Endoscope Reprocessing: Problem and trends

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Presentation transcript:

Endoscope Reprocessing: Problem and trends

Difficulty of cleaning and disinfecting endoscopes Due to the endoscope material the endoscope is build with : no heat sterilization Due to the hospital practice and habits Due to the endoscope design

BIOFILM AND ENDOSCOPES Internal surface of a brand new endoscope biopsy channel (Teflon ) 4µm

BIOFILM AND ENDOSCOPES Internal surface of an endoscope biopsy channel after 300 exams (Teflon) 20µm

BIOFILM AND ENDOSCOPES Internal surface of an endoscope biopsy channel after 300 exams (Teflon) 4µm

BIOFILM AND ENDOSCOPES Internal surface of an endoscope biopsy channel after 600 exams (Teflon) 4µm

Where do we come from ? Cleaning only the distal part of the endoscope because endoscopes were not waterproof because the contamination risk was ignored The only thing the doctors cared about was : the reprocessing time between two patients not to damage their endoscopes

New awareness of the contamination risk Changes in the types of germs Changes in the legal responsibility Changes in the types of patients Hepatitis, Aids, multi resistant mycobacteria, SARS, Creutzfeld Jacob (mad cow)…. Elderly people, Immunodepressed patients…. The doctor and the hospital can be sued

New awareness of the chemical risk Skin, eyes and respiratory toxicity: allergy, asthma For the nurse For the patient For the environment Colitis due to improper rinse of the endoscope Non biodegradable disinfectant kills the bacteria used in sewage plants

New risk management for the hospital Need for : More endoscopes Writing and implementation of protocols Evaluation, improvement of these protocols Respect of protocols Traceability In one word : Quality and safety for the patient

New risk management in general New Chemistry New Guidelines & Regulatory New Technologies Need for :