will harden and create a situation that will require additional soaking
and brushing," she says. Also, the amount of bacteria on an endo-
scope doubles every 20 to 30 minutes after use. That's why she
endorses established guidelines that recommend OR staff pre-clean
instruments right away; disposable bedside kits can help to prevent
bioburden from drying and solidifying in endoscope channels.
"If there is any delay in getting the device to reprocessing, OR staff
should have a mechanism to let the reprocessing department know so
they can plan accordingly," she says. "Unfortunately, most ORs rarely
communicate with central sterile about those kinds of things."
2. Use only water-based substances. Clinicians often resort to
using lubricants, de-foaming agents and other substances — cooking
sprays, for example — to facilitate certain GI procedures. These
substances go against manufacturers' instructions for use and may
be contributing to some reprocessing failures, in part because cen-
tral sterile might not be aware that such substances are being used.
The most universally used products that interfere with reprocessing
include infant gas-relief drops that contain the anti-foaming agent
simethicone, says Ms. Ofstead. These products aren't sterile and con-
tain sweeteners and thickeners, along with silicone
(osmag.net/BJtUs2), while cooking sprays have oils — silicone, too
— that can be quite difficult to remove from the channel of a scope
even with a thorough cleaning.
"A nurse or doctor might be using something like infant gas-relief
drops to reduce foam and bubbles that impede their ability to see
clearly during procedures, or cooking sprays that help lubricate
guidewires before they're passed through the channel," she says.
"These consumer products may be inexpensive options, but they're
not intended for those medical uses and may create a lot of problems
1 0 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 7
