The ASGE Quality Course: Improving Quality and Safety in the Endoscopy Unit (Virtual) | November 2025-Reprocessing Guidelines Comparison and Guideline Adoption

Pdf Summary

This document by James Collins, an Endoscopy Accreditation Program Manager, outlines the fundamental guidelines for endoscope reprocessing to ensure patient safety and infection prevention. The guidelines serve as a cornerstone for reprocessing practices, aiming to reduce pathogenic transmission and are integral to facility infection control plans and certification processes.<br /><br />Key core principles include staff training and competency verification, appropriate room construction separate from patient care areas, immediate point-of-use treatment, leak testing, manual cleaning, high-level disinfection (HLD), rinsing, drying, storage, surveillance, and maintenance of equipment. Staff must be trained in specific methods, with competency documented and periodically audited. Reprocessing should strictly follow manufacturers’ instructions for use (MIFU).<br /><br />The process starts immediately after use with cleaning solutions applied externally and internally, followed by leak testing. Manual cleaning involves enzymatic solutions, brushing, flushing, and rinsing. Endoscopes undergo visual inspection possibly aided by magnification or borescopes. High-level disinfection is mandatory, typically using automated endoscope reprocessors (AERs), but there is no consensus on disinfectant chemistry. Rinse water quality is debated, with many recommending sterile water or tap water followed by alcohol rinse and drying.<br /><br />Alcohol flushing and drying are critical steps but consensus is lacking on methods. Storage cabinets should meet size and security requirements, though optimal features remain undefined. Accessories should not be stored inside instruments; policies on accessory storage vary. No definitive hang time or shelf life for stored scopes is agreed upon.<br /><br />Routine microbiological surveillance of endoscopes is generally not recommended except in outbreaks. Cleaning verification programs are advised, with documentation of reprocessing steps encouraged, though content varies across guidelines.<br /><br />Leadership should adopt a multidisciplinary approach, coordinate in case of breaches, and notify relevant authorities. Sterilization practices, especially for duodenoscopes, lack consensus, with recent guidelines suggesting single HLD suffices over repeated disinfection or EtO sterilization.<br /><br />Future directions call for research to standardize checks on HLD solution efficacy, optimal storage times, and verification methods, advocating for national organizations to collaborate on unified, evidence-based best practices.

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Jim Collins, BS, RN, CNOR

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Concept Cleaning

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Keywords

Endoscope reprocessing

Patient safety

Infection prevention

Staff training and competency

High-level disinfection (HLD)

Manual cleaning

Automated endoscope reprocessors (AERs)

Storage and drying

Microbiological surveillance

Sterilization practices

ASGE Reprocessing Guidelines

Cleaning

Disinfection

Scope Reprocessing Workflow

Manual Cleaning

High-Level Disinfection