Scoping out the Situation-One Hospital's Review of Flexible Endoscope Handling and Reprocessing Methods Within Acute Care and Ambulatory Settings

Abstract

<h3>Background</h3> Literature recognizes the risks of inadequately reprocessed flexible endoscopes. Our growing academic medical center and ambulatory settings perform various methods of handling and reprocessing flexible endoscopes. We recognized the need to evaluate methods used in each location with a goal to standardize processes. <h3>Methods</h3> Using endoscopy and sterile processing department best practices as a standard for flexible endoscope reprocessing, direct observations were completed in 12 locations of the inpatient and outpatient settings over a 6 month period by a multidisciplinary team. An extensive auditing tool was used to identify stable practices and variances related to flexible endoscope cleaning and disinfection, storage, handling, transport, and documentation processes. Data was reviewed at multiple meetings during the process with leadership and staff from each location. A gap analysis was then performed based on evaluations completed in each location. <h3>Results</h3> Deviations were identified when compared to best practices used in endoscopy and sterile processing departments. Variations included methods for cleaning and disinfection, times manual cleaning is initiated, identification of reprocessing date versus expiration date, methods used for documentation, documentation of cleaning stages, methods for documenting patient traceability, methods for transporting, designs of storage cabinets, competencies and certifications, use of personal protective equipment, and repair procedures. <h3>Conclusions</h3> Our study found that adopting standardized processes is ideal to provide the most consistent method for flexible endoscope reprocessing. Due to environmental and monetary constraints in certain locations, deviations in best practice are allowed to continue at this time. All methods adhere to manufacturer instructions for use and ensure effective, safe handling and reprocessing of flexible endoscopes.