Marsha Wallander, RN, is assistant director, accreditation services, for the Accreditation Association for Ambulatory Health Care.
Q: We have a GI (endoscopy room) situated by the post-op/nurse's station. We would plan on bagging and placing the scope once wiped down into a closed container and transporting it through the double doors into the OR corridor and down the hall to the decontamination room, which is 100 feet away. Would this not be an acceptable practice since we are entering the OR corridor?
Marsha Wallander: Transport of a pre-cleaned endoscope through a restricted area corridor should be managed in the same manner that other pre-cleaned or soiled instruments are transported outbound. Appropriate pre-cleaning, containerizing and scrupulous adherence to hand hygiene should be present in this organization's risk assessment and active surveillance performed when physical plant layouts present challenges such as described by this writer. Encourage staff training and awareness of potential pathways for contamination in frequent ongoing education.
Earlier this year, the "Multi-Society Guideline for Reprocessing Flexible Gastrointestinal Endoscopes" was updated. Several scholarly participant and endorsing organizations, including AAAHC, are listed in the guideline, as are three prominent GI professional societies, SHEA, AORN and APIC. For additional reference, you could obtain a copy of AORN's comprehensive "Recommended Practices for Cleaning and Processing Flexible Endoscopes and Endoscope Accessories."
Here are some guidelines taken directly from the Multi-Society Guideline for Reprocessing Flexible Gastrointestinal Endoscopes:
2. Pre-cleaning should be performed at the point of use, before bioburden has an opportunity to dry and before complete decontamination. Point-of-use pre-cleaning should remove visible debris by wiping the exterior of the endoscope with appropriate detergent solution and aspiration of a large volume of detergent solution through the air/water and biopsy channels. Category IB25-27,29,30
3. After point-of-use pre-cleaning, transport the soiled endoscope to the reprocessing area for subsequent steps in high-level decontamination before remaining soil dries. During transportation, soiled endoscopes should be contained in a manner that prevents exposure of staff, patients, or the environment to the potentially infectious organisms. An open container can suffice for transport to immediately adjacent reprocessing rooms, but fully enclosed and labeled containers or bags should be used for transportation to distant reprocessing areas. Category II30
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