Storing endoscopic devices: seven common mistakes and fixes
by Mark Roberts, Product Manager, InnerSpace - a division of Stanley Helathcare
When it comes to endoscopic procedures and the care and storage of endoscopes, maintaining cleanliness and avoiding contamination are the most important issues faced by doctors, nurses and support staff. To maintain cleanliness and reduce the risk of contamination and unnecessary damage, avoid or address these seven mistakes:
Mistake #1: storing dirty scopes
Even the best scope storage system will not prevent infection and the possibility of patient illness or death if a scope is not properly cleaned before it is placed in storage. Endoscopes can be difficult to clean. They require full disassembly prior to cleaning, and must be thoroughly dried prior to storage to ensure proper sterilization and disinfection. Proper cleaning requires aggressive disinfection as well as thorough leak testing before the scope is immersed in fluid. Furthermore, depending on whether a scope is autoclavable or temperature- or moisture-sensitive, it may require ethylene oxide (EO) or gas plasma sterilization. Whichever cleaning process is used, it is imperative that scopes are properly cleaned before being stored.
Mistake #2: a dirty cabinet
The cabinets that are used to store endoscopes must have a regular cleaning protocol, same as the scopes they protect. Endoscopic storage cabinets are specifically designed to store endoscopes as well as protect them from damage and environmental contaminants. With this in mind, these cabinets are engineered to keep scopes from touching each other while in storage, and to minimize the risk of handlers touching other scopes while removing or replacing a scope. To ensure consistently clean scopes, however, storage cabinets must also be cleaned and disinfected on a regular basis.
Mistake #3: damp scopes
Water is a dangerous breeding mechanism for microorganisms. Prior to storage, endoscope moisture must be minimized to prevent the chance of disease-causing microorganisms forming on scope surfaces. A proper high-level disinfection process will ensure that all scopes are cleaned and fully dry prior to storage. Endoscope storage cabinets are now available with built-in fans that help reduce moisture and the likelihood of scope contamination.
Mistake #4: open cabinet doors
Another mistake commonly made by OR staff is not keeping endoscope storage cabinet doors closed at all times. Doors can sometimes get left open in busy procedural settings as it is easier and faster to grab scopes without opening and closing a cabinet door each time. Address this mistake with staff to decrease the risk of contaminants reaching the scopes and causing potential infection.
Mistake #5: lack of circulation
Stagnant air can cause a number of scope storage issues, primarily an increase in the risk of infection. In addition to proper ventilation, some of today’s newest endoscope storage cabinets come equipped with built-in fans as well as HEPA air filters to reduce the likelihood of scope contamination and minimize the risk of case delays. This type of storage ventilation system is also designed to reduce the threat of CRE (Carbapenem-Resistant Enterobacteriaceae), an ongoing concern in the medical community.
Mistake #6: improperly-sized cabinets
Many of today’s latest endoscope designs are longer in length than traditional scope cabinets. This can present a serious problem if scopes are stored in cabinets that are too short and the scope is coming into contact with cabinet surfaces that are not 100 percent cleaned. On the flip side, if a scope is stored in a cabinet that is too long for its length, staff members have to unnecessarily stretch to reach the scope, reducing ergonomics, adding stress, increasing the risk of injury, and at a minimum, wasting time. To address this problem, InnerSpace has recently developed a cabinet designed to accommodate extended-length scopes while maintaining good infection control practices and supporting a microbe-free environment. These cabinets allow staff members, with one hand, to lower the scope head to a reachable level for easy access, eliminating the risk of injury from extreme reaching. With this type of cabinet, scopes of all sizes can be stored in the same designated work area, eliminating the task of gathering case supplies from multiple storage locations.
Mistake #7: improper scope transport
Improper transportation of endoscopes can lead to serious damage. To ensure scope longevity, it is important to transport scopes one at a time, separately from scope accessories. Flexible tubes should always be loosely coiled, as repeated over-coiling or creasing the tube with sharp bends can cause buckling. It is also imperative to separate the light guide connector from the bending section of the tube during transport to reduce the chance of a sharp edge damaging the bending rubber. Contaminated scopes should always be contained during transport to avoid contamination of surrounding environments. There are many endoscope storage cart options available to organize and protect scopes as they move from storage room to procedure room and back again. The newest models feature keyless entry systems, cart access programming, and user management software. These carts are also designed for optimal ergonomics, delivering a small footprint and the ability to move through narrow, crowded hallways and smaller procedure rooms.
While the primary goal of effective endoscope processing is the elimination of disease-causing microorganisms, the proper processing, storage, and handling also contributes significantly to efficient OR workflow and overall operational efficiency.
aei is the exclusive distributor in Southern California of InnerSpace endoscope cabinets. Learn more