manual cleaning of scopes

7/30/2019 manual cleaning of scopes

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Ronald Wassenburg

Pre-cleaning, manual cleaning procedures

for flexible endoscopes


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At the end of this presentation you should be able to:

- explore how manual pre-cleaning procedures developed over the

years

- recognize responsibilities regarding manual pre-cleaning

- debate future developments in manual pre-cleaning


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A CHALLENGE THE ENDOSCOPE

INTRODUCTION


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1. Air channel


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Air supply

1. Air channel

2. Water channel


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Pay attention to thedisinfection or

sterilization of the

water bottle

Special care forcleaning the valves

Channels interferingwith each other


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1. Air channel

2. Water channel


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1. Air channel

2. Water channel

3. Biopsy channel

4. Suction channel


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Nozzles: difficult accessibleUse the right brushes

Not all channelscan be brushed


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1. Air channel

2. Water channel

3. Biopsy channel

4. Suction channel


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1. Air channel

2. Water channel

3. Biopsy channel

4. Suction channel

5. Water jet channel

dont forget to flush possible auxilary channels

Elevator channel of a duodenoscope


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THECONSTRUCTION

OF ANENDOSCOPE

A CHALLENGE?

YES!


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Channels interfering each other

Different channel diameters

Different soiling levels

Difficult accessible nozzles


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EVOLUTION

MANUAL PRE-CLEANING AND CLEANING


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2. Leakage test

1. Bed side cleaning (wiping)

3. Manual pre-cleaning


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4. Cleaning

5. Disinfection

6. Rinses

preferred

preferred

preferred


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BEDS

IDECLEANIN

G

LEA

KAGETEST

PRE-CLEANING

CLE

ANING

DIS

INFECTION

RIN

SES

20XX1990 2012


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HOW CAN STANDARDS HELP US?

MANUAL PRE-CLEANING PROCEDURES


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The Standard for Endoscope Reprocessing

ISO 15883

- Requirements for EWDs

- Instructions on how to use those

Not easy to understand!


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NATIONAL GUIDELINES

Like the SFERD PROFESSIONAL

STANDARD HANDBOOK

http://www.infectiepreventieopleidingen.nl/do

wnloads/SFERD_handbook_2011.pdf

Practical national guidelines


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THE SFERD PROFESSIONAL STANDARD HANDBOOK:

1. LEADERSHIP: VISION AND ORGANIZATION

2. STRATEGY & POLICY

3. HUMAN RESOURCE MANAGEMENT

4. RESOURCE MANAGEMENT

5. PROCESS MANAGEMENT

6. APPRECIATION BY CUSTOMERS

7. APPRECIATION BY HEALTH CARE STAFF

8. APPRECIATION BY SOCIETY

9. RESULTS

10. IMPROVEMENT AND INNOVATION BYAUDIT & CONTROL

APPENDIXES

Responsibilities!


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9. RESULTS


APPENDIXES

Advice on room interior


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9. RESULTS


APPENDIXES

!!!


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PRACTICAL EXAMPLE OF AN OPTIMUM

ENDOSCOPE REPROCESSING DEPARTMENT

ENDOSCOPE REPROCESSING ON THE HIGHEST LEVEL


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After the procedure the endoscope is transported in aspecial transport tray to the central endoscope

reprocessing department and with the usage of a pass

through door placed into the reprocessing area.


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State-of-the-art pre-cleaning: the basin can be filledhandsfree and the detergent is dosed automatically. Ofcourse after the manual leakage test is performed.


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Using ISO 15883 compliant (passthrough) systems for automatic

endoscope reprocessing. The

reprocessing room is separated by the

machines into a contaminated andclean area.


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The processes in the endoscope washer disinfector can beremotely monitored with traceability and registrationsoftware.


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The pass through principle: after thecycle in the pass through EWD is

finished successfully, the endoscope can

be unloaded on the other side of the

machine (clean area).


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On the clean side the

hospital applied a

strict hygienic

regime, to ensure

that once the

endoscope has

its reprocessed anddisinfected status, it will

keep it!


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After unloading from the EWD, the endoscope is placed

for drying in one of the drying cabinets.


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or the endoscopes is directly needed

within another procedure and with the

use of the transport system through

anothor pass through door safely

transported to the treatment rooms.


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CONCLUSION

PRE-CLEANING, MANUAL PROCEDURES FOR FLEXIBLE ENDOSCOPES


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Pre-cleaning, manual cleaning procedures

for flexible endoscopes: more and more automated.

Critical factors success:

- Perfect controlled endoscope logistics

- Implementing quality assurance systems


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Ronald WassenburgManaging Director of Wassenburg Medical Devices B.V., The Netherlands

Representative of the Dutch normalization committee, in the ISO TC198 working group 13

Active member of the Dutch Sterilisation and Sterility (NEN) normalization committee

THANK YOU FOR YOUR ATTENTION!


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NEN-EN-ISO 15883-1 (en): Washer-disinfectors - Part 1: General requirements, terms and definitions and tests (ISO

15883-1:2006,IDT) (EUROPEAN COMMITTEE FOR STANDARDIZATION)

NEN-EN-ISO 15883-4 (en): Washer-disinfectors - Part 4: Requirements and tests for washer-disinfectors employing

chemical disinfection for thermolabile endoscopes (ISO 15883-4:2008,IDT) (EUROPEAN COMMITTEE FOR

STANDARDIZATION)

Technical Specification ISO/TS 15883-5 : Washer-disinfectors Part 5: Test soils and methods for demonstrating

cleaning efficacy (EUROPEAN COMMITTEE FOR STANDARDIZATION)

Health Technical Memorandum 2030: Washer-disinfectors, Design considerations (London: The Stationery Office) Health Technical Memorandum 2030: Washer-disinfectors, Operational management (London: The Stationery Office)

Health Technical Memorandum 2030: Washer-disinfectors, Validation and verification (London: The Stationery Office)

PROFESSIONAL STANDARD HANDBOOK FLEXIBELE ENDOSCOPES - Cleaning and Disinfection: Dutch Advisory

Board Cleaning and Disinfection Flexible Endoscopes (SFERD)

Leitlinie zur Validierung maschineller Reinigungs- Desinfektions- prozesse zur Aufbereitung thermolabiler Endoskope

(German working group under the supervision of: Schmidt V. (AKI), Beilenhoff U. (DEGEA), Jones A. (DGSV), Krger

S. (DGKH))

Cleaning and disinfection endoscopes (Infection Prevention Working Party (WIP))

Proper Maintenance of Instruments - Red Brochure (Arbeitskreis Instrumenten-Aufbereitung [Instrument Preparation

Working Group])

ISO (International Organization for Standardization) http://www.iso.org/iso/home.html

FDA (U.S. Food and Drug Administration) http://www.fda.gov/

User manual of the endoscope

manual cleaning of scopes

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