Endoscopy Basics
What is flexible endoscopy used for?
Flexible endoscopy is used as a diagnostic and therapeutic tool.
What is one major risk associated with the use of endoscopes?
The transmission of infections, including outbreaks linked to defective or inadequately reprocessed equipment.
What is the first step in reprocessing a flexible endoscope?
Precleaning or point-of-use cleaning.
What is high-level disinfection (HLD)?
The elimination of all forms of microbial life except low levels of bacterial spores.
Why is ongoing education and competency validation important for personnel reprocessing endoscopes?
To ensure adherence to infection prevention protocols and proper reprocessing techniques.
Name one complex feature of flexible endoscopes that makes them challenging to reprocess.
Long, narrow lumens and multiple channels.
What type of pathogens can be transmitted through inadequately reprocessed endoscopes?
Exogenous pathogens, such as antibiotic-resistant bacteria.
Why is leak testing performed on endoscopes?
To detect damage that could lead to fluid invasion and potential infection transmission.
What must be verified before using an AER for high-level disinfection?
Compatibility with the specific endoscope model.
What should be included in a facility's quality assurance documentation for endoscope reprocessing?
Logs indicating the patient's details, procedure, endoscope serial number, and staff involved in each stage.
Why are flexible endoscopes preferred over open surgical procedures?
They reduce risks associated with open surgery and anesthesia, minimize recovery time, and reduce healthcare costs
Name one type of infection linked to endoscopes despite strict adherence to reprocessing protocols.
Carbapenem-resistant Enterobacteriaceae (CRE) infections.
Describe one key step in manual cleaning of an endoscope.
Meticulously clean all channels and components according to the manufacturer's instructions for use (IFU).
What is one supplemental measure for reprocessing duodenoscopes recommended by the FDA?
Microbiological culturing and other monitoring methods.
What type of audit is necessary to verify compliance with reprocessing protocols?
Periodic audits of PPE compliance and reprocessing procedures.
What is a duodenoscope and why is it difficult to clean?
A duodenoscope is used during ERCP procedures and has an elevator channel, making it harder to clean and disinfect.
What is biofilm and why is it significant in the context of endoscopy?
A matrix of microorganisms that is difficult to remove and can decrease the effectiveness of disinfection and sterilization processes.
What is the purpose of using a borescope in endoscope reprocessing?
To inspect internal channels for damage and retained debris.
Name one chemical used for high-level disinfection.
Paracetic acid or hydrogen peroxide.
What is one recommendation for the storage of reprocessed endoscopes?
Store them in a clean, well-ventilated, and secured area, preferably in drying cabinets.
What classification do flexible endoscopes fall under according to the Spaulding system?
Semicritical devices.
Which device used for high-level disinfection has been linked to transmission of infection?
Automated endoscope reprocessors (AERs).
What type of water should be used for the final rinse in manual reprocessing?
Critical water or sterile water, depending on the manufacturer's IFU.
What is the significance of drying endoscopes after HLD?
It greatly reduces the possibility of recontamination by waterborne microorganisms.
What is one of the key roles of infection preventionists in endoscopy?
Conducting surveillance and audits to ensure adherence to reprocessing protocols and prevent infection transmission.