J A N U A R Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 5
Instrumentation, the Society of Gastroenterology Nurses and
Associates or AORN, for example. What does matter is that you con-
sistently apply the guidelines you choose to follow. Accreditation and
Medicare surveyors don't prefer one organization's guidelines over
another, but they will check to make sure you're following one of the
directives on a consistent basis.
3. Lack of training. How often do you train staff on cross-contamina-
tion prevention? Many facilities conduct refresher courses on an annu-
al basis, during orientation for new hires and when new endoscopes or
reprocessing equipment is purchased. That's not often enough.
Conduct staff-wide training — with physical demonstrations on how
endoscopes should be cleaned and handled, and how automatic endo-
scope reprocessors work — more than once a year. The CDC recom-
mends quarterly competency evaluations.
4. Inadequate pre-cleaning. Endoscope reprocessing begins at the
patient's bedside, where techs should wipe down the exterior of the
insertion tube and flush internal channels as soon as procedures are
concluded. This critical first step prevents biofilm from forming on the
scope's external and internal surfaces.
5. Inadequate manual cleaning. Even the best automatic endoscope
reprocessors machines can't disinfect endoscopes that haven't been
properly cleaned. Be sure diligent manual cleaning includes the flushing
and brushing of all valves, channels, connectors and detachable parts.
6. Ignoring innovation. It doesn't make sense to ignore the benefits
offered by the technologies and tests that provide real-time evidence
that scopes have been properly cleaned and disinfected. Take advan-
tage of borescopes and real-time ATP testing to confirm scopes have
been effectively reprocessed and are ready for repeated use.
— Jared Bilski
