Endoscope Cleaning:

Importance of Biofilm Removal



Adequate disinfection of endoscopes begins with cleaning of accumulated biofilm. Thorough penetration and removal of biofilm requires the correct combination of detergent and cleaning method to access all of an endoscope where biofilm can grow. The importance of the cleaning combination on biofilm removal has been extensively studied. The study results and the impact on endoscope cleaning will be presented.

Target Audience

This web-based independent study is intended primarily for RNs with an interest in the impact of biofilm in GI Endoscopy. It will also be of interest to allied healthcare personnel and MDs involved in endoscopy.

Learner Objectives

Upon completion of this presentation, participants will be able to:

  1. Describe the role of biofilm in bacterial growth and infection
  2. Consider information from recent studies in order to examine existing disinfection practices in the clinical area
Teaching Methodology

Participants will complete the web-based learning activity. They will view the audio/video presentation, then register to take the post-test and complete the evaluation on the website. They will submit the documentation as directed. A bibliographic reference is included for those wishing additional information.

Contact Hours

Upon completion of the entire program, achieving a score of 80% on the post-test and submission of required documentation, participants will be granted 1 contact hour. No partial credit will be granted.


Provider approved by the California Board of Registered Nursing, Provider Number 08747, the District of Columbia Board of Nursing, Provider Number 50-574, the Florida Board of Registered Nursing, Provider Number 50-574, the Georgia Board of Registered Nursing, Provider Number 50-574 and the West Virginia Board of Examiners for Registered Professional Nurses, Provider Number 50-26112.

It is the responsibility of the licensee to verify acceptance of contact hours for relicensure.

ABCGN: According to the criteria of the American Board of Certification for Gastroenterology Nurses, the approved hours in this activity are are considered GI Specific (Category 5) for the purpose of recertification by contact hours through the ABCGN.  

CBSPD: This program has been pre-approved by the Certification Board for Sterile Processing and Distribution for 1.0 contact hour.

IAHCSMM: This program has been approved by the International Association of Healthcare Central Service Materiel Management for 1.0 contact hour.

NCCT: This program is acceptable for surgical technologist recertification by the National Center for Competency Testing.

  1. Successful completion: Participants will view the module, then register online, achieve a score of 80% on the post-test and submit required documentation. An active printer connection is required to print the certificate of completion.
  2. Conflict of interest: Planners disclose no conflict of interest. The subject matter experts disclose salary or honorarium from the commercial support entity; they have signed a statement agreeing to present material fairly and without bias
  3. Commercial company support: Fees are underwritten by education funding provided by Cantel Medical.
  4. Non-commercial company support: None.
  5. Alternative/Complementary therapy: None.
Certificate Issue / Replacement

Participants successfully completing the activity and submitting required documentation will be permitted to print a certificate of completion. Participants are advised to retain the certificate for eight years following activity completion.

Replacement of misplaced certificate is available from Educational Dimensions. There is a fee for this service. Request a replacement by contacting Educational Dimensions.

Guide to Study

Detailed instructions for completing this eLearning activity

The following steps will assist you in your successful completion of this eLearning Activity.

  1. Read the content or view the recorded presentation. If you want contact hours at the completion of studying the eLearning material, you will be required to register, complete an evaluation and take a post-test prior to printing your Certificate of Completion. We urge you to complete the eLearning activity once you have started. However, if you do need to come back later, you can sign in with your email and eLearning ID.
  2. First Time Visitors will be asked to register using an email address as your User Name. Make a note which email address you have used. Then you will create an eLearning ID using a combination of at least 6-10 letters or numbers. Please make a note of your eLearning ID and if for some reason you forget, you may request that your eLearning ID be sent to you. The web site is secured by Trustwave.
  3. Return Visitors: If you have registered already you do not need to register again. Just Sign In using your email and eLearning ID.
  4. Evaluation Form: Once you have registered or signed in you will be asked to complete an evaluation form and submit it. This is required to obtain the Certificate of Completion.
  5. Post-test: A post-test, based on the content of the eLearning activity, will need to be taken. A passing score of 80% is required. This is required to obtain the Certificate of Completion.
  6. Printing Your Certificate of Completion: Once you have successfully passed the post-test you will be able to print your Certificate of Completion. You will be given an opportunity to verify the information that will be printed on your certificate. Please make sure your printer is ready to print. You will not have access to the certificate page on later visits unless you contact us. Once you choose to print the Certificate of Completion, it will not be possible to make corrections. To obtain a corrected certificate you will need to contact Educational Dimensions. Fees may apply.
  7. Contact Hours: Upon completion of the entire program, submission of required documentation and achieving a score of 80% on the post-test, participants will be granted 1 contact hour. No partial credit will be granted.
  8. Browser recommendations: We require using an up-to-date browser with JavaScript enabled. You must enable cookies from this site in order to access the secure areas.
  9. If you encounter any technical problems during this eLearning activity, please contact us.

Enjoy learning more about "Endoscope Cleaning: Importance of Biofilm Removal"

eLearning Activity - Video

Suggested Readings
  1. Alvarado C, Reichelderfer M. 2000. APIC guideline for infection prevention and control in flexible endoscopy. American Journal of Infection Control. 138-55.
  2. ASGE. 2011. Multisociety guideline on reprocessing flexible gastrointestinal endoscopes. American Society of GI Endoscopy. 1075-1084.
  3. Cowen AE. 2001. The clinical risks of infection associated with endoscopy. Canadian Journal of Gastroenteroloy. 321-331.
  4. Fang Y, et al. 2010. A study of the efficacy of bacterial biofilm cleanout for gastrointestinal endoscopes. World Journal of Gastroenterology. 1019-1024.
  5. Kampf G, Blob R, Martiny H. 2004. Surface fixation of dried blood by gluteraldehyde and peracetic acid. Journal of Hospital Infection. 139-143.
  6. Prakash B, Veeregowda B, Krishnappa G. 2003. Biofilms: A survival strategy of bacteria. Current Science. 1299-1307.
  7. Rutala WA. 1996. APIC Guideline for selection and use of disinfectants. American Journal of Infection Control. 313-42
  8. SGNA. 2012. Standards of Infection Control in Reprocessing of Flexible Gastrointestinal Endoscopes. Chicago: Author.
  9. Sutherland I. 2001. Biofilm exopolysaccharides: A strong and sticky framework. Institute of cell and molecular biolology 3-9.
  10. Vickery K, Pajkos A, Cossart Y. 2004. Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination? Journal of Hospital Infection. 224-229.


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