Do You Have an Endoscopic Infection Connection?

Abstract

ISSUE: In the recently published multisociety guideline for reprocessing flexible gastrointestinal endoscopes, the position statement listed 34 recommendations for gastrointestinal (GI) endoscopic reprocessing. Published articles suggest that the estimates of pathogen transmission during GI endoscopy may be underestimated and report that there have been no published reports of transmission of infection when current guidelines have been followed. We decided to look for additional opportunities for improvement in our current processes using the 34 recommendations. PROJECT: Our infection control department staff had worked closely in the past with the endoscopy staff reviewing the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) public health advisories and articles about process improvements for endoscopy cleaning and disinfection. We had documentation of required staff education and compliance with published guidelines. To begin the review, healthcare professionals from infection control and GI endoscopy met with the endoscope manufacturer's representative and conducted a thorough, detailed drilldown of our current processes using the position statement's recommendations. RESULTS: We found multiple opportunities for further improvements to current processes using the position statement recommendations. LESSONS LEARNED: Using a multidisciplinary team approach, close scrutiny and meticulous examination of our current GI endoscopy processes revealed opportunities for strengthening our processes. Working with the device manufacturer allowed cleaning and disinfection practices to be updated or revised as needed since equipment models change. Examining the use of disposable or reusable brushes, identifying tubing change practices, determining availability of current manuals for the model of endoscope in use for staff reference, reviewing the current policy and procedures, and updating staff competencies provided strong evidence for adherence to critical infection control issues in our GI device reprocessing. We then used this template to review other endoscopy procedures.