Optimizing the Decontamination and Reprocessing of Endoscopic Equipment

Flexible Gastrointestinal Endoscopy is a commonly performed procedure about the globe as either a diagnostic or therapeutic tool in the treatment of GI Disease. In the United States, it has been estimated that over 20 million endoscopic procedures are performed annually. The reprocessing of an endoscope is an extremely detailed and multi-stepped process which is required after each procedure to render a contaminated instrument safe for reuse. Endoscopes are rather intricate instruments constructed with multiple long narrow internal channels with right angles. In addition to their complex construction, endoscopes must transverse an environment which bear high and diverse level of microbial population and organic matter. Due to this architectural structure, successful endoscope reprocessing is built upon a foundation of 9 primary steps which must be meticulously performed in concert with the Manufacturer's Instructions for Use as well as guidelines from professional organization to mitigate the potential of the transmission of Endoscope Associated Infections. The 9 pillars of effective endoscope reprocessing are: point of use precleaning, leakage testing, manual cleaning, rinse after cleaning, inspection, high level disinfection, liquid chemical sterilization or sterilization, rinse after high level disinfection or Liquid Cemical Sterilization, drying and storage. completing these steps each and every time an endoscope is processed is mission critical in the prevention of lapses and breaches in the reprocessing of endoscopes. Table 1 a well-trained and highly engaged reprocessing staff is also necessary to carry out these duties in accordance with strict institutional oversight of reprocessing protocols. While it is possible to gain insight into the general reprocessing practices throughout the nation through the use of surveys and interviews of endoscopists and nurses, due to the anonymity of these tools, it is often difficult to isolate specific facilities to gain a deeper appreciation of their practice unless the activities of these facilities has been published. Several topics and concepts related to opportunities to enhance reprocessing will be explored in this writing to evaluate and augment endoscope reprocessing with in the facility.