Outpatient Surgery Magazine - Subscribers

Healing is Coming - February 2021 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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F E B R U A R Y 2 0 2 1 • O U T P A T I E N T S U R G E R Y . N E T • 5 7 To keep cases moving through your facility in order to give more patients access to potentially life-saving care, reemphasize proper endoscope handling techniques, tap into advances in reprocessing tech- nologies and rely on a properly trained staff. Running an effi- cient center has never been more important. Standard rules apply The six basic steps of scope reprocessing — point-of-use pre-cleaning, careful transport, leak testing, manual cleaning and flushing, disinfection and sterilization, and careful storage — should apply, no matter how busy your facility gets. Now certainly isn't the time to cut corners or take shortcuts to respond to increased caseloads. Changing or modi- fying any of these essential steps to proper endo- scope care will do more harm than good. • Bedside care. Flush a scope's channels and wipe off the exterior of the insertion tube imme- diately after exams are complete and before the scope is transported to the reprocessing area. Pre-assembled kits containing a syringe, basin, sponge and soap make the point-of-use cleaning more efficient. • Safe transport. Scopes are fragile and expen- sive, so you need containers that will safely hold them in place as they're being moved to the repro- cessing area. Federal regulations require contain- ers to be labeled as carrying biohazardous material to alert staff that they contain soiled instruments. Make sure the containers are made of a sturdy, puncture-resistant plastic and are large enough for the instruments to lie in without the tubes crimp- ing and high enough on the sides to keep coiled scopes fully contained. • Leak testing. When scopes arrive at the repro- cessing area, leak test the scopes with either a dry or wet leak tester, following the tester manufactur- er's instructions for use. Visually inspect the inser- tion tube, control body, light cord, and any sections that bend and the cord to look for holes or cracks in the coating that indicate the scope needs to be taken out of the rotation and repaired. Leak testers will detect leaks that the eyes of the techs cannot. • Manual cleaning and flushing. Once the scopes have passed the leak tests, the narrow chan- nels within the scope must be brushed. It's impor- tant to use the proper size brushes designed to accompany each scope and scrub the entire device, including valves and buttons set in all positions. After manual brushing is complete, connect scopes to an automated cleaner that flushes channels with enzymatic soap and/or a high-level disinfectant. • High-level disinfection. Automatic endoscope reprocessors allow you to run the scopes though several cycles of cleaning, disinfecting, rinsing and alcohol flushes to ensure they are high-level disin- fected. This can take up to 45 minutes to complete. The alcohol flush is important, as it dries internal channels before scopes are moved to the storage area. Examining scopes with a small-diameter borescope after high-level disinfection is recom- mended as an extra step to check the scopes' lumens for residual bacteria. • Proper storage. To maximize drying and mini- mize the chance of recontamination, scopes should be hung vertically in specially designed storage cab- QUICK RINSE Kits that contain the supplies needed for cleaning endoscopes at the bedside can help speed the process along. Casey Czarnowski

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