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  • What’s inside your scopes? Simethicone and other insoluble products used during endoscopy

    Contains 6 Component(s), Includes Credits

    This CE-eligible webinar will provide information about insoluble products like simethicone, lubricants, and tissue glue that may impact endoscope reprocessing effectiveness.

    Eligible for Contact Hours | IAHCSMM: 1.0 Contact Hours | CBSPD: 1.0 Contact Hours | RN: 1.0 Contact Hours

    During this webinar, the presenter describes her team’s groundbreaking discovery of simethicone inside gastrointestinal endoscopes. She explains how the substance was originally identified and describes her team’s detection of other insoluble products on bronchoscopes and GI endoscopes. The presenter discusses the nature of these products, their clinical value, and the dilemma posed by policies that prohibit their use. This course is designed to empower clinicians, perioperative nurses, central service managers, and reprocessing personnel interested in identifying suspicious residues found on endoscopes. The webinar includes recommendations for addressing the use of these insoluble products, including methods for determining which products are being used, conducting risk assessments, and developing strategies for reducing the risk.

    Objectives

    By the end of this one-hour webinar, participants will be able to:

    1. Describe four types of insoluble products that are commonly used during endoscopy
    2. Explain how the use of these products impacts reprocessing effectiveness
    3. Summarize guidelines and manufacturer statements on the use of insoluble products
    4. Discuss strategies for addressing the potential impact of these products

    Content outline
    1. Background
      1. Endoscope reprocessing does not reliably eliminate soil or bioburden
      2. The use of insoluble products may be making the situation worse
    2. Discovery of simethicone inside endoscopes
      1. Initial observations during visual inspections with borescopes
      2. Collaborating with facility personnel to determine potential sources
      3. Capturing samples and running laboratory tests to identify the substances
      4. Identifying the foreign substance
      5. Learning about the nature and clinical value of simethicone
      6. Exploring the implications for endoscope reprocessing and maintenance
    3. Detection of other insoluble products used during endoscopy:
      1. Lubricants containing oils and silicone
      2. Tissue glue
      3. Hemostatic powders and sprays
    4. Guidelines and manufacturer statements about insoluble products


    5. Addressing the use of insoluble products during endoscopy:
      1. Determining which products are being used during endoscopy
      2. Reviewing product labels, manufacturer IFU, guidelines, and facility policies
      3. Evaluating current procedures for detecting and removing foreign substances
      4. Conducting a risk assessment and developing strategies for reducing risk
    6. Sponsor acknowledgement (Supported by an educational grant from Healthmark)

    Cori L. Ofstead, MSPH

    President & CEO, Ofstead & Associates

    Cori L. Ofstead, MSPH, is an epidemiologist with 30 years of experience designing and conducting studies about the impact of clinical processes on patient outcomes. She has served as the Principal Investigator on numerous studies related to infection prevention, instrument reprocessing, and vaccination against infectious diseases. Ms. Ofstead is nationally recognized for her groundbreaking research, and her studies have been published in peer-reviewed journals including CHEST, AJIC, ICHE, Journal of Hospital Infection, Gastroenterology Nursing, and Vaccine. She currently serves as a reviewer for AJIC, Endoscopy, and the Journal of Urology, and is an active member of the editorial board for AJIC. She has presented the findings of her studies at national and international conferences sponsored by the CDC, APIC, IAHCSMM, AORN, SGNA, AGA, and several universities. In addition, she currently serves as a preceptor for epidemiology students in the School of Public Health at the University of Minnesota.

  • COVID-19 and bronchoscopy: Evidence from the field (FREE) Cannot use Internet Explorer browser

    Contains 1 Component(s)

    This webinar provides an overview of scientific evidence related to bronchoscope reprocessing effectiveness and the use of bronchoscopes during COVID-19 outbreaks.

    FREE WEBINAR. Not eligible for CE credit.

    Bronchoscopy played an important role in identifying the virus responsible for the current COVID-19 pandemic, and there will be a continued need for bronchoscopy among critically ill COVID-19 patients and others with serious conditions. There is substantial evidence that bronchoscope reprocessing is not consistently effective. Inadequate reprocessing puts healthcare personnel and patients at risk of exposure to COVID-19 and other pathogens harbored in bronchoscopes. This webinar is designed to provide timely evidence to clinicians, infection preventionists, and reprocessing personnel who handle reusable bronchoscopes. The presenter is an epidemiologist who specializes in infection prevention. She explains key findings from her bronchoscope reprocessing studies and COVID-19 studies by others working in the field. This webinar also describes strategies for reducing bronchoscopy-associated risks that impact healthcare personnel and patient safety.

    Objectives

    By the end of this short webinar, participants will be able to:

    1. Describe the role bronchoscopy plays in COVID-19
    2. Summarize recent research on bronchoscope reprocessing ineffectiveness
    3. Explain risks related to using bronchoscopes contaminated with COVID-19 or other pathogens
    4. Discuss strategies for reducing the risk of exposure to contaminated bronchoscopes

    Content outline
    1. Evidence sparking concern about contaminated bronchoscopes
    2. Bronchoscope reprocessing effectiveness
    3. The need for universal precautions during COVID-19 outbreaks
    4. Strategies for reducing risk
    5. Sponsor acknowledgement (Supported by an educational grant from Ambu)

    Cori L. Ofstead, MSPH

    President & CEO, Ofstead & Associates

    Cori L. Ofstead, MSPH, is an epidemiologist with 30 years of experience designing and conducting studies about the impact of clinical processes on patient outcomes. She has served as the Principal Investigator on numerous studies related to infection prevention, instrument reprocessing, and vaccination against infectious diseases. Ms. Ofstead is nationally recognized for her groundbreaking research, and her studies have been published in peer-reviewed journals including CHEST, AJIC, ICHE, Journal of Hospital Infection, Gastroenterology Nursing, and Vaccine. She currently serves as a reviewer for AJIC, Endoscopy, and the Journal of Urology, and is an active member of the editorial board for AJIC. She has presented the findings of her studies at national and international conferences sponsored by the CDC, APIC, IAHCSMM, AORN, SGNA, AGA, and several universities. In addition, she currently serves as a preceptor for epidemiology students in the School of Public Health at the University of Minnesota.

  • Minimizing the risk of exposure, injury, and infection during bronchoscopy (FREE)

    Contains 6 Component(s), Includes Credits

    This CE-eligible webinar will provide information about bronchoscopes and help you implement quality management strategies for bronchoscope reprocessing and maintenance.

    Eligible for Contact Hours | IAHCSMM: 1.0 Contact Hours | CBSPD: 1.0 Contact Hours | RN: 1.0 Contact Hours

    Numerous outbreaks and patient injuries have been linked to the use of contaminated and damaged bronchoscopes. Residual bioburden in bronchoscopes can also impact clinical lab results and cause patients to be treated for infections they may not have. Bronchoscopes are used and reprocessed by diverse personnel in numerous departments, which makes it challenging to ensure that reprocessing is done correctly every time—especially when bronchoscopes are used in emergency situations. This webinar explores factors that contribute to patient vulnerability and reprocessing effectiveness. The presenter will discuss insights from her research and recommendations for quality management strategies that participants can implement in their own institutions. This course is designed to provide clinicians, perioperative nurses, central service managers, and reprocessing personnel with information and resources that will enable them to evaluate and improve their bronchoscope reprocessing and maintenance programs.

    Objectives

    By the end of this one-hour webinar, participants will be able to:

    1. Discuss the consequences of using damaged or dirty bronchoscopes
    2. List several factors that increase the risk of complications for bronchoscopy patients
    3. Describe common challenges encountered during bronchoscope reprocessing
    4. Explain key findings from real-world studies on bronchoscope reprocessing effectiveness
    5. Outline five quality assurance strategies for improving safety for bronchoscopy patients

    Content outline
    1. Patient injuries and infections due to the use of damaged or contaminated bronchoscopes
    2. The impact of pseudo-outbreaks on laboratory results and patient care
    3. Basics on bronchoscopes (anatomy, procedural use, characteristics of different types of scopes)
    4. Factors that increase the risks associated with bronchoscopy
    5. Guidelines for reprocessing and quality assurance (AORN, AAMI ST91, ACCP/AAB)
    6. Real world evidence on reprocessing quality and outcomes
    7. How to assess quality and identify areas for improvement
    8. What to expect when conducting audits, performing tests for residual soil, and inspecting bronchoscopes using lighted magnification and borescopes
    9. Strategies for improving the quality of bronchoscope reprocessing and storage
    10. Sponsor acknowledgement (Supported by an educational grant from Healthmark)

    Cori L. Ofstead, MSPH

    President & CEO, Ofstead & Associates

    Cori L. Ofstead, MSPH, is an epidemiologist with 30 years of experience designing and conducting studies about the impact of clinical processes on patient outcomes. She has served as the Principal Investigator on numerous studies related to infection prevention, instrument reprocessing, and vaccination against infectious diseases. Ms. Ofstead is nationally recognized for her groundbreaking research, and her studies have been published in peer-reviewed journals including CHEST, AJIC, ICHE, Journal of Hospital Infection, Gastroenterology Nursing, and Vaccine. She currently serves as a reviewer for AJIC, Endoscopy, and the Journal of Urology, and is an active member of the editorial board for AJIC. She has presented the findings of her studies at national and international conferences sponsored by the CDC, APIC, IAHCSMM, AORN, SGNA, AGA, and several universities. In addition, she currently serves as a preceptor for epidemiology students in the School of Public Health at the University of Minnesota.

  • The endoscope drying imperative: what, why, when, where, and how?

    Contains 6 Component(s), Includes Credits

    This CE-eligible webinar will help you evaluate your endoscope drying practices and implement a drying verification program.

    Eligible for Contact Hours | IAHCSMM: 1.0 Contact Hours | CBSPD: 1.0 Contact Hours | RN: 1.0 Contact Hours

    Retained moisture can foster the growth of microbes and biofilm inside endoscopes. This webinar will describe research that demonstrates the importance of using effective, evidence-based methods for drying and what happens when endoscopes are stored wet. Participants will learn about current guidelines for drying and storing patient-ready endoscopes. Stories with photos and videos will illustrate the what, when, why, where, and how to get endoscopes dry. The presenter will share her experience evaluating drying practices and using drying verification tools. This webinar will provide frontline reprocessing personnel and managers with strategies for assessing and improving their drying practices.

    Objectives

    By the end of this one-hour webinar, participants will be able to:

    1. Discuss the rationale for ensuring that endoscopes are completely dried before storage
    2. Describe current AORN, SGNA, and AAMI guidelines for drying endoscopes
    3. List three commonly used methods for drying endoscopes
    4. Explain methods for detecting moisture and verifying that endoscopes are dry
    5. Outline strategies for ensuring endoscopes are completely dry before sterilization or storage

    Content outline
    1. Background and rationale for removing moisture from endoscopes (drying scopes)
      1. Endoscopes are highly contaminated during procedures
      2. HLD is not reliably effective at eliminating viable microbes
      3. Endoscopes are wet after HLD, and microbes thrive in moist conditions
      4. Outbreaks of infection have been linked to wet scopes
    2. Guidelines for drying scopes
      1. Dry exteriors with a lint-free cloth or sponge
      2. Purge the channels using forced air
      3. Use a special drying cabinet or store vertically in enclosed, well-ventilated cabinets
    3. Evidence from the field on drying effectiveness
      1. Ofstead’s microbial culture “Toolkit Study”
        1. Waterborne pathogens were found in colonoscopes, gastroscopes, and bronchoscopes in a site with good adherence to guidelines and IFU
        2. Tests determined the root cause was contaminated rinse water, with inadequate drying
      2. Ofstead’s longitudinal study
        1. Cultures were positive for 60% of colonoscopes and gastroscopes
        2. Visual inspection with borescopes identified droplets in 95% of endoscopes
        3. Increasing the alcohol volume and AER air purge time did not dry the scopes
      3. Ofstead’s multisite drying study
        1. Compared drying effectiveness for three methods: (1) Drip dry in passively ventilated cabinet, (2) Brief purge with forced air and passive ventilation, (3) 10 minutes of forced air and active ventilation
        2. Found higher levels of microbial growth in sites with wet scopes
    4. Drying verification methods
      1. Visual inspection of:
        1. Cabinets for puddles of fluid or stains on the bottom of cabinets
        2. Endoscopes using borescopes to look inside ports and channels
      2. Chemical indicator test strips that can detect water
      3. Microbial cultures (not pro-active; identifies bacteria and mold when it’s too late)
    5. Strategies for enhancing drying and storage practices
      1. Establishing protocols and selecting tools for drying scopes and verifying drying effectiveness
      2. Evaluating the effectiveness of your drying protocols
      3. Training and support needed for personnel
      4. Challenges and gaps in knowledge (e.g., role of alcohol flush, impact of simethicone)
    6. Sponsor acknowledgement (Supported by an educational grant from Healthmark)

    Cori L. Ofstead, MSPH

    President & CEO, Ofstead & Associates

    Cori L. Ofstead, MSPH, is an epidemiologist with 30 years of experience designing and conducting studies about the impact of clinical processes on patient outcomes. She has served as the Principal Investigator on numerous studies related to infection prevention, instrument reprocessing, and vaccination against infectious diseases. Ms. Ofstead is nationally recognized for her groundbreaking research, and her studies have been published in peer-reviewed journals including CHEST, AJIC, ICHE, Journal of Hospital Infection, Gastroenterology Nursing, and Vaccine. She currently serves as a reviewer for AJIC, Endoscopy, and the Journal of Urology, and is an active member of the editorial board for AJIC. She has presented the findings of her studies at national and international conferences sponsored by the CDC, APIC, IAHCSMM, AORN, SGNA, AGA, and several universities. In addition, she currently serves as a preceptor for epidemiology students in the School of Public Health at the University of Minnesota.

  • Performing biochemical tests to verify cleaning effectiveness for flexible endoscopes

    Contains 7 Component(s), Includes Credits

    This CE-eligible webinar will help you design and implement a quality assurance program to verify your endoscope cleaning effectiveness.

    Eligible for Contact Hours | IAHCSMM: 1.0 Contact Hours | CBSPD: 1.0 Contact Hours | RN: 1.0 Contact Hours

    Residual soil that is not removed from endoscopes during manual cleaning may reduce the effectiveness of HLD and sterilization, putting patients at risk for exposure to other patients’ tissue, secretions, and potential pathogens. Cleaning verification using rapid indicators is one method for determining if endoscopes are clean before they are disinfected or sterilized. This webinar will introduce several types of cleaning verification tests and explain how they can be used and interpreted. The presenter will provide insights, photos, and videos of rapid indicator tests from her experience in the field. Participants will learn strategies for setting up their own programs that improve patient safety with sustainable cleaning verification processes. This course is designed to give frontline managers and reprocessing personnel the tools they need to develop their own quality assurance program for manual cleaning.

    Objectives

    By the end of this one-hour webinar, participants will be able to:

    1. Discuss the rationale for verifying cleaning effectiveness before HLD or sterilization
    2. Describe current AORN, SGNA, and AAMI guidelines for cleaning verification during reprocessing of flexible endoscopes
    3. List three types of biochemical tests for organic soil
    4. Explain methods for collecting samples and conducting cleaning verification tests
    5. Outline strategies for designing and implementing a cleaning verification program

    Content outline
    1. Background and rationale for performing cleaning verification tests
    2. Guidelines for cleaning verification using biochemical tests
    3. Types of cleaning verification tests and sampling methods
    4. Performing and interpreting the results of cleaning verification tests
    5. Acting on the findings from cleaning verification tests
    6. Strategies for implementing a cleaning verification program

    Cori L. Ofstead, MSPH

    President & CEO, Ofstead & Associates

    Cori L. Ofstead, MSPH, is an epidemiologist with 30 years of experience designing and conducting studies about the impact of clinical processes on patient outcomes. She has served as the Principal Investigator on numerous studies related to infection prevention, instrument reprocessing, and vaccination against infectious diseases. Ms. Ofstead is nationally recognized for her groundbreaking research, and her studies have been published in peer-reviewed journals including CHEST, AJIC, ICHE, Journal of Hospital Infection, Gastroenterology Nursing, and Vaccine. She currently serves as a reviewer for AJIC, Endoscopy, and the Journal of Urology, and is an active member of the editorial board for AJIC. She has presented the findings of her studies at national and international conferences sponsored by the CDC, APIC, IAHCSMM, AORN, SGNA, AGA, and several universities. In addition, she currently serves as a preceptor for epidemiology students in the School of Public Health at the University of Minnesota.

  • Conducting visual inspections of flexible endoscopes using lighted magnification

    Contains 7 Component(s), Includes Credits

    Help improve patient safety with this CE-eligible webinar. Part 2 in a series.

    Eligible for Contact Hours | IAHCSMM: 1.0 Contact Hours | CBSPD: 1.0 Contact Hours | RN: 1.0 Contact Hours

    Numerous patient injuries and infections have been caused by the use of damaged and dirty endoscopes. To help improve patient safety, AAMI/ANSI, AORN, and SGNA guidelines recommend that endoscopes be inspected using good lighting and magnification every time they are used. This webinar describes tools and methods for conducting visual inspections of the outsides of flexible endoscopes. It illustrates important differences between ureteroscopes, cystoscopes, bronchoscopes, colonoscopes, gastroscopes, and specialty scopes such as EBUS, EUS, and ERCP scopes. Participants will see numerous photos of defects and debris and learn from an epidemiologist about evidence on the clinical impact of such defects. This course will empower front line reprocessing specialists, nursing personnel, infection preventionists, and clinic managers to conduct visual inspections of endoscopes and identify issues that could impact reprocessing effectiveness, impede procedural success, or injure patients. It will increase the evidence base regarding reprocessing effectiveness and endoscope durability.

    Objectives

    By the end of this one-hour webinar, participants will be able to:

    1. Describe guidelines for visual inspections issued by AORN, SGNA, AAMI, and international agencies
    2. Discuss clinical implications of visible defects that were not identified before procedures
    3. Explain why lighted magnification is necessary when doing visual inspections
    4. Discuss methods for conducting visual inspections using lighted magnification
    5. Recognize that different types of endoscopes have unique features
    6. Outline issues to consider before doing visual inspections using lighted magnification

    Content outline
    1. Patient exposures, injuries, and infections associated with endoscopy
      1. Evidence of organic soil and microbial bioburden found on “patient-ready” endoscopes
      2. Infections linked to residual contamination on damaged or dirty scopes
      3. Injuries linked to the use of damaged or defective endoscopes
    2. Guidelines for visual inspection of flexible endoscopes
      1. US guidelines, including SGNA, AORN, and AAMI/ANSI
      2. Guidelines from other geographies, including Europe and Australia
      3. Manufacturer instructions for use
    3. Tools and methods for conducting visual inspections using lighted magnification
      1. Purpose of magnification
      2. Types of magnification equipment available
      3. Methods for inspecting exterior surfaces of a flexible endoscope
      4. Documenting and addressing the findings of visual inspection
      5. Cleaning and disinfecting your magnification equipment
    4. Interpreting findings of external inspections using lighted magnification
      1. Appearance of new control handles, ports, valves and buttons, insertion tubes, bending sections, and distal ends
      2. Common problems that may be discovered (e.g., buckling; scratches; gaps; cracks; chips; dents; chemical damage; and residual blood, mucous, fluid, lubricants, or debris)
    5. Importance of visual inspection for identifying:
      1. Endoscopes requiring additional cleaning, repair, or refurbishment
      2. Issues that may spark internal risk assessments
      3. A need for improvements in reprocessing protocols, materials, or water quality
    6. Strategies for moving forward
      1. Obtaining lighted magnification equipment
      2. Training and support for persons conducting visual inspections using magnification
      3. Logistics for conducting visual inspections
      4. Policies and protocols for responding to findings of visual inspections
    7. Sponsor acknowledgement (Supported by an educational grant from Healthmark and information from Endoscopy Repair Specialist, Inc.)

    Cori L. Ofstead, MSPH

    President & CEO, Ofstead & Associates

    Cori L. Ofstead, MSPH, is an epidemiologist with 30 years of experience designing and conducting studies about the impact of clinical processes on patient outcomes. She has served as the Principal Investigator on numerous studies related to infection prevention, instrument reprocessing, and vaccination against infectious diseases. Ms. Ofstead is nationally recognized for her groundbreaking research, and her studies have been published in peer-reviewed journals including CHEST, AJIC, ICHE, Journal of Hospital Infection, Gastroenterology Nursing, and Vaccine. She currently serves as a reviewer for AJIC, Endoscopy, and the Journal of Urology, and is an active member of the editorial board for AJIC. She has presented the findings of her studies at national and international conferences sponsored by the CDC, APIC, IAHCSMM, AORN, SGNA, AGA, and several universities. In addition, she currently serves as a preceptor for epidemiology students in the School of Public Health at the University of Minnesota.

  • Conducting visual examinations of flexible endoscopes: A focus on channels and ports

    Contains 7 Component(s), Includes Credits

    Help improve patient safety with this CE-eligible webinar. Part 1 in a series.

    Eligible for Contact Hours | IAHCSMM: 1.0 Contact Hours | CBSPD: 1.0 Contact Hours | RN: 1.0 Contact Hours

    AAMI/ANSI, AORN, and SGNA guidelines recommend visual inspection using good lighting and magnification. Borescopes allow technicians to examine the complex interiors of flexible endoscopes, which facilitates early identification of scopes that would benefit from additional cleaning, repair, or refurbishment. This is a CE course on visual inspection based on scientific evidence and our experience examining hundreds of endoscopes. This webinar describes tools and methods for conducting visual exams using borescopes and provides insights about common findings and their clinical implications. This course will empower front line reprocessing specialists, nursing personnel, infection preventionists, and clinic managers to conduct visual examinations of endoscopes and identify issues that could impact reprocessing effectiveness, impede procedural success, or injure patients. It will increase the evidence base regarding reprocessing effectiveness and endoscope durability.

    Objectives

    By the end of this one-hour webinar, participants will be able to:

    1. Describe current guidelines for visual inspection of flexible endoscopes
    2. Explain methods for conducting borescope examinations of endoscope interiors
    3. Describe several defects that are commonly identified during borescope exams
    4. Discuss the clinical implications of damage and debris found inside endoscopes
    5. Outline several issues that should be considered before implementing visual exams

    Content outline
    1. Patient exposures, injuries, and infections associated with endoscopy
      1. Injuries linked to the use of damaged endoscopes
      2. Material from previous cases remaining in endoscopes after reprocessing
      3. Bioburden found in “patient-ready” endoscopes
      4. Infections due to reprocessing breaches and damaged scopes
    2. Guidelines for visual inspection of flexible endoscopes
      1. SGNA
      2. AORN
      3. AAMI/ANSI
    3. Tools and methods for conducting visual exams using borescopes
      1. Purpose of borescope systems
      2. Diameter and length considerations
      3. Steps involved in setting up the borescope
      4. Methods for inspecting the interior of a flexible endoscope
      5. Documenting the findings
      6. Reprocessing and storing borescopes
    4. Interpreting findings of borescope exams
      1. Appearance of new control handles, ports, channels, and distal ends
      2. Potential problems that may be discovered inside endoscopes (e.g., fluid, simethicone, discoloration, damage, debris, and built-up biofilm
    5. Relevance of visual inspection findings
      1. Need for endoscope repair or refurbishment
      2. Outbreaks linked to visually apparent defects and debris inside endoscope channels
    6. Strategies for moving forward
      1. Sizes of borescopes needed
      2. Training and support for persons conducting visual examinations using borescopes
      3. Logistics for conducting borescope examinations
      4. Policies and protocols for responding to findings of visual examinations
    7. Sponsor acknowledgement (Supported by an educational grant from Healthmark)

    Cori L. Ofstead, MSPH

    President & CEO, Ofstead & Associates

    Cori L. Ofstead, MSPH, is an epidemiologist with 30 years of experience designing and conducting studies about the impact of clinical processes on patient outcomes. She has served as the Principal Investigator on numerous studies related to infection prevention, instrument reprocessing, and vaccination against infectious diseases. Ms. Ofstead is nationally recognized for her groundbreaking research, and her studies have been published in peer-reviewed journals including CHEST, AJIC, ICHE, Journal of Hospital Infection, Gastroenterology Nursing, and Vaccine. She currently serves as a reviewer for AJIC, Endoscopy, and the Journal of Urology, and is an active member of the editorial board for AJIC. She has presented the findings of her studies at national and international conferences sponsored by the CDC, APIC, IAHCSMM, AORN, SGNA, AGA, and several universities. In addition, she currently serves as a preceptor for epidemiology students in the School of Public Health at the University of Minnesota.