DRYING FLEXIBLE ENDOSCOPES: FACT AND FICTION

Overview

General

Drying is a big focus in flexible endoscopy practice right now.  SGNA and other professional societies recommend "complete drying" before storage, but no one prescribes exactly how to get there.  Figuring out the solution is a growing challenge for the typical GI department. Research illustrates that incomplete drying is a source of post-processing contamination and may be related to biofilm proliferation and patient exposure.  Less than optimal storage and transport of high-level disinfected, patient ready endoscopes can also be a source of problems - for your scopes and accessories and for the people on whom they're used. In this faculty-directed, learner-paced activity, you will learn more about what you can do to elevate your practice and safeguard your patients. 

Target Audience

This independent study is intended primarily for RNs with an interest in flexible endoscope reprocessing and ensuring patient safety in GI Endoscopy and other flexible endoscopy procedures. It will also be of interest to allied healthcare personnel and MDs involved in endoscopy.

Learner Objectives

Upon completion of the continuing education activity, participants should be able to:

  • Review evidence-based practice related to the importance of complete drying of flexible endoscopes before use or storage of the endoscopes.
  • Discuss human error observed during endoscope reprocessing research related to drying of the flexible endoscopes after high level disinfection.
  • Compare professional society guideline recommendations for storage of reprocessed flexible endoscopes.
Teaching Methodology

Participants will complete the printed module learning activity. They will register online to complete the evaluation and take the post-test. They will submit the documentation as directed. A bibliographic reference is included for those wishing additional information.

Contact Hours

Upon successful completion of the entire online program and submission of required documentation, participants will be granted 1 contact hour. No partial credit will be granted.

Accreditation

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 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.

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

This program has been pre-approved by the Certification Board for Sterile Processing and Distribution (CBSPD).

This program has been approved by the International Association of Healthcare Central Service Material Management (IAHCSMM).

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

Disclosures
  1. Successful completion: Participants must complete the entire program, register, achieve a score of 80% on the post-test and submit required documentation.
  2. Conflict of interest: Planners disclose no conflict of interest. The speakers 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.
Suggested Readings
  1. Alfa, M. J., Degagne, P., & Olson, N. (1999). Worst-case soiling levels for patient-used flexible endoscopes before and after cleaning. American Journal of Infection Control, 27(5), 392-401.

    Alfa, M. J., & Singh, H. (2020). Impact of wet storage and other factors on biofilm formation and contamination of patient-ready endoscopes: a narrative review. Gastrointestinal Endoscopy, 91(2), 236–247. https://doi.org/10.1016/j.gie.2019.08.043

    Barakat, M.T., Huang, R.J., Banerjee, S. (2019). Comparison of automated and manual drying in the elimination of residual endoscope working channel fluid after reprocessing (with video). Gastrointestinal Endoscopy, 89 (1), 124-132.

    Dirlam Langlay, A. M. D., Mueller, N. J., Tosh, P. K., Baron, T. H., & Wetzler, H. P. (2013). Reported gastrointestinal endoscope reprocessing lapses:  The tip of the iceberg.  American Journal of Infection Control, 41(12), 1188-1194.

    Edmiston, C. E. & Spencer, M. (2014). Endoscope reprocessing in 2014: Why is the margin of safety so small? AORN Journal, 100(6), 609-615.

    Herrin, A., Loyola, M., Bocian, S., Diskey, A. Friis, C. M. 7 et al. (2016). Standards of infection prevention in reprocessing flexible gastrointestinal endoscopes. Gastroenterology Nursing, 39(5), 404-418.

    Kovaleva, J., Degener, J. E. & van der Mei, H. C. (2010). Mimicking disinfection and drying of biofilms in contaminated endoscopes. Journal of Hospital Infection, 76(4), 345-350.

    Kovaleva, J., Peters, F. T. M. van der Mei H. C., & Degener, J. E. (2013). Transmission of infection by flexible gastrointestinal endoscopy and bronchoscopy. Clinical Microbiology Reviews, 26(2), 231-254.

    Muscarella, L. F. (2006). Inconsistencies in endoscope-reprocessing and infection control guidelines: The importance of endoscope drying. American Journal of Gastroenterology, 101, 2147-2154.

    Ofstead, C. L., Dirlam Langlay, A. M., Mueller, N. J., Tosh, P. K. & Wetzler, H. P. (2013). Re-evaluating endoscopy-associated infection risk estimates and their implications. American Journal of Infection Control, 41, 734-736.

    Ofstead, C. L., Dirlam Langlay, A. M., Wetzler, H. P., Tosh, P. K., Baron, T. H., & et al. (2013). Poster: Reprocessing lapses: What are we missing? Minnesota Regional Society of Gastroenterology Nurses and Associates.

    Ofstead, C. L., Wetzler, H. P., Johnson, E. A., Heymann, O. L., Maust, T. J., &Shaw, M. J. (2016). Simethicone residue remains inside gastrointestinal endoscopes despite reprocessing. American Journal of Infection Control, 44, 1237-1240. 

    Ofstead, C. L., Wetzler, H. P., Snyder, A. K., & Horton, R. A. (2010). Endoscope reprocessing methods, a prospective study on the impact of human factors and automation. Gastroenterology Nursing, 33(4), 304-311.

    Ofstead, C. L, Hopkins, K. M., Buro, B. L., Eiland, J. E. and Wetzler, H. P. 2019. Challenges in Achieving Effective High-Level Disinfection in Endoscope Reprocessing. American Journal of Infection Control, 48 (3), 309-315, doi:10.1016/j.ajic.2019.09.013.

    Perumpail, R.B., Marya, N.B., McGinty, B.L., Muthusamy, V.R. (2019). Endoscope reprocessing: Comparison of drying effectiveness and microbial levels with an automated drying and storage cabinet with forced filtered air and a standard storage cabinet. American Journal of infection Control, 47 (9), 1083-1089.

    Pineau, L., Villard, E., Duc, D. L., & Marchetti. (2008). Endoscope drying/storage cabinet: Interest and efficacy. Journal of Hospital Infection, 68, 59-65.

    Van Winklin, S.A., Conner, R., & Spry, C. (2016). AORN Recommended Practices for Endoscope Reprocessing in Guidelines for Perioperative Practice 2017 Ed. Denver, CO. AORN Publishing.

    Wiktorczyk, N., Kwiecińska-Piróg, J., Skowron, K., Michalska, A., Zalas-Więcek, P., Białucha, A., Budzyńska, A., Grudlewska-Buda, K., Prażyńska, M., & Gospodarek-Komkowska, E. (2019). Assessment of endoscope cleaning and disinfection efficacy, and the impact of endoscope storage on the microbiological safety level. Journal of Applied Microbiology. https://doi.org/10.1111/jam.14558

    Wu, R. P., Xi, H.J., Qi, K., Dong, W., Nie, X. & Li, S. S. (2014). Correlation between the growth of bacterial biofilm in flexible endoscopes and endoscope reprocessing methods. American Journal of Infection Control, 42, 1203-1206.

Please visit Cantel at SGNA 2020 to obtain this module.

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