SGNA has two new clinical practice guidelines, one on reprocessing of flexible GI endoscopes and a second on infection prevention in the GI setting. These can be downloaded from SGNA using this link: https://www.sgna.org/Education/Standards-Practice-Guidelines
In the flexible scope document SGNA provides guidance on minimum cycle documentation including:
• procedure date and time
• patients name and MR #
• endoscopists name
• endoscope model and serial number or other identifier
• names of individuals who reprocessed the endoscope.
This cycle documentation differs from what we have previously described from AAMI, so again, pick your CPG, know what your CPG requires and be sure you have the basic requirements covered.
SGNA is now recommending a 7-day scope storage “hang time,” where previously they had no recommendation on when a scope in storage needed to be re-processed. They are also recommending that endoscope buttons and valves be processed and stored with each scope as a set.
The flexible scope document also recommends a Spill Containment Plan for the reprocessing staff. Many times there is a spill containment plan for the hospital and staff have some minimal knowledge of who to call, but may not be able to actually discuss any details, or specific actions they must take.
The flexible scope document recommends a “time out” or safety stop for a visual inspection of a cleaned scope prior to sending it for reprocessing. This is a step we seldom hear staff describe, as there is usually a presumption that pre-cleaning followed by cleaning worked effectively and it is thus safe to send for HLD. This SGNA document also cross references and suggests use of AAMI guidance to include adequate lighting and magnification during this visual inspection process.
Whether you have selected SGNA as your CPG or not, you will want your endoscopy and infection control leadership to review these documents and decide if changes are needed in you practices. Knowing the minutiae in clinical practice guidelines and implementing all the minutiae in your selected CPG is essential. The seemingly minor differences in guidance can lead to “gotchas” during survey if you are not clear whose advice you adhere to.
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