Antisepsis, Disinfection and Sterilization
Concurrent Education Session - 60 minutes
Cori Ofstead, MSPH
President and CEO
Ofstead & Associates, Inc.
Saint Paul, Minnesota
3M Healthcare: Advisory Committee/Board Member, Consultant/Advisory Board, Other Research Support, Research Grant, Speaker/Honoraria; Advanced Sterilization Products: Advisory Committee/Board Member, Consultant/Advisory Board, Research Grant, Speaker/Honoraria; Ambu, Inc: Consultant/Advisory Board, Other Research Support, Research Grant; Auris Surgical Robotics: Consultant/Advisory Board; Boston Scientific: Consultant/Advisory Board, Research Grant, Speaker/Honoraria; Convergascent: Consultant/Advisory Board; Fortive: Consultant/Advisory Board; Healthmark: Consultant/Advisory Board, Other Research Support, Research Grant, Research Support; Laborie/Cogentix: Advisory Committee/Board Member, Consultant/Advisory Board, Research Grant, Speaker/Honoraria; Medivators: Consultant/Advisory Board, Other Research Support, Research Grant
Current guidelines from several professional associations recommend routine monitoring of endoscope reprocessing effectiveness. Many institutions have begun performing biochemical tests to assess the amount of organic soil remaining after manual cleaning. Some facilities are also conducting microbial cultures to detect bioburden remaining on endoscopes after HLD or sterilization. The results of these tests are frequently surprising, and IPs may be called upon to interpret the findings and evaluate the risk of infection after substantial soil, high colony counts, or potential pathogens are found.
This session will provide an overview of practical methods that can be used to monitor endoscope reprocessing effectiveness, with an emphasis on rigorous methods of sample collection and testing that address the potential for built-up difficult-to-detect biofilm. Participants will hear real-world data illustrating the results for cultures, hemoglobin, protein, and adenosine triphosphate (ATP) tests done on various components of colonoscopes, gastroscopes, duodenoscopes, bronchoscopes, and ureteroscopes.
Case studies will be used to demonstrate the impact of multiple factors on test results, including endoscope age and condition, procedural length and complexity, and methods used for reprocessing. Since tests for organic soil are intended to identify endoscopes that require additional cleaning before HLD or sterilization, case studies will be used to demonstrate the impact of repeated reprocessing. Participants will explore associations between organic soil levels and results of microbial culture and will explain why ATP levels may not correlate with colony counts. The origin and utility of benchmarks will be explained, along with the benefits of conducting positive and negative control tests to contextualize findings.
To support the successful implementation of data-driven quality improvement initiatives, the session will include strategies for interpreting data, assessing risk, and responding to adverse test results to reduce risk and improve outcomes.