Improving Quality and Safety in the Endoscopy Unit (On-Demand) | October 2024-ASGE guidelines for safety in the GI unit

ASGE guidelines for safety in the GI unit

Pdf Summary

The document provides guidelines for maintaining safety in gastrointestinal (GI) endoscopy units, with a focus on infection control, facility standards, staffing, and sedation protocols. Historically, the emphasis was on infection control, especially endoscope reprocessing. However, outbreaks linked to GI endoscopy have highlighted the need to address additional safety gaps. In 2009, the CMS Conditions for Coverage aligned standards for GI endoscopy units with those for sterile operating rooms, despite lacking evidence for improved outcomes. This guideline, from the American Society for Gastrointestinal Endoscopy (ASGE), offers recommendations to elevate safety in endoscopy settings.<br /><br />Key issues addressed include:<br />1. Facility Design: Structural requirements such as 36-inch doors and at least 180 square feet per room are deemed adequate for endoscopy units.<br />2. Traffic Patterns: Written policies should define low and high-risk areas and appropriate personal protective equipment (PPE) usage.<br />3. PPE Guidelines: Staff should wear specific PPE during high-risk exposure but are not required to match sterile operating room standards, like hair covers and booties.<br />4. Sedation: Moderate sedation can be supervised by a qualified non-anesthesia physician, with minimal staff requirements, depending on the sedation depth.<br />5. Staffing: A nurse monitors patients under moderate sedation, performing interruptible tasks. An additional assistant is available if needed for technical support.<br /><br />The document underscores the low risk of infection transmission during endoscopic procedures, though improper cleaning and other breaches have caused significant incidents. Recommendations aim to balance safety, efficient care, and cost-effectiveness. The endorsement by multiple professional organizations underscores its comprehensive approach to enhancing patient and staff safety in non-sterile endoscopic environments.

Keywords

GI endoscopy safety

infection control

facility standards

sedation protocols

endoscope reprocessing

CMS Conditions for Coverage

facility design

personal protective equipment

moderate sedation

staffing guidelines