The BSG (British Society of Gastroenterology) has issued new guidance for the decontamination of equipment used in gastrointestinal endoscopy.
These recommendations have been put forward in the wake of recent incidents involving contaminated duodenoscopes. In the document provided, the BSG highlights eight specific points that all members of staff responsible for the decontamination of flexible endoscopes should conform to:
• Adherence to manufacturers' instructions at all times is essential.
• The pre clean procedure should take place at the patient bedside, as described in the instructions from the UK suppliers and BSG guidance.
• The cover on the raiser bridge mechanism at the distal tip should be removed prior to brushing all areas of the distal tip and cleaning with detergent and replaced on completion of the decontamination process. The brush must be used on all surface areas of the distal tip ensure that all debris is removed.
• The elevator wire channel should be flushed with detergent during the manual cleaning ensuring the correct size syringe is used. If automated flushing systems are used for this stage of the process, staff should ensure that this channel is included.
• Staff should ensure that the endoscope washer disinfector has the capability of flushing the elevator wire channel with detergent, disinfectant and rinse water.
• If stored in a drying cabinet, the elevator wire channel should be flushed with HEPA filtered air along with all the other channels. If this channel is not flushed with air, the endoscope should be used within 3 hours or the endoscope reprocessed before patient use. Not all cabinets have this facility. An EN standard, EN 16442, has now been published for endoscope storage drying cabinets.
• Routine microbiological surveillance of processed endoscopes is not recommended. However, this may be carried out on advice from the infection prevention and control team if an outbreak is known or suspected.
• Staff should receive comprehensive training, and a record retained, on all aspects of the decontamination of endoscopes, in particular, duodenoscopes.
While endoscope sterilization using EtO is not included in this list of recommendations, the three-hour usage restrictions mentioned in the document don't apply when sterilizing with ethylene oxide since the endoscope is wrapped in a sterile barrier system.
Click here to access the full document issued by the BSG.