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Endoscopes must be carefully handled and stored. Endoscope drying can be easily, quickly, and inexpensively achieved by flushing the endoscope’s internal channels, and wiping its external surfaces, with 70–90% ethyl or isopropyl alcohol, to facilitate drying after reprocessing, followed by flushing with compressed air. Wetness or moisture left inside or on scopes can be a source of contamination creating a breeding field for microbes. The longer moisture remains in or on a scope the greater the likelihood for contamination as organisms multiply. The environment and storage condition can also impact the rate and degree of microbial growth. Drying of endoscopes may be as important to the prevention of nosocomial infection as is the cleaning and disinfection. Wet or inadequately dried endoscopes can pose an increased risk of contamination and have been associated with transmission of waterborne microorganisms and nosocomial infection. Properly cleaned, disinfected and thoroughly dried endoscopes have not been linked to nosocomial infection.

Not all healthcare facilities dry their endoscopes after reprocessing. Published guidelines and individual hospital policies vary. Some guidelines and policies recommend drying the endoscope after completion of every reprocessing cycle, both throughout the day and before storage, while others deemphasize the importance of routine drying and recommend endoscope drying only before storage. Instead of recommending endoscope drying before storage, some guidelines and hospital policies recommend reprocessing endoscopes before the first patient of the day. Endoscope manufacturers also are required to provide users with cleaning and reprocessing instructions. Regardless of what guidelines or manufacturers recommendations may indicate no harm can be done to endoscopes by drying after each cleaning process.

I am very much in favor of having a standardized procedure in place for the reprocessing and drying of all endoscopes which is followed by all personnel consistently throughout the day. The likelihood of error and the transmission of infectious agents are increased when processing protocols are varied allowing individuals to alter processing methods. Each and every patient deserves the same quality of service and care regardless of where their procedure may fall on the daily schedule. We know that moisture allowed to stand in scopes can provide a reservoir for bacteria and with the passage of time the bacteria will multiply; waterborne organisms and inadequately processed scopes have been linked to disease transmission between endoscopic procedures and patients. Properly processed endoscopes, which included thorough drying, with an alcohol flush, have never been linked to a nosocomial infection. In my opinion the best practice would therefore include the drying of all endoscopes by flushing scope lumen channels, (in accordance with manufacturer’s instructions) with 70–90% ethyl or isopropyl followed by compressed air.

1. Run an empty cycle to warm up or preheat the sterilizer to operating temperature.

2. Run the Bowie-Dick test pack in an empty cycle, place on the bottom shelf over the drain if required.

3. Run the biological indicators process challenge device (PCD) in the first full load of the day, place on the bottom shelf over the drain.

In summary, only one warm up, empty cycle is required and that is a requirement for the Bowie-Dick testing. The biological indicator PCD can be run whenever you have your first full load.