1. Infection Control in the GI Setting
Lisa Maslak BSN, RN, CIC
Director of Infection Control
Brooks Memorial Hospital

2. Why is it so important?

3. Microbial Transmission to Patients
Most cases of microbial transmission to patients, via contaminated endoscopes, are a result of nonadherence to reprocessing guidelines
Patients can be exposed to multiple organisms, both bacterial and viral. Pseudomonas, Serratia, Proteus, Staph, Clostridium difficile and more.

4. Guidelines

6. Reprocessing Errors
Not removing patient biomaterial immediately after a procedure
*dries and hardens making it difficult for disinfectants and sterilizing agents to penetrate and kill microorganisms
Did you know? Patient biomaterial can inactivate disinfectants?

7. Not cleaning all channels… including unused ones
*Fluid and debris can enter the channels at the distal tip

8. Not soaking in appropriate enzymatic detergent when pre-cleaning is not initiated within one hour
*debris dries and hardens
Why would this happen?

9. Using worn or damaged channel brushes
*ineffective cleaning or damage to the channels. The brush has to contact the channel wall to cause abrasion and remove debris.

10. Failure to fully submerge the scope in the disinfectant for the required amount of time.
*timing is important-use a timer
too little- not clean enough
too much-can damage scope
not submerged-residual debris

11. Not rinsing with water
*residual detergent can interfere with disinfectant solution which can inhibit or cause staining. Can cause chemical irritation to the patient.

12. Not storing scopes in clean, dry, and well-ventilated area
*minimize the possibility of recontamination. Remove all valves and caps during storage. Do you use distal tip protectors?

13. Cleaning Verification
The scope is free of damage and debris before being high level disinfected.

14. Visual inspection-can use lighted magnifier
Examine inside of scope with borescope

15. Check for residual blood, protein or organic matter
Verification Tests
Check for residual blood, protein or organic matter
Chemistry
ATP swab test
Can be done by the tech after manual cleaning either periodically or routinely.

16. Hang scopes vertically in a clean, well-vented, dust free area
Hang scopes vertically in a clean, well-vented, dust free area. They MUST be dried prior to storing.
Reprocess after 7 days-label
Remove buttons, caps, valves, or any removable parts. Store together for tracking. Consider disposable.

17. Option B
Disposable scopes-FDA approved
-pros and cons
Sterile sheaths

18. Environmental Cleaning
Surfaces should be cleaned with an EPA disinfectant
Contact time
Between cases
Terminal

19. PPE Gown, gloves and mask
when directly involved in the endoscopy, or any procedure that splashing or contamination is possible
Remove prior to leaving procedure area

20. Device Failures Report any device failure to the manufacturer or FDA
Keep logs

21. Hand Hygiene Soap and water or hand sanitizer No artificial nails
Nail polish
Remove jewelry

22. Medication Handling Single patient use vials Multi dose vials
Aseptic technique
Prep area
Syringe use

23. Staff
Staff training
Staff competency
Staff accountability

24. Infection Prevention Champions
Check the SGNA website for information on the Infection Prevention Champion program.
Resources and support for those interested in this area

25. Quality Assurance
Audits
logs, refrig,
outdates

26. Thank you Questions?