will be far
more difficult,
and they'll be
far more likely
to fail, if repro-
cessing doesn't
begin where it
ought to: at the
point of use.
Otherwise, by
the time an
instrument gets
down to the
sterilization
department — which may be hours later — the contaminants coating
the insides of the channel are likely to be rock hard and almost impos-
sible to remove. The clock starts ticking when blood, bone and biobur-
den enter the channel of a drill bit or an endoscope. It's crucial that
you flush, clean out and irrigate channels and lumens at the point of
use — whether you're in an OR or in an endoscopy suite. That's a les-
son you need to emphasize and re-emphasize until point-of-use clean-
ing becomes as automatic as sunrise.
Be sure to flush lumens and channels with a syringe and sterile
water periodically throughout the procedure to reduce the risk that
biofilm will form. It's important to use sterile water with stainless
steel instruments, and not saline, which is corrosive and can cause
pitting. Depending on what the manufacturer recommends, you can
also soak instruments in an enzymatic solution. Make sure instru-
ments stay moist until they get to the processing department. Pre-
cleaning kits are also available for flexible scopes.
6 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 6
• TURNOVER TIME Automated endoscope reprocessors, which high-level disinfect endoscopes and acces-
sories, can also eliminate some steps in the manual cleaning process.
