Automated Endoscope Reprocessor Vs. Decontamination

Question:

We have a new surgery center that will open soon and the staff placed the automated endoscope reprocessing cleaner in the decontamination room.

The scope cleaner rep told our staff that the endoscope reprocessing cleaner needed to be located in the clean/sterile processing room near the pass-through window.

There has been a lot of back-and-forth discussion regarding this, what is the appropriate placement?

Answer:

The vendor is correct.  AAMI recommends that the manual cleaning and decontamination process be physically separated from the automated endoscope reprocessor.  

We have summarized the relevant section below.  They clearly say that sometimes the proper separation is not possible but since this space is new, we would recommend trying to move it. Ideally, the AER is just on the other side of the pass-through window.  This allows things to go from dirty to clean and it prevents aerosolized material from getting the AER dirty.

ANSI/AAMI

ST91:2015

Flexible and semi-rigid endoscope processing in health care facilities 

3.2.2 Physical separation

The manual cleaning area should be physically separated by walls or partitions to control contaminants generated during manual cleaning. Doors and pass-through windows separating the decontamination area from the adjoining disinfection/sterilization area should be kept closed.

An area for disinfection/sterilization should be separate from the manual cleaning/processing area.  You should have unidirectional processing procedures in place to reduce risks of cross-contamination. 

AAAMI gives the following rationale: “Physical enclosure of the decontamination area is necessary because contaminated aerosols, droplet nuclei, and dust particles can be carried from “dirty” to “clean” areas by air currents. Separating “clean” and “dirty” areas helps prevent environmental contamination. Segregation of contaminated items from items being removed from mechanical processing equipment can help protect processed items (e.g., flexible and semi-rigid endoscopes) from recontamination.”