Ensure Effective Endoscope Reprocessing

Standardized protocols ensure better compliance with the many steps involved in scope reprocessing, limit potential variation and provide a reliable process for staff to follow. “Continuously evaluating the process through quality auditing helps to ensure staff are performing their jobs effectively and efficiently,” says Mr. Galvan.

There are many quality assurance steps involved in making sure compliance is maintained. Regular auditing, which can involve visually observing team members reprocessing endoscopes or reviewing documentation of the reprocessing steps, is a fundamental piece of monitoring staff performance. “Auditing identifies opportunities for improvement — in the actual process, in a lack of education or both — and helps leadership figure out a way to address them so issues aren’t repeated down the line and patient harm is prevented,” says Mr. Galvan.

If any of the scopes’ instructions for use (IFUs) change or are even slightly modified, Ms. Young makes sure her staff is aware. “The manufacturer of our endoscopes recently required that we wipe them down with a sponge or a lint-free cloth at the sink in the reprocessing room,” she says. “We already do that at the bedside, but we make sure to adhere to all directives and now have reprocessing techs wipe down the exterior of scopes during manual cleaning.”

The modified IFUs also now require staff to remove the entire scope from the sink and place it on a towel while unhooking the leak tester instead of just pulling out the head of the scope, unhooking the leak tester and putting the head back in the sink for cleaning. “The scope manufacturer had been seeing reports of damage occurring when only the scope’s head was removed, which is why this change was made,” says Ms. Young.

When changes to IFUs occur, the scope manufacturer will send a representative to train Ms. Young’s staff on the new recommendations. “I also type up and laminate the updates and post them throughout the reprocessing room,” she says. “Staff can get used to repeatedly performing the same steps, so if something changes, a visual reminder is always helpful.”

Ms. Young holds frequent team meetings and sends out electronic newsletters to keep proper endoscope care top of mind at all times. “I huddle with reprocessing techs each morning or afternoon to see if they have any concerns and to make sure they’re caring for scopes properly. I also open up the floor to the team so they can discuss issues they’re having.”

She requires her staff to document how long it takes to reprocess each scope, from when they begin leak testing to the time it goes into the AER. This is an essential step in endoscope care because it helps to prevent scopes from sitting around covered in bioburden for hours before getting cleaned. It also holds her staff accountable to do the job efficiently.

Ms. Young employs other ways to track how efficiently scopes are moved through the reprocessing process. Each patient’s chart contains two sticker labels. After a scope is cleaned at the bedside, the tech notes the time and their initials on one of the stickers, which is placed on a sheet of paper in the cleaning room. The tech who performs the manual cleaning notes the scope’s serial number on the second label, which is placed on another piece of paper that notes the case in which the scope was used. Techs also enter their operator number, the scope number and the case number into the AER, and must initial a tag attached to the scope after it’s been inspected following the disinfecting cycle.

Continuously evaluating the process through quality auditing helps to ensure reprocessing staff are performing their jobs effectively and efficiently.
— Benjamin D. Galvan, MLS(ASCP), CIC

“If we ever encounter an issue with one of our scopes, we should be able to easily figure out which tech last handled it and in which case it was used,” says Ms. Young. “We have documentation for every step of the process.”