contact patients. Once the disinfection period ends, the AER rinses
and flushes both external and internal surfaces with filtered water to
remove residue left by the sterilant and disinfectant solutions.
It's important to understand what pre-cleaning is and what it isn't.
Some AERs have cycles that state they can replace manual cleaning
processes in sterile processing. While the FDA validates this cleaning
claim, it's clear that it doesn't replace pre-cleaning. As William A.
Rutala, PhD, MPH, one of the foremost experts in reprocessing, says,
"Any deviation from the recommended reprocessing protocol can lead
to the survival of microorganisms and an increased risk of infection."
An intelligent consumer
When trying to determine which AER best suits your needs and your
workflow, here are some of the questions you should ask:
1. What's the cycle time? Some AERs have shorter cycles but only
process one scope at a time. But if your scope inventory struggles to
keep up you with your caseload, you might want to look at a dual-
scope AER with a short cycle time and separate basin(s) for inde-
pendent cycle times so you can reprocess 2 scopes at once.
2. What's the cost per cycle? AERs involve a lot of add-ins and con-
sumables, such as chemicals, filters and maintenance costs. It's vital to
drill down and find out how much those things are going to cost on a
per-cycle or per-month basis. Manufacturers aren't always forthcoming
when it comes to the exact cost per cycle, but they know, and it's
important for you to know, too.
If enhanced reprocessing methods or sterilization become standard
for endoscopes, your cost per cycle will become much more impor-
tant. Recent outbreaks involving duodenoscopes have the CDC rec-
ommending such "enhanced" reprocessing methods as double high-
level disinfection with periodic microbiologic surveillance. Dr. Rutala
1 0 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 6
Thinking of Buying …
TB
