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

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.

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Certificate IAHCSMM
1.00 Contact Hour credit  |  Certificate available
1.00 Contact Hour credit  |  Certificate available Provider approved by IAHCSMM (APPROVAL CODE: Ofstead & Associates, Inc. 191212). This Certificate must be retained by the participant for a period of 3 years after course completion.
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1.00 Contact Hour credit  |  Certificate available Provider approved by CBSPD (APPROVAL CODE: #6419BWCORP19) 2019-2024. This Certificate must be retained by the participant for a period of 5 years after course completion.
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