scope's manufacturers.
Alternatively, you might consider installing an automated endoscope
reprocessor (AER), which streamlines high-level disinfection. "By
connecting a few fittings to the scopes, you've got thorough channel
flushing and continuous leak testing at the push of a button," says Ms.
Swanson. The FDA has even cleared some AER makers to market the
claims that their devices include cycles that can replace the need for
manual cleaning. Keep in mind, however, that "no AER can make up
for a failure to pre-clean the scope at the point of use," she says.
Besides bringing convenience to high-level disinfection, AERs also
safeguard the process. The machines will halt their operations and
notify the user if they detect an error in a cycle or a flaw in a scope,
and they document their results to verify the successful completion or
the interruption of a job, says Ms. Swanson. Their contained process
also limits employees' exposure to the disinfectant chemicals.
Recent superbug outbreaks linked to cross-contamination from diffi-
cult-to-clean duodenoscopes have raised a big question: Is high-level
disinfection sufficient for reprocessing scopes? The short answer,
according to experts: Maybe not, but in order to sterilize them you'll
need either more time or more scopes.
High-level disinfection is the industry standard for reprocessing flexi-
ble endoscopes, as dictated by the Spaulding Classification System.
But epidemiological experts have pointed out that the margin of safety
may be narrow, depending on how effectively reprocessing's steps are
A P R I L 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 9 3
It's like leaving dirty dishes in the sink.
If you let them go too long, they dry out
and it's difficult to get the soil off.
— Chris Lavanchy, ECRI Institute
