What are the Guidelines for Processing STERIS Equipment?

Question:

I am employed as an endoscopy nurse at a freestanding endoscopy/surgery facility. For our Fujinon endoscopes, we manually clean first and then the AER, followed by alcohol flush. We follow the current SGNA guideline regarding scope reprocessing.

There is a group within our facility who use Olympus endoscopes, clean manually, then use the STERIS. Their feeling is that the STERIS "blows dry" the scope in the process, therefore not needing an alcohol flush.Also, leak testing for these Olympus scopes are left to the end of the day. This seems in direct opposition to how our endoscopy group has been trained to process scopes. Although we use the AER and are disinfecting, the other group feels the STERIS sterilizes and does not leave water in the scope, therefore no alcohol flush is needed.

Is there any updated information regarding the STERIS process/steps required? I have searched online and have not found much information re: STERIS and steps required.

Should leak testing be done after each use before placing in STERIS? Should an alcohol flush be done after the scope comes out of the STERIS?

Answer from STERIS:

There are two different responses to this question, depending on the STERIS system you are using; Reliance EPS™ Endoscope Processing System (which is a high-level disinfection system) or the STERIS SYSTEM 1® Sterile Processing System.

If you are using the SYSTEM 1 Sterile Processing System:

This is a sterilization process. There is not a drying cycle in the SYSTEM 1 unit. The devices are wet upon completion of the cycle. We do not take a position for or against an alcohol flush for devices processed in SYSTEM 1. However, it is important for the customer to know that alcohol is not sterile. Therefore, STERIS does not specifically recommend it, particularly if the endoscope is going to be used right away. If the intent is to process the scope and let it hang before using it again hours later or the following day, many customers will perform an alcohol flush to facilitate drying so that there is no residual water for microorganisms to grow. With that said, SGNA does have guidelines that advise an alcohol flush. If the facility is following that guidance, STERIS is not indicating that the customer cannot do that. It is perfectly acceptable.

If you are using the Reliance EPS system:

There is an air purge in the Reliance EPS system for the removal of residual water from the process. The Reliance EPS unit performs a high-level disinfection process, so the fact that alcohol is not sterile is of no consequence with this processor. For the Reliance EPS high-level disinfection system, STERIS does not formally recommend an alcohol flush, but is supportive of customers who are adhering to SGNA guidelines with respect to the use of alcohol for drying. Whether they use alcohol or not, the most important aspect is that the customer documents what they are doing in the form of procedures and then follows that.