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Challenges in Achieving Effective High-Level Disinfection in Endoscope Reprocessing

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Endoscope reprocessing is often ineffective, and microbes frequently remain on endoscopes after the use of high-level disinfectants (HLDs). Several factors impact reprocessing effectiveness, including non-adherence to guidelines, use of damaged endoscopes, use of insoluble products during endoscopy, insufficient cleaning, contaminated rinse water, and inadequate drying before storage.

Recognition of the need for quality improvement is growing, and infection preventionists should take action to build on this momentum and collaborate with manufacturers, endoscopists, and reprocessing personnel to improve the effectiveness of high-level disinfection.

In their ground-breaking research study published recently in the American Journal of Infection Control, Ofstead & Associates used diverse data sources including literature review, interviews with frontline personnel, retrospective review of data from audits and site visits, and a survey of sterile processing technicians and managers to expose challenges with current endoscope reprocessing practices1.

“We have observed widespread non-adherence to minimum standards for HLD use and MEC2 testing at many sites. In one study, steps were skipped or done incorrectly for 99% of the endoscopes, and substandard high-level disinfection practices were among the errors made.”

C.L. Ofstead et al. / American Journal of Infection Control.

By automating key compliance procedures, ASP can help address many of the factors impacting HLD effectiveness3

Non-adherence to MRC2 testing is widespread puts patients at risk1.

In most automatic endoscope reprocessors, MRC monitoring with test strips can be easily skipped or done incorrectly.

With the ASP AEROFLEX Automatic Endoscope Reprocessor (AER), MRC monitoring is automated and accurate for every cycle, reducing the patient risk associated with test strip errors.1

References

  1. C.L. Ofstead et al. / American Journal of Infection Control (2019) 1−7, Accessed 12/12/2019 www.ajicjournal.org/article/S0196-6553(19)30849-1/fulltext
  2. Minimum Effective Concentration (MEC). Measurement of the Minimum Effective Concentration level of the active ingredient in the biocide. Minimum Recommended Concentration (MRC). Measurement of the Minimum Recommended Concentration level of the active ingredient in the biocide. MEC and MRC are sometimes used interchangeably.
  3. With AUTOSURE MRC Monitor may enhance compliance to ASP AERO-OPA and ASP AEROFLEX AER instructions for use (IFU), professional society guidelines for endoscope reprocessing, healthcare facility policies and procedures for endoscope reprocessing and government and local environmental regulations for chemical disposal. ASP AEROFLEX AER with AUTOSURE MRC Monitor may enhance compliance through automated features for HLD minimum recommended concentration (MRC) testing, verified chemistry confirmation, endoscope reprocessing record-keeping and neutralization of ASP AERO-OPA before disposal.