[PDF] - Disclosure PDF Document, free download

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3/8/2017 1

Flexible Endoscope Reprocessing and the Importance of Standards and Recommendations in Prevention of Infections

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Healthmark Policy

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3/8/2017 2

Objectives

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The ECRI 2017 List

Processing / Reprocessing

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3/8/2017 3

Risk of Endoscopy Related infection or Other Adverse Patient Reactions

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Risk of Endoscopy Related Infection or

Other Adverse Patient Reactions

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What are the SGNA Guidelines?

SGNA Standards and Practice Guidelines:

1. Guideline for Use of High-Level

Disinfectants & Sterilants in the Gastroenterology Setting (2017)

2. Standards of Infection Prevention in

Reprocessing of Flexible Gastrointestinal Endoscopes (2016)

3. Standard of Infection Prevention in

the Gastroenterology Setting (2015)

SLIDE 4

3/8/2017 4

SGNA Reprocessing Steps

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What is ANSI/AAMI ST 91?

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Other Guidelines for Endoscopes

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3/8/2017 6

Best practices for processing flexible endoscopes

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Best practices in Precleaning

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3/8/2017 7

Contaminated Transport

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Best practices for Leak Testing

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Best practices for manual cleaning

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Rinsing after cleaning

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Best Practices for Endoscope Inspection and Cleaning Verification

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SGNA – Visual inspection

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3/8/2017 11

SGNA “Visibly Clean”

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Optical & Enhanced Inspection

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Inspection

http://www.apic.org/Resource_/TinyMceFileManager/mediaImages/ERCP_Press _Release_APIC_SHEA_02242015.pdf “Because duodenoscopes are more complex than other endoscope instruments, it requires meticulous attention to detail and step-by-step precision to render them safe for re-use. After observing the cleaning and disinfecting processes and asking questions so that each step of the process is understood, the IP or HE may visit the department regularly to observe scope cleaning practices and reinforce the importance of the work being done. The IP or HE will evaluate human factors, including ensuring that the cleaning area is set up with a bright light and magnification so all sections of the scope being cleaned can be well visualized.”

SLIDE 12

3/8/2017 12

Cleaning verification recommendations

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Manual Cleaning Verification Monitors

Combination test strips

ATP Systems Channel Sample Carbohydrate, protein & hemoglobin Detects ATP Flush and swab methods Many systems available

Protein swabs Hemoglobin swabs Swab methods Flush methods

Best practices for High-Level Disinfection

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3/8/2017 13

High-level Disinfection

Best practices for High-Level Disinfection

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3/8/2017 14

Remember to Rinse!

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Drying and Alcohol Flush

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Drying Best Practices

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Proper Storage of Reprocessed Endoscopes

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Current recommendations for length of storage “hang time”

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https://www.cdc.gov/hicpac/pubs/flexible-endoscope-reprocessing.html, page last updated

1/12/2017. Accessed 3/1/2017.

Quality Systems for IP

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3/8/2017 17

Labelling for identification

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Microbial Surveillance

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Enzymes specific to Gram-negative

bacteria hydrolyze the substrate in the reagent vial

This generates fluorescence, which is

read by the fluorometer , which then gives a reading.

ST91: Types of verification testing may include

enzyme based tests

Such as the gram negative test kit

Monitoring for Gram-negative

rganisms in reprocessed scopes

SLIDE 19

3/8/2017 19

Simethicone usage

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3/8/2017 20

Summary

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