motions," he says.
Beginning at the bedside
The moment Mr. Tavera and his colleague
Raymundo Gonzales, CGTS, receive a scope at the
end of procedures at PIH Health Downey (Calif.)
Hospital, they remove the air-water valve and
replace it with a valve that has been checked to
ensure it's not clogged or blocked. "We then suction
300 ml of clean water through the scope's channels
and wipe down the exterior with enzymatic soap,"
says Mr. Tavera.
Pre-cleaning scopes at the
patient's bedside by following the
instructions for use (IFU) will
help to remove bioburden and
prevent the buildup of biofilm.
Some facilities don't pre-clean
endoscopes, leading to a domino
effect of problems — scopes that
aren't properly cleaned can't be
properly high-level disinfected.
Staff members who care for
scopes at the bedside when pro-
cedures end must therefore pay
close attention to this critical
first step, according to Mr.
Czarnowski. "Fortunately, bed-
side kits for cleaning endo-
scopes immediately after they've
been used are readily available,"
he says. "They include a small
plastic basin, a packet of pow-
dered soap and a syringe."
Diligent cleaning
After bedside cleaning, contami-
nated scopes should be placed
in a closed bag or container for
transport to the reprocessing
room, where they're hooked up
to an automated leak tester.
Leak tests detect damage to the
external surface of the scope, as
well as the internal channels.
Imperfections, no matter how
small, can lead to inadequate disinfection and
even further damage to the scope.
The leak test is a crucial step in the reprocessing
process, according to Joyce Mackler, RN, MSN,
CASC, nurse manager at the Seaford (Del.)
Endoscopy Center. "Don't rush through it," she
says, "and be sure to observe the scope in clean
water for at least 30 seconds while angulating the
bending sections of a scope in all directions."
After the scope has passed the leak check, brush
its internal channels twice with properly sized
5 0 • O U T P A T I
E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 2 0
SAFE PASSAGE Endoscopes should be transported in closed containers to prevent damage to the delicate instruments
and limit cross-contamination risks.
