Endoscope workshop delivers powerful, hands-on learning experience
On Saturday, April 28, 2018, 200 participants from around the U.S. and beyond gathered in Phoenix, AZ, at the 2018 IAHCSMM Conference with one common purpose: to enhance their knowledge of flexible endoscope reprocessing. Attendees spent five hours listening to endoscope and epidemiology experts and observing and practicing techniques to develop skills and learn the most current best practices in each phase of endoscope reprocessing.
Both the morning and afternoon workshops began with a presentation by Keith Nelson, Director of Infection Control and Product Development for Fujifilm Medical Systems U.S.A. Inc. – Endoscopy, on flexible endoscope design and a review of common issues associated with flexible endoscopes. Nelson also brought with him several teaching endoscopes to help participants better understand the inner components of endoscopes.
Immediately following Nelson’s presentation, Cori Ofstead, MSPH, President and CEO
Ofstead & Associates and a leading researcher in flexible endoscope issues, and John Eiland, RN, MS, Ofstead Senior Research Associate, presented information on the challenges of endoscope reprocessing and risks associated with using contaminated endoscopes. They shared findings from several studies evaluating endoscope reprocessing effectiveness that were conducted at several facilities throughout the U.S.
Ofstead and Eiland shared compelling evidence that endoscopes become highly contaminated during use and easily transmit microorganisms. Perhaps most surprising was that their findings show infections have been linked to every type of flexible endoscope. The two experts discussed strategies for improving the quality of endoscope reprocessing and reviewed the requirements for wearing proper personal protective equipment (PPE) when handling flexible endoscopes.
Immediately following the general session lectures, the collective group of attendees broke into smaller groups that rotated through five different labs. National and international endoscope experts were on hand to provide instruction in each lab, and each lab was outfitted with equipment and supplies to make the experience truly interactive.
Before entering each lab, participants were required to dress in appropriate PPE for the task they were to perform. Studies and observations have revealed that PPE is often forgotten or inappropriately used in the workplace; therefore, the use of PPE was added to the experience to reinforce requirements.
What follows are brief descriptions of the lab experiences offered during the workshop:
025Leak testing is a critical part of flexible endoscope reprocessing; it helps identify leaks, which can cause extensive endoscope damage and may allow contaminated fluid to enter the endoscope, thereby, creating an infection risk to patients.
Leak Testing Lab learning objectives included: Demonstrating wet and dry methods of leak testing; demonstrating how to determine a leak tester is performing correctly; and discussing generic principles of leak testing.
A focus on proper brushing
the Brushing Lab provided attendees with information on proper brush selection and brushing technique. Participants had an opportunity to practice proper brushing.
Brushing Lab learning objectives included: demonstrating how to select the correct brush; outlining steps/techniques for proper brushing; and identifying when to clean or dispose of brushes.
Inspection and cleaning verification
Inspection is a critical part of endoscope reprocessing. Lighted magnifiers, borescopes and cleaning verification systems were provided during the lab to help participants learn more about each process.
Inspection and Cleaning Verification Lab learning objectives included: Identifying current standards and guidelines for performing inspection with magnification and cleaning verification testing; inspecting endoscopes using different types of magnifiers and borescopes; and performing cleaning verification and data collection using adenosine triphosphate (ATP) monitors, different types of protein tests, hemoglobin tests, and combination test strips.
Automated endoscope reprocessors
The Automated Endoscope Reprocessor (AER) Lab focused on the operator’s role in AER use. Attendees learned about general AER maintenance and operational information, as well as tips to help ensure a successful process. AER units were provided for specific demonstrations.
AER Lab learning objectives included: Identifying what current standards and guidelines state regarding AERs, automated cleaning cycles, testing and other processes; reviewing quality parameters for AER operation (e.g., ensuring proper connections, testing high-level disinfectants, documentation, water quality and preventive maintenance); and identifying proper PPE for endoscope placement and removal from the AER.
Drying and storage
Thorough drying is a crucial component of endoscope reprocessing, and storage and transport activities can result in unsafe endoscopes. The Drying and Storage Lab explored strategies to reduce the risk of providing an unsafe endoscope. Attendees were introduced to a variety of techniques and equipment to help ensure good work practices for endoscope drying, storage and transport.
Drying and Storage Lab learning objectives included: Identifying current standards and guidelines for flexible endoscope drying, storage and transport; demonstrating drying techniques using various equipment and products; and demonstrating proper placement of endoscopes in drying cabinets.
Take-home tools
The goal of the Endoscope Workshop was to provide attendees with education and tools that they could take back to their facility and share with colleague what they had learned. Each participant received a binder with information on proper PPE, available resources and other information related to endoscope reprocessing. Each lab also provided attendees with handouts that provided best practices as well as applicable information on recommendations from the Association for the Advancement of Medical Instrumentation (AAMI), the Association of periOperative Registered Nurses (AORN) and the Society of Gastroenterology Nurses & Associates Inc. (SGNA).
IAHCSMM would like to sincerely thank the following companies that provided equipment, supplies and skilled educators to help make this event such a success: 3M Health Care; Aesculap; Advanced Sterilization Products; Boston Scientific; Cygnus Medical; Endoscopy Repair Specialist; Envision Inc.; Fujifilm Medical Systems U.S.A. Endoscopy; Healthmark Industries; Key Surgical; Cantel Medivators; Medline Industries; Mobile Instrument Service and Repair; Ofstead & Associates; PULL THRU; SP Concepts; and STERIS Corporation.