and scratches and stains where manual cleaning might be ineffective?
"If they don't have a borescope, they're cleaning blind," says Mr.
Myers. "If they tell you a scope is clean, they better have examined it
with a borescope. Claiming to clean a medical device without actually
looking inside of it is baffling to me."
3. Ensure adequate drying
Michelle Alfa, PhD, and Cori Ofstead, MSPH, each conducted studies that
found residual water remained in endoscope channels after high-level
disinfection (osmag.net/CQZqk3 and osmag.net/e4YyVQ, respectively).
Both researchers independently identified the same problem, which
was detectable only by looking inside the scopes, says Mr. Myers.
Constant air movement through a scope's internal lumens after high-
level disinfection is needed to keep the channels dry. "We now recog-
nize the importance of adequate scope drying," says Dr. Petersen. "A
number of studies demonstrate that it takes a minimum of 10 minutes
of forced-air flow through each of a scope's channels to prevent resid-
ual water from forming. I would guess many centers are not up to
speed on that requirement."
Automated endoscope reprocessors include drying cycles, which
often involve a very brief alcohol purge — not necessarily enough to
prevent water from remaining in internal lumens during scope stor-
age. Wall-mounted drying units with manifolds that hook up to a
scope's channels and newer endoscope storage cabinets circulate air
through internal lumens during regular, prolonged intervals.
"Endoscope storage cabinets with integrated drying mechanisms are
becoming more commonplace and, in my opinion, are a superior
option," says Mr. Myers. "My facility has decided to invest in drying cab-
inets moving forward, because the data on how many scopes remain
wet in storage is so disturbing."
OSM
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