Author: J. Vincent Sanchez, CRCST | Client Manager
Across the world, medical facilities use flexible endoscopes to care for, diagnose, and treat patients. Because these devices are intricate and generally constructed from delicate materials, they are difficult to disinfect,⁵ but the stakes are high: failing to properly clean and disinfect flexible endoscopes can result in infecting patients with diseases like HIV, hepatitis B, and tuberculosis.
To avoid this risk, more facilities are moving away from manually soaking flexible endoscopes and are instead using automated endoscope reprocessors (AERs). These machines provide several distinct benefits over manual disinfection:
Benefit 1: Patient Safety
An examination of data regarding endoscope-transmitted infections found that 23.9 percent of bacterial cultures from endoscope channels on 72 gastrointestinal endoscopes resulted in the growth of more than 100,000 bacterial colonies after disinfection/sterilization and before use on the next patient.⁵
When it comes to transmitting infection, the major factors are inadequate cleaning, staff choosing the wrong disinfecting agent, and/or staff failing to follow manufacturer guidelines for cleaning and disinfection.⁵ Facility staff should be continually trained on proper cleaning processes, but utilizing an AER can effectively avoid the latter two problems. Automating the cleaning process ensures compliance with manufacturer instructions and has been shown to more effectively remove residual organic matter.¹
The AER also ensures that flexible endoscopes are properly rinsed at the end of the disinfection cycle, which is crucial since patient exposure to disinfectants can cause issues such as chemical colitis, keratopathy, and damage to the cornea. (Residue levels of glutaraldehyde, a toxic chemical disinfectant, have been found to be 25 times higher on manually cleaned endoscopes than on those processed in an AER.⁵)
Benefit 2: Staff Safety
Many of the chemicals used in high-level disinfection can have profound, negative effects on health. For example, exposure to liquid glutaraldehyde can result in nasal irritation and bleeding, difficulty breathing, throat/lung irritation, hives, and contact dermatitis.² Manual disinfection processes have the potential to expose workers to such disinfectant agents, while modern AERS, such as Advanced Sterilization Products’s Evotech ECR, protect staff by minimizing exposure to disinfectant agents.
Benefit 3: Process Standardization
In larger, busier facilities—especially those with multiple reprocessing areas—it can be tough to make sure all staff use the same processes for reprocessing flexible endoscopes. Plus, there may be pressure to reprocess pieces as rapidly as possible to cope with case volume. This can lead staff to use procedural shortcuts and neglect attention to detail in order to move pieces faster. By purchasing and deploying modern AERs across your facility’s reprocessing areas, you can make sure that all technicians adhere to the established processes and reduce the opportunities for human errors that compromise patient care.
Benefit 4: Facility Productivity
A 2014 study on endoscope use in Russia, China, and India found significant increases in productivity when facilities switched to automated endoscope reprocessing—especially when the average manual soak time was longer than the average endoscopy procedure time. For example, in Russia, the average endoscopy procedure time was 24.4 minutes, while the average manual endoscope turnaround time was 47.5 minutes. Switching from manual reprocessing to an AER reduced turnaround time and increased efficiency to the extent that the Russian facility was able to add an average of 3.9 procedures per day. This improved efficiency was consistent in facilities where the manual process times were already fairly rapid.³
Benefit 5: Finances
AERs lead to a variety of financial benefits. First, an increase in productivity means more cases can be scheduled and processed each day, which means facilities will have higher profitability. Additionally, 18 percent of endoscope damage happens while they’re being handled for reprocessing—and AER reduces handling of endoscopes by 34 percent. Thus, a switch to an AER would decrease endoscope damage and the need for repairs, saving facilities money which in today’s healthcare market is critical.³
When you line up these benefits next to the cost of an AER, it should be easy to see that an AER will rapidly pay for itself—whether through decreased endoscope repair, increased productivity, decreased staff downtime, or improved patient safety. Switching from manual soak to automated reprocessing is, quite simply, a no-brainer.
Never Doubt the Safety of Your Equipment
ANSI/AAMI ST79:2017. Association for the Advancement of Medical Instrumentation (AAMI)
Performance Management & Quality Improvement. CDC. https://www.cdc.gov/publichealthgateway/performance/index.html
Performance Management: Turning Point. Public Health Foundation. http://www.phf.org/programs/turningpoint/Pages/Turning_Point_Performance_Management_Refresh.aspx
Process. A Publication of the International Association of Healthcare Central Service Material Management. May/June 2020. www.iahcsmm,org
Quality Audit – A Tool for Continuous Improvement and Compliance. https://www.mastercontrol.com/gxp-lifeline/quality_audit_tool_compliance_0810/
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If you like this post, check out these:
1. Alfa, Michelle. ”Current Issues Result in a Paradigm Shift in Reprocessing Medical and Surgical Instruments.” American Journal of Infection Control, vol. 44, 2016.
2. ”CDC - NIOSH Publications and Products - Glutaraldehyde - Occupational Hazards in Hospitals (2001-115).” Centers for Disease Control and Prevention, www.cdc.gov/niosh/docs/2001-115/.
3. Funk, S E, and N L Reaven. ”High-Level Endoscope Disinfection Processes in Emerging Economies: Financial Impact of Manual Process versus Automated Endoscope Reprocessing.” Journal of Hospital Infection, vol. 86, 2014, pp. 250?254.
4. Medivators, Inc. Advantage Plus Pass Through . Advantage Plus Pass Through , Medivators, Inc, 2018. 4
5. Rutala, William, et al. ”Draft Guideline for Disinfection and Sterilization in Healthcare Facilities.” 2008.