Patient safety and reprocessing: A usability test of the endoscope reprocessing procedure

Abstract

When endoscopes are reprocessed correctly, endoscopy is a safe procedure. Recent incidents of insufficient reprocessing, however, have resulted in public concern. Results of a usability test of the reprocessing procedure identified that none of 24 users, naïve to the procedure, could reprocess endoscopes correctly, nor could they correctly complete any of the component tasks in the procedure. Five of the 76 subtasks were identified as particularly critical. These were 1) brushing the instrument channel, 2) attaching the channel plug and injection tube, 3) identifying leaks, 4) blowing water out of the endoscope's internal channels during high‐level disinfection, and 5) aspirating solution through the endoscope to remove debris loosened by brushing. Additionally, three themes were identified as causes of the majority of problems: 1) lack of visibility, 2) high memory demands, and 3) insufficient user feedback. Design recommendations for these problems are discussed. © 2012 Wiley Periodicals, Inc.

Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5‐year experience in an endoscopy center

“…26,27 Despite established processing guidelines, high rates of noncompliance to the reprocessing process remain. 13,28 A lack of regular evaluation of reprocessing staff competence (60%) and regular microbiological inspection (56%) 29,30 in the endoscopy unit was previously shown to result in guideline noncompliance. Education of endoscopy staff was shown to decrease the rate of endoscope contamination after high-level disinfection.…”

Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5 year-experience in an endoscopy center

“…Despite established processing guidelines, high rates of non-compliance to the reprocessing process remain [13,28]. A lack of regular evaluation of reprocessing staff competence (60%) and regular microbiological inspection (56%) [29,30] in the endoscopy unit was previously shown to result in guideline non-compliance. Education of endoscopy staff was shown to decrease the rate of endoscope contamination after high-level disinfection [19,27].…”

“…Thus, in 2018, a lack of familiarity with the new system and a mixture of different endoscope modes (Olympus 260 model and Olympus 2290 model ) were attributed to the increased incidence of human error in our endoscopy unit. This obvious challenge in the current endoscopy reprocessing procedures [30][31][32] was not addressed in the recent endoscopy reprocessing guidelines [1,2]. A wide variety of devices continually require reprocessing in the endoscopy unit, and technicians need to identify each type, brand, and model of endoscope and apply appropriate reprocessing procedure.…”

A Health System’s Preparedness for the “Next Ebola”

“…First, more than once we observed a simulated Ebola patient vomiting as she was transported down a hallway where real patients were sitting. Second, involving all types of health care providers facilitated our observing support services (often not part of medical simulation exercises; see Jolly et al, 2012), such as housekeeping and security. Housekeepers were noted to be unfamiliar with the donning-and-doffing process, and security staff were uncertain as to whether or not they needed to don PPE.…”