By Kelly Pyrek
The following is an executive summary of the special report, "Best Practices for High-Level Disinfection and Sterilization," sponsored by Advanced Sterilization Products. The report addresses medical devices overall, as well as a special focus on scope cleaning, disinfection and sterilization.
As the "Multisociety Guideline on Reprocessing Flexible GI Endoscopes" (updated in the summer of 2011) acknowledges, "The beneficial role of GI endoscopy for the prevention, diagnosis, and treatment of many digestive diseases and cancer is well established. Like many sophisticated medical devices, the endoscope is a complex, reusable instrument that requires reprocessing before being used on subsequent patients. The most commonly used methods for reprocessing endoscopes result in high-level disinfection.
To date, all published occurrences of pathogen transmission related to GI endoscopy have been associated with failure to follow established cleaning and disinfection/sterilization guidelines or use of defective equipment. Despite the strong published data regarding the safety of endoscope reprocessing, concern over the potential for pathogen transmission during endoscopy has raised questions about the best methods for disinfection or sterilization of these devices between patient uses… Additional outbreaks of infection related to suboptimal infection prevention practices during endoscopy or lapses in endoscope reprocessing have been well publicized. In some instances, risk of infection transmission has been linked to less willful, but incorrect, reprocessing as a result of unfamiliarity with endoscope channels, accessories, and the specific steps required for reprocessing of attachments. Recent on-site ambulatory surgery center surveys confirm widespread gaps in infection prevention practices."