in GI Endoscopy

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The document outlines several safety and logistical challenges within the field of gastrointestinal (GI) endoscopy, highlighting three distinct cases.<br /><br />**Case 1: Fluid Shortages in Endoscopy Units**<br />Following a hurricane, there are acute shortages of both intravenous (IV) fluids and sterile water. In response, some endoscopy units have decided to close temporarily to conserve these fluids for other critical hospital uses. It is noted that not all procedures may require IV fluids. A recently published article emphasizes a gap in comprehensive data regarding the use of sterile water in endoscopy. The challenge for the unit is to develop a strategy that adapts to these shortages without compromising patient care. This may entail reassessing procedures to minimize fluid use. Gaining staff buy-in would require communicating the importance of resource conservation and demonstrating successful adaptation models from other healthcare settings.<br /><br />**Case 2: Concerns Over Endoscopic Practice**<br />A nurse manager raises concerns about an endoscopist’s practice of using a single colonoscope for both gastroscopy and colonoscopy on the same patient without reprocessing it. The primary concern is infection control and the potential risk to patient safety. It suggests that such practices should undergo scrutiny and cannot be left to the discretion of individual physicians without adherence to established reprocessing guidelines.<br /><br />**Case 3: Safety in Expanding Endoscopy Units**<br />As the unit expands into new procedural rooms, safety concerns arise due to the absence of standard equipment such as monitor booms, which may affect ergonomics and workflow. Requests for ensuring safety might include acquiring ergonomic designs to prevent staff injuries and optimizing room layout and equipment to align with existing safety standards.<br /><br />Each case presents unique challenges needing evaluation and a coordinated approach to maintain high standards of patient care and safety.

Keywords

gastrointestinal endoscopy

fluid shortages

IV fluids

sterile water

infection control

endoscopic practice

patient safety

ergonomics

safety standards

resource conservation