clinical managers conduct weekly "wet checks" of 20% of the facility's
scope inventory. They flush sterile water down the channels of ran-
domly selected scopes and swab residual water in the channels to
check for microbial growth.
Borescopes let you visually inspect the scope's inner workings and
detect retained fluid in interior channels. Reprocessing techs who use
a borescope "should look inside channels to see if droplets are pres-
ent," says Dr. Ofstead. "When performing the exam, they should move
the borescope through the channels slowly. Moving too quickly will
flatten droplets, making them harder to spot."
Though there are plenty of new technologies on the market to help
dry endoscope channels and confirm that complete drying takes
place, many facilities have been slow to incorporate them into their
reprocessing practices.
Efforts to ensure scopes are properly dried after reprocessing is
made more challenging by the constant pressure to turn over scopes
as quickly as possible and by endoscope inventories that are often
"just enough" to meet case volumes. Unfortunately, because of those
factors, it's not uncommon for drying times to be abbreviated or for
drying to be skipped altogether, says Mr. Whelan.
Dr. Ofstead says the results of her study not only suggest that the dry-
ing and storage of scopes is a significant issue that needs to be
addressed, but also that high-level disinfection ultimately may not be
enough to eliminate cross-contamination risks and additional steps
might need to be taken to protect patients from harm.
"The bottom line is that disinfection is not eliminating all of the
microbes, and residual moisture fosters the growth of bacteria and
fungi," says Dr. Ofstead. "Because of that, I don't know if there is a
safe hang time for endoscopes. Instead, we should be heading toward
sterilization."
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