monitored. Here are its key elements:
• Inventory management. Develop a method for tracking scopes,
and a quarantine process for scopes awaiting culture results. Have
staff log the model of the scope and the date it was cleaned, quaran-
tined and cultured. Staff should also note who performed the culture,
the date of reprocessing after the culture and the date of quarantine
pending return of the culture. Finally, the date the cultures were
returned, whether they were deemed acceptable or unacceptable and
who released the scope from quarantine should all be recorded.
Knowing who was involved during the process and at which step will
allow you to identify those who may need further training.
You should also develop a premature release and tracking proto-
col for emergency use. Thanks to our logs, we could easily track
scopes prematurely removed from quarantine. For example, cul-
tures for scopes used on Monday morning and cultured that after-
noon aren't back until Wednesday or Thursday. But if an emer-
gency case requires use of that scope on Tuesday, and the cul-
tures taken Monday subsequently come back "unacceptable," we'd
easily be able to inform both the Monday patient and the Tuesday
emergency patient of possible exposure. Fortunately, we've never
had an instance where a scope pulled out of quarantine came
back "unacceptable."
• Categorize pathogens. In a paper I recently coauthored
(osmag.net/UMe9Md), we identified "high concerning" contami-
nants as yeast, Staph aureus, enterococci, and gram-negative
enteric bacilli. "Low concerning" organisms were coagulase-nega-
tive staphylococci, micrococci, and gram-positive rods.
Very low numbers of low concerning organisms are considered
"acceptable." Remember, you're not sterilizing scopes. You're
high-level disinfecting them, so you can't expect a totally negative
J U L Y 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 2 3
