Ergonomics in endoscopy reprocessing requires rigid flexibility

Oct. 27, 2020

When you have to clean, disinfect, sterilize, store and handle very delicate, sensitive and complex devices like endoscopes, it can be easy to overlook some of the obvious issues in the process.

That’s because the intricate process of reprocessing endoscopes and other endoscopic devices involves disassembling the devices to a degree, as well as conducting detailed inspections of products along the way.

Performing these tasks can be stressful on Sterile Processing and Distribution (SPD) technicians, particularly in the physical areas of gait between stations, posture at workstations and standing for long periods of time.

As a result, ergonomics should be considered a serious factor.

“Ergonomics play a distinct role in the reprocessing arena,” insisted Betty McGinty, RN, CGRN, CER, Fellow, Clinical Education Services, Boston Scientific Corp., who cited the Society of Gastroenterology Nurses and Associates’ “Ergonomics in the Gastroenterology Setting,” a 2020 Position Statement. “Potential injury opportunities include repetitive motions as well as sustained awkward positions. Supportive corrective responses include education about, as well as adherence to, proper body mechanics, rest and use of assistive devices. Reprocessing room design that includes attention to sink depth and counter height (adjustable if possible) as well as use of anti-fatigue mats in the front of the sink (to increase lower extremity blood flow) are ergonomic suggestions. Assistive devices include channel flushing aids.”

Much depends on the departmental footprint and workspace design, according to Melissa  Kubach, Clinical Education and Training Manager, Mobile Instrument Service & Repair.

“People do jobs well when they are well trained, practice the process regularly and have the resources to make the job easy to do,” she noted. “Installing sinks and working counter space that can adjust to accommodate the reprocessing technicians’ height is a big help. Also, cleaning is improved with the use of automated flushing devices to limit repetitive motion.” 

SPD technicians who reprocess endoscopes handle a variety of devices that require certain equipment, according to Jahan Azizi, Special Projects Manager, Healthmark Industries Co.

“The long scopes require large, deep sinks that the height needs to be adjusted to accommodate a wide range of individuals,” Azizi indicated. “The high-demand, fast-paced department could [and] will cause additional stress.”

Azizi specified the need for height-adjustable sinks and tables, an “assembly line approach” to reprocessing for high-demand departments and “a quality control person to verify 100 percent enhanced visual inspection after cleaning.”

Proper tools of the trade can make a monumental difference, according to Gregg Agoston, Vice President, Business Development, SPD Transformation Services, SpecialtyCare.

“Newer cleaning equipment and aids, such as trough-type sinks that allow the flexible endoscope to be stretched out versus coiled and flush/suction devices like Scope Buddy Plus,  greatly assist the technician handling and processing of flexible endoscopes,” Agoston said. “Pass-through AERs that allow for separation between the dirty and clean area are a great help as well as the Medivators horizontal storage cabinets that automate the tracking of the endoscopes [and] extend hang time to 30 days are a great benefit. Advances like these greatly enhance the likelihood that endoscope reprocessing will be done correctly.”

But Ron Banach, Director, Clinical Training, Ruhof Corp., calls for deeper efforts earlier.

“The device manufacturers must work with end users to design products that meet all the necessary guidelines to allow for cleaning and safe use,” he said. “Unfortunately, it comes down to the analysis of costs versus the quality of the outcome.”

Several manufacturers contend they already are working with end users by designing and delivering a different kind of product that doesn’t involve such detailed and intricate cleaning.

“For the last 20 years, hospitals have been trying to meet increasing patient procedure demand – and the corresponding increase in reprocessing protocols – with more people, time and financial investment in reusable equipment,” said Christian Escobar, Director, Marketing –  Vizualization, Ambu. “Reusable endoscope ergonomics and design may improve incrementally to address a contamination challenge, but the overall ergonomics (size, length, etc.) are not expected to dramatically change. Utilizing more single-use endoscopes is a way to alleviate the overall volume of reusable scopes that require reprocessing, storage, transport and handling.”
Rob Cripe, Chief Commercial Officer,  Integrated Endoscopy, concurs.

“As a manufacturer of single-use rigid scopes, we put a lot of energy into ergonomics relative to the user,” Cripe said. “Many times these ‘human factors’ are the most important in driving adoption and can be a significant challenge to incorporate the right combination of function and form. As it relates to cleaning/sterilization, this obviously is not considered since all single-use products are sterilized during the manufacturing process.”

About the Author

Rick Dana Barlow | Senior Editor

Rick Dana Barlow is Senior Editor for Healthcare Purchasing News, an Endeavor Business Media publication. He can be reached at [email protected].