Development of a checklist as self-assessment tool to evaluate the reprocessing of endoscopic instruments in an Italian teaching hospital.

Abstract

The present study aims to develop a checklist, as a self-assessment tool, for evaluating all the items involved in the endoscope reprocessing that could be useful for the improvement and/or development of a safety endoscope reprocessing system. A three-step modified Delphi method, with an embedded qualitative component, was adopted to develop the checklist. According to it, corrective actions were performed before its further re-administration. Contextually, the microbiological surveillance of the endoscopes and of the wash disinfector machine was carried out. Five areas were included in the checklist. After the 1st checklist application, only one of three wards reached the excellent scores in all the items. The other two wards showed an improvement in the Traceability and Endoscope Reprocessing areas after corrective actions. The McNemar's test reported significant difference in the proportion of satisfactory results before and after the 1st and 2nd checklist application. The microbiological surveillance, conducted after the 1st administration, showed unsatisfactory results for the 2 bronchoscopes available in the Intensive Care Unit and for 2 automated endoscope reprocessors. The analysis performed after the 2nd administration showed good results. The periodic administration of the checklist is functional for a self-assessment of quality reprocessing procedures carried out in the large endoscopic services and in the wards occasionally providing those services, according to the good practice guidelines and for any corrective actions to increase the safety.