Challenges in achieving effective high-level disinfection in endoscope reprocessing
| Autor: | Krystina M. Hopkins, John E. Eiland, Brandy L. Buro, Harry P. Wetzler, Cori L. Ofstead |
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| Rok vydání: | 2020 |
| Předmět: |
Quality management
Endoscope Epidemiology Human error Product issues 03 medical and health sciences 0302 clinical medicine Equipment Reuse Humans Medicine 030212 general & internal medicine Endoscopes Cross Infection 0303 health sciences 030306 microbiology Practice patterns business.industry Health Policy Public Health Environmental and Occupational Health Disinfection Infectious Diseases Risk analysis (engineering) Rinse water Equipment Contamination Flexible endoscope business Quality assurance |
| Zdroj: | American Journal of Infection Control. 48:309-315 |
| ISSN: | 0196-6553 |
| Popis: | Endoscope reprocessing is often ineffective, and microbes frequently remain on endoscopes after the use of high-level disinfectants (HLDs). Several factors impact reprocessing effectiveness, including non-adherence to guidelines, use of damaged endoscopes, use of insoluble products during endoscopy, insufficient cleaning, contaminated rinse water, and inadequate drying before storage. Our team suspected that issues with HLD chemistries and monitoring could also contribute to reprocessing failures. We conducted a mixed-methods analysis of published literature, our interviews with frontline personnel, and evidence from our previous studies. The evidence showed that reusable HLDs commonly failed tests for minimum effective concentration (MEC) before their maximum usage periods. MEC tests also detected failures associated with single-use HLDs that did not fully deploy. These failures were due to product issues, process complexities, and personnel non-adherence with guidelines and manufacturer instructions. HLDs will likely continue to be used for the foreseeable future. More research is needed to assess real-world practice patterns related to the high-level disinfection step and MEC testing and to establish more realistic usage periods for reusable HLD chemistries. Manufacturers and researchers should evaluate the ability of technological solutions and engineered safeguards to overcome human error. Recognition of the need for quality improvement is growing, and infection preventionists should take action to build on this momentum and collaborate with manufacturers, endoscopists, and reprocessing personnel to improve the effectiveness of high-level disinfection. |
| Databáze: | OpenAIRE |
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