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The automated reprocessing of endoscopes is the last step in the whole cleaning process. Removal of the last bacteria is the end goal of the automated reprocessing stage. But, automated reprocessing can only be successful if the endoscope is correctly manually cleaned prior to placing the endoscope into the machine!
In each phase of the endoscope cleaning and disinfecting process there are contamination risks. Some risks during the reprocessing phase are:
- Re-contamination due to poor water and air quality
- Damaging or re-contamination of the endoscope due to transport or touching of the endoscope.
How to control these risks will be explained below!
Automated reprocessing of an endoscope
During the automated reprocessing there will be a LOG 4 up to LOG 6 reduction. When this process is successfully executed, the endoscope will be LOG 0 contaminated.
Be aware: LOG 0 is NOT 0, but still 1
This is important to keep in mind, because re-contamination is still possible.
After the endoscope is disinfected and is entering the rinse & air purge phase, there are a few re-contamination risks. Although the endoscope is clean after the disinfection phase, it could be re-contaminated before leaving the AER. Some potential causes are:
- The water that is used in the disinfection machine to rinse the endoscope after disinfection is poor quality.
- The air used for the air purge is not clean and is poor quality.
How to minimise risk 1
The quality of incoming water
Why is the quality of incoming water important for the automated reprocessing of endoscopes? Well, after the disinfection phase the endoscope is rinsed with water to remove all the chemical leftovers. When this water contains micro-organism, the endoscope gets directly re-contaminated.
The best solution?
Reverse Osmose (RO) water
After sterilized water is Reverse Osmose water the highest possible standard. RO water is created by abstracting proteins and bacteria out of the water with the use of micro filtration systems.
The quality of incoming air
After rinsing the endoscope there follows an air-purge to get as much water as possible out of the endoscope channels. This is done to prepare the endoscope for the drying process. When the air used for the air-purge isn’t filtered to a high standard, then this dirty air can cause re-contamination of the endoscope. Make sure you use high-quality and clean filters and change them frequently.
How to minimise risk 2
By using a cassette system, you can connect the endoscope to the cassette after the manual cleaning and then place the cassette into the AER and afterwards into the drying cabinet, without touching the endoscope.
The advantages of using a cassette system are:
- Less chance of damaging the endoscope
- Less chance of re-contamination
- More ergonomic to work with
- Optimizing the workflow
Summarizing:
The automated endoscope reprocessing is used to remove the last bacteria form and out of the endoscope. Unless, this is executed under the right circumstances since there are always contamination risks.