Here are four best practices for maintaining good infection control at GI/Endoscopy-driven surgery centers.
1. Suction gross contamination out of the scope post procedure. Generally, GI/endoscopy-driven ASCs go through a multi-stage high-level disinfection process. The first stage requires removal of gross contamination by suctioning the scope's channel with a high volume of water and detergent in addition to wiping down the exterior of the scope after a procedure. Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, says GI/endoscopy-driven ASCs often fall into the trap of skipping this crucial first step with the belief that jumping ahead to the second stage of brushing the scope will be sufficient enough in removing gross contamination.
"One of the biggest misnomers that I've come across is ASCs believe there is no need to suction the channel and wipe down the scope before soaking and brushing the equipment," Mr. Sweeney says. "To this day, a lot of people don't understand this first step is critical to make sure there is no gross contamination because simply brushing is not intended to remove that amount of bioburden."
2. Disinfect surfaces correctly. The EPA has directed producers to specifically state "the surface must remain 'visibly wet' for the prescribed contact time in order to produce disinfection." "In other words, if the disinfection time listed on the label is 10 minutes, the surface must remain visibly wet for the entire 10 minutes," says Jack Wagner, president of Micro-Scientific. "The key phrase in this new directive is 'visibly wet.'
"Some healthcare workers have interpreted advertised claims to imply that simply swiping surfaces then walking away is sufficient. This puts patients and staff at risk of exposure to environmentally transmitted infectious microorganisms.
"EPA requirements are very specific as to the manner in which a disinfectant is to be used and applied. Furthermore, EPA requirements are very specific as to the minimum amount of time, in minutes, a particular disinfectant must remain visibly wet in order to allow the solution enough time to penetrate microbial cell walls and kill all target microorganisms listed on the label."
3. Use daily documentation, checklists and reminders. Use daily checklists that contain information on infection control-related responsibilities, such as the procedures for terminally cleaning, along with dates, times and concentrations of solutions for scope reprocessing. The checklists are laminated and posted in view in the scope reprocessing room, says Susan Rahn, clinical manager of Endoscopy Center of St. Louis. Utilizing check lists not only ensures that standards are being followed but also provides the manager with accountability of the staff.
In conjunction with daily checklists, scope reprocessing logs are utilized to record scope numbers, times of day, dates and concentrations for reprocessing solutions. This process is repeated for every scope.
"This is also a means for measuring accountability," Ms. Rahn says. "These logs can be used as a tracking mechanism should problems arise."
4. Create processes to avoid using out-dated supplies. Staff members can use stickers marked with dates to show when certain supplies have been opened, which helps others avoid the potential of using supplies that have been open for too long.
"At the end of every day, we make sure everything's thrown away properly and cleaned up," says Karen Smith, nursing director at Central Illinois Endoscopy Center in Peoria. "Also, to make double sure someone hasn't forgotten to dispose of something that's old, there are stickers on everything. So every time a staff member has to open a supply, there are pre-printed stickers with the staff member's name, time and date. Putting that on the object ensures they aren't using something that's been out for too long, like sterile water. Staff member would just have to look at the printed sticker at the bottom of the water basin."
1. Suction gross contamination out of the scope post procedure. Generally, GI/endoscopy-driven ASCs go through a multi-stage high-level disinfection process. The first stage requires removal of gross contamination by suctioning the scope's channel with a high volume of water and detergent in addition to wiping down the exterior of the scope after a procedure. Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, says GI/endoscopy-driven ASCs often fall into the trap of skipping this crucial first step with the belief that jumping ahead to the second stage of brushing the scope will be sufficient enough in removing gross contamination.
"One of the biggest misnomers that I've come across is ASCs believe there is no need to suction the channel and wipe down the scope before soaking and brushing the equipment," Mr. Sweeney says. "To this day, a lot of people don't understand this first step is critical to make sure there is no gross contamination because simply brushing is not intended to remove that amount of bioburden."
2. Disinfect surfaces correctly. The EPA has directed producers to specifically state "the surface must remain 'visibly wet' for the prescribed contact time in order to produce disinfection." "In other words, if the disinfection time listed on the label is 10 minutes, the surface must remain visibly wet for the entire 10 minutes," says Jack Wagner, president of Micro-Scientific. "The key phrase in this new directive is 'visibly wet.'
"Some healthcare workers have interpreted advertised claims to imply that simply swiping surfaces then walking away is sufficient. This puts patients and staff at risk of exposure to environmentally transmitted infectious microorganisms.
"EPA requirements are very specific as to the manner in which a disinfectant is to be used and applied. Furthermore, EPA requirements are very specific as to the minimum amount of time, in minutes, a particular disinfectant must remain visibly wet in order to allow the solution enough time to penetrate microbial cell walls and kill all target microorganisms listed on the label."
3. Use daily documentation, checklists and reminders. Use daily checklists that contain information on infection control-related responsibilities, such as the procedures for terminally cleaning, along with dates, times and concentrations of solutions for scope reprocessing. The checklists are laminated and posted in view in the scope reprocessing room, says Susan Rahn, clinical manager of Endoscopy Center of St. Louis. Utilizing check lists not only ensures that standards are being followed but also provides the manager with accountability of the staff.
In conjunction with daily checklists, scope reprocessing logs are utilized to record scope numbers, times of day, dates and concentrations for reprocessing solutions. This process is repeated for every scope.
"This is also a means for measuring accountability," Ms. Rahn says. "These logs can be used as a tracking mechanism should problems arise."
4. Create processes to avoid using out-dated supplies. Staff members can use stickers marked with dates to show when certain supplies have been opened, which helps others avoid the potential of using supplies that have been open for too long.
"At the end of every day, we make sure everything's thrown away properly and cleaned up," says Karen Smith, nursing director at Central Illinois Endoscopy Center in Peoria. "Also, to make double sure someone hasn't forgotten to dispose of something that's old, there are stickers on everything. So every time a staff member has to open a supply, there are pre-printed stickers with the staff member's name, time and date. Putting that on the object ensures they aren't using something that's been out for too long, like sterile water. Staff member would just have to look at the printed sticker at the bottom of the water basin."