Abstract
Background and Aims. International studies revealed prevalences of around 50% of microbiological contaminations in reprocessed flexible endoscopes. In Germany a system was installed where the qualification for refund for colonoscopies was made conditional on successfully passing twice annually a microbiological surveillance test of reprocessed endoscopes. This study is an implementation and outcome evaluation as well as a general discussion of the quality assessment assurance in colonoscopy in Germany.Methods. German data from 2003–2008 were analysed: number of endoscopic units performing therapeutic and/or screening colonoscopies; results of all microbiological surveillance tests of reprocessing quality; number of failed surveillance tests and retests; number of qualifications for refund from the public health system cancelled due to repeated failure of microbiological surveillance tests.Results. After the introduction of the quality assessment assurance, the percentage of failed microbiological surveillance tests dropped significantly and steadily from close to 17% to below 5%.Conclusions. This study evidences (1st) the successful implementation of the quality assessment assurance in Germany and (2nd) a substantial improvement in the quality of reprocessing flexible endoscopes achieved by these measures.
Highlights
Flexible endoscopes invariably become contaminated with microorganisms during clinical use
E frequencies of performed hygiene surveillance tests per year were expressed as a percentage of the tests prescribed by the assurance system, that is, 100% are reached when two tests per year were conducted per endoscopic unit. e frequencies of failed microbiological surveillance tests per year were expressed as a percentage of the number of conducted routine surveillance tests. e frequencies of repeated failure of microbiological surveillance tests per year were expressed as a percentage of the number of conducted initial routine surveillance tests. e frequencies of quali cations for refund from the public health system cancelled due to repeated failure of microbiological surveillance tests were listed as raw numbers
We present the data on the implementation and outcome of the German nationwide continuous monitoring of colonoscope reprocessing by microbiological surveillance cultures of reprocessed endoscopes
Summary
Flexible endoscopes invariably become contaminated with microorganisms during clinical use. To minimize the risk of infection transmission via endoscopes many gastroenterological and hygienic societies worldwide developed national guidelines for reprocessing exible endoscopes and endoscopic accessories [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35]. Implementation of these guidelines in clinical practice and outcome are not evaluated at all. E present study is an implementation and outcome evaluation of the German quality assurance agreement with the speci c aims to analyse surveillance culture data from 2002 to 2008 in detail and to assess whether linking reprocessing quality indicators to funding of colonoscopy will improve colonoscope reprocessing quality in the long run
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