The Science Behind Endoscope Reprocessing
Endoscope reprocessing involves multiple key steps, and any missed step or error can result in safety events. Each step of the process has potential risks and points of failure. Healthcare personnel should be aware of the rationale for each process step and the risks associated with non-compliance. This issue brief is intended to be used as a resource to succinctly explain the evidence-based requirements and recommendations, regulatory requirements, best practices, and controversial issues in endoscope reprocessing.
Background
In the 21st century, the endoscope has become an invaluable diagnostic and therapeutic tool for performing minimally invasive procedures to examine the gastrointestinal tract, lungs, urinary tract, throat, abdominal cavity, and nose. The complex construction and design of some endoscopes can pose reprocessing challenges due to the multiple channels, narrow lumens, and other specialty features like the duodenoscope’s elevator area. In 2015, the Centers for Disease Control and Prevention (CDC) requested that the Healthcare Infection Control Practices Advisory Committee (HICPAC) elevate the standards in facilities to improve the infrastructure and management of endoscopy reprocessing programs. Since then, multiple organizations, such as the Association for the Advancement of Medical Instruction (AAMI), Association of periOperative Registered Nurses (AORN), and Society of Gastroenterology Nurses and Associates, Inc. (SGNA), have released national guidelines dedicated to current research and advancements in flexible endoscope reprocessing specific to these key process steps.
This issue brief provides a scientific overview of the rationale for the key process steps and risks associated with non-compliance in endoscope reprocessing that may result in patient safety events, in addition to several controversial topics that warrant further research to strengthen evidence-based practices and regulatory requirements. Improving patient safety in endoscopy is multifactorial, and future efforts to standardize materials and protocols can decrease variations in practice.
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