Endoscope decontamination: making the guidance work in practice

Abstract

Endoscope decontamination prevents cross-infection and misdiagnosis. Legislation and guidance exist to ensure this, and Joint Advisory Group (JAG) accreditation is dependent on correct adherence. Due to their cost and complex construction, endoscopes have to be decontaminated between patients. Manual cleaning is an integral part of the decontamination process and helps ensure prions, which can transmit Creutzfeldt-Jakob disease (CJD), are cleared. Guidelines and standards include Medicines and Healthcare products Regulatory Agency (MHRA) Top Ten Tips, British Society of Gastroenterology (BSG) guidance, Department of Health and Social Care (DHSC) advice and the health technical memorandum, MTH-01-06. Over recent years, guidance has been updated. Changes incorporate tracking and traceability, levels of essential practice and best practice requirements, time from bedside clean to endoscope washer disinfection processing and issues around CJD. Guidance includes following the manual decontamination process, use of endoscope washer disinfectors, choice of disinfectants, rinse-water quality, safety, endoscope storage, operational management, environmental design and training. By following the most up-to-date guidance and legislation, nurses can ensure the safety of both patients and staff.