This module looks specifically at endoscope decontamination. Its focus is on cleaning and leak testing of flexible endoscopes and cleaning of rigid endoscopes. High level disinfection of flexible endoscopes and sterilization of rigid endoscopes is included.
Introduction to Endoscopes
Flexible and rigid endoscopes, single use and reuseable devices. Explanation of the basic design features of a variety of some flexible endoscopes ; gastroscopes, colonoscopes, bronchoscopes, thoracoscopes, nasendoscopes, cystoscopes.
Overview of the endoscope decontamination process
The reprocessing pathway from theatre through the Endsoscope Reprocessing Unit (ERU). Manual cleaning (pre-cleaning) and inspection/testing of endoscopes, automated endoscope reprocessing (AER) (washer disinfection process), inspection and handling post post AER, drying cabinets and the storage and transport of endoscopes to theatre.
Chemical agents used in Endoscope reprocessing
The chemistry of the cleaning and disinfectant agents used in the endoscope reprocessing unit; detergents, aldehydes, peracetic acid, isopropanol, enzymatic and non-enzymatic cleaning agents, etc. Residual testing and Safety considerations in the storage, transport, use and disposal. Chemical spillage, leak, fire and accident risk and emergency response.
Infectious risks associated with endoscopy
Infectious risks associated with ERUs: CRE, VRE, MRSA, C. diff, agents of tuberculosis, Hepatitis and HIV, Transmissible Spongiform Encephalopathies. Risks and precautionary practices when on contact with fecal matter, blood and body fluid residues. Sharps risks, precautions and emergency response. Case Studies involving adverse chemical events and infections associated with endoscope use.
Aseptic practices in Endoscope decontamination units
Gowning and PPE necessary for aseptic practice in ERUs. Aseptic practice requirements in the transportation and handling of used endoscopes from theatre to the ERU. Contamination control during considerations in manual washing and leak tests. Summary of the endoscope decontamination pathway with an emphiasis on the contamination risks at each stage in the process. Facility cleaning and disinfection within the ERU. Aseptic management of the endoscopes and accessories used in the cleaning process.
Design considerations for Endoscope decontamination units
Optimal design of endoscope decontaminaton units minimising the potential for cross-over contamination events. Layout of the area, positioning of access points, equipment including sinks, benchtops, storage units Automate Endoscope Reprocessing (AER) machines and drying cabinets. Revew of utility supplies within the unit (Reverse Osmosis (RO) or purified water), gases and air flitration and ventillation. Management of traffic through the unit, ventilation and waste management. Air quality and aseptic containment measures post-processing. Review of the experiences of participants.
Irish standards and international best practice in endoscopy
Classification of endoscopes as medical devices and corresponding decontamination requirements. JAG and the Irish HSE Standards and Recommendations for Endoscope Reprocessing Units. Summary recommendations to minimise risk of transmission of infections associated with reusable medical devices.
Sampling testing and surveillance used in endoscopy units
The purpose of Testing Endoscopes and AERs. Manual and automated Endoscope leak tests. Testing of rinse water from empty AERs. Testing Air post AER. Maximal permissible levels of residual chemicals and microorganisms. Monitoring RO Water supplies to AERs and Air Quality in drying cabinets
Use and Validation of automated endoscope reprocessing devices
Overview of the purpose of validation. Review of the design specifications of an AER. Outline of the validation process and interpretation of validation reports.
| Module Content & Assessment | |
|---|---|
| Assessment Breakdown | % |
| Other Assessment(s) | 50 |
| Formal Examination | 50 |