Gastroenterology's Gut journal (osmag.net/3gGxYE) investigated
infection rates after colonoscopies and osophagogastroduodeno-
scopies performed at same-day surgery centers. It found that "posten-
doscopic infections (those present within 7 or 30 days after the proce-
dure) are more common than previously thought and vary widely by
the ASC facility," and that "observed postendoscopic infection rates at
some ASCs are over 100 times higher than their expected rates."
The Association of periOperative Registered Nurses (AORN) has
published highly detailed, heavily vetted, evidence-based, end-to-end
guidelines for processing flexible endoscopes, which represent the
most up-to-date science on this issue. To hit on all the main points in
handling and transporting scopes, we consulted Erin Kyle, DNP, RN,
CNOR, NEA-BC, perioperative practice specialist with AORN in
Denver, Colo.
1. Pre-treat after withdrawal.
You need to act with a sense of
urgency here, because the safe-processing clock starts ticking imme-
diately after the scope is withdrawn from the patient, says Dr. Kyle.
Check with the endoscopist: "Are you finished with this scope?" Get a
release from her or him and begin the pre-treatment process right
away.
The process for your specific endoscope can be found in its
Instructions for Use (IFU) document, which will describe everything
that needs to be done to adequately prepare the scope and related
reusable accessories for safe transport and processing. These steps
typically include removing the accessories, suctioning a cleansing
fluid through the channels, wiping the exterior of the scope, and plac-
ing a cap over the camera. Staff should be wearing proper protective
equipment during this procedure.
Follow the IFU to the letter, as there are minor variations from ven-
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