CONTINUING EDUCATION
Back to Basics: Flexible Endoscope
Processing 1.6
www.aornjournal.org/content/cme
LISA SPRUCE, DNP, RN, CNS-CP, CNOR, ACNS, ACNP, FAAN
Continuing Education Contact Hours
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indicates that continuing education (CE) contact hours are
available for this activity. Earn the CE contact hours by
reading this article, reviewing the purpose/goal and objectives,
and completing the online Examination and Learner
Evaluation at http://www.aornjournal.org/content/cme. A score
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Conflict-of-Interest Disclosures
The contact hours for this article expire May 31, 2019.
Pricing is subject to change.
Purpose/Goal
To provide the learner with knowledge of best practices related
to flexible endoscope processing.
AORN is provider-approved by the California Board of
Registered Nursing, Provider Number CEP 13019. Check
with your state board of nursing for acceptance of this activity
for relicensure.
Lisa Spruce, DNP, RN, CNS-CP, CNOR, ACNS, ACNP,
FAAN, has no declared affiliation that could be perceived as
posing a potential conflict of interest in the publication of this
article.
The behavioral objectives for this program were created by
Helen Starbuck Pashley, MA, BSN, CNOR, clinical editor,
with consultation from Susan Bakewell, MS, RN-BC,
director, Perioperative Education. Ms Starbuck Pashley and
Ms Bakewell have no declared affiliations that could be
perceived as posing potential conflicts of interest in the
publication of this article.
Objectives
1. Discuss common areas of concern that relate to perioperative best practices.
2. Discuss best practices that could enhance safety in the
perioperative area.
3. Describe implementation of evidence-based practice in
relation to perioperative nursing care.
Sponsorship or Commercial Support
No sponsorship or commercial support was received for this
article.
Disclaimer
Accreditation
AORN is accredited as a provider of continuing nursing
education by the American Nurses Credentialing Center’s
Commission on Accreditation.
AORN recognizes these activities as CE for RNs. This
recognition does not imply that AORN or the American
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mentioned in the activity.
http://dx.doi.org/10.1016/j.aorn.2016.03.002
ª AORN, Inc, 2016
www.aornjournal.org
AORN Journal j 489
Back to Basics: Flexible Endoscope
Processing 1.6
www.aornjournal.org/content/cme
LISA SPRUCE, DNP, RN, CNS-CP, CNOR, ACNS, ACNP, FAAN
ABSTRACT
Flexible endoscopes are important tools in patient care, yet recent outbreaks of infections in patients
who have undergone endoscopic procedures have increased awareness of how the complex design
of these instruments makes them difficult to clean. This Back to Basics article focuses on flexible
endoscope processing and provides sterile processing, endoscopy, and perioperative team members
with strategies for successful processing of these instruments. AORN J 103 (May 2016) 490-496.
ª AORN, Inc, 2016. http://dx.doi.org/10.1016/j.aorn.2016.03.002
Key words: flexible endoscopes, processing, infection, cleaning.
I
n 2015, the Centers for Disease Control and Prevention
joined forces with the Los Angeles County Health
Department to investigate a cluster of patients infected with
carbapenem-resistant Enterobacteriaceae (CRE) after exposure to
contaminated duodenoscopes.1 This is just one example of a
recent investigation; previous investigations of CRE outbreaks
related to duodenoscopes have revealed breaches of approved
cleaning protocols, although some have not found breaches in
duodenoscope reprocessing.1 This emphasizes the risk that
patients face when undergoing flexible endoscopic procedures.
Some patients who have undergone these procedures have been
infected with antibiotic-resistant organisms that have caused
significant medical problems and, in some instances, death.1
The US Food and Drug Administration (FDA) has identified
critical lapses in endoscope processing and a failure to follow
the manufacturer’s instructions for use (IFU) as contributing
factors to these infections.2 Flexible endoscopes can become
contaminated with tissue and body fluids, and the complex
design of some flexible endoscopes does not allow for adequate
cleaning of certain parts of the device.3 When there is
inadequate cleaning and processing of the endoscopes,
transmissible infections can occur.
AORN recently published its updated, evidence-rated
“Guideline for processing flexible endoscopes”4 that provides
guidance to endoscopy, perioperative, and sterile processing
personnel for processing flexible endoscopes and their
accessories. The guideline discusses the complex design of
flexible endoscopes and provides guidance on how personnel
can clean and process them effectively. This Back to Basics
article highlights the flexible endoscope processing cycle
(Figure 1). For a complete, in-depth look at this topic,
readers should refer to the guideline in its entirety.
HOW-TO GUIDE
It is imperative that personnel who process flexible endoscopes
follow the manufacturer’s IFU and the steps in the endoscope
processing cycle listed as follows:
precleaning at the point of use;
transporting, leak testing, cleaning, and inspecting;
using high-level disinfection or liquid chemical sterilization,
or packaging and sterilizing the endoscope; and
storing the endoscope correctly.4
Additionally, because of the complexity of these devices and
the difficulty in cleaning them, it is imperative that all
personnel responsible for processing endoscopes undergo
specific education and competency verification related to best
practices for processing flexible endoscopes.4
http://dx.doi.org/10.1016/j.aorn.2016.03.002
ª AORN, Inc, 2016
490 j AORN Journal
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May 2016, Vol. 103, No. 5
Back to Basics: Flexible Endoscope Processing
precleaning the endoscope’s water, air, and other channels by
alternately flushing them with the cleaning solution and air;
inspecting the endoscope visually for damage; and
discarding the cleaning solution and used cloths or sponges.4
Transporting
Endoscopes should be safely transported from the procedure
room to the endoscopy processing room as soon as possible after
use.4 To accomplish this, transport personnel should keep the
endoscopes and accessories wet or damp but not submerged
in liquid during transport. Personnel must transport the
endoscopes in a closed container or closed transport cart that
is leakproof, puncture resistant, and large enough to contain
all contents.5 In addition, transport personnel
Figure 1. The flexible endoscope processing cycle. All
instruments, whether purchased, loaned, or returned
from repair, are leak tested first. The Roman numerals
indicate the recommendation number in the guideline
where detailed guidance and discussion of the evidence
is provided. Reprinted with permission from Guideline
for processing flexible endoscopes. In: Guidelines for
Perioperative Practice. Denver, CO: AORN, Inc; 2016.
Precleaning
Precleaning the endoscope (ie, cleaning it at the point of use,
immediately after the procedure and before it is transported to
the endoscopy processing room) helps to moisten, dilute,
soften, and remove debris that accumulates during the procedure and reduces the formation of biofilm; this, in turn,
helps to improve the final cleaning process. The perioperative
RN, scrub person, or endoscopy technician should begin
cleaning as soon as the endoscopist completes the procedure
and before organic material has dried in the channels or on the
surface of the endoscope.5 The team member responsible for
precleaning at the point of use should perform this in
accordance with the manufacturer’s IFU.4 Precleaning steps
may include
preparing a fresh solution of the cleaning product recommended by the manufacturer;
washing the exterior surfaces of the endoscope with a soft,
lint-free cloth or sponge that has been saturated with the
cleaning solution;
suctioning the cleaning solution through the biopsy and
suction channels;
placing the distal end of the endoscope into the cleaning
solution and suctioning the solution through the scope;
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must label the transport cart with an orange or orange-red
biohazard label,5
should transport the endoscope horizontally rather than
suspended,4 and
should transport accessories with the endoscope but in a
separate container.4
When delivered to the decontamination area, personnel should
process the endoscope and accessories as soon as possible after
arrival in the endoscopy processing room.4 If there is a delay in
initiating processing, personnel should follow the
manufacturer’s IFU for delayed processing.4 Endoscopy and
sterile processing personnel should collaborate to develop and
implement a procedure for recording the times when the
procedure is completed and when the cleaning is initiated.4
Leak Testing
Not every endoscope requires leak testing. Leak testing is a
procedure that detects openings in the internal channels or
surfaces of the endoscope that could permit chemicals, water, or
organic matter to enter a portion of the endoscope not intended
for fluids.4 Leak testing helps to decrease patients’ risk of
infection or injury as a result of using an endoscope that is not
completely sealed and may also reduce repair costs by
preventing damage that might occur during the cleaning
process if the endoscope has been compromised.4 Sterile
processing personnel should perform leak testing according to
the endoscope manufacturer’s IFU and should also perform
leak testing before placing the endoscope into the cleaning
solution and before manually cleaning it.4 Steps for leak
testing may vary between manufacturers but should include
pressurizing the endoscope to the recommended pressure;
placing the endoscope in a loose configuration (eg, not
kinked or coiled tightly);
AORN Journal j 491
Spruce
manipulating all moveable parts, angulating the bending
section of the distal end, and actuating video switches; and
maintaining pressure and inspection for a minimum of 30
seconds.4
When an endoscope fails a leak test, it should be removed
from service and replaced or repaired.4
Cleaning
Perhaps the most important step in the processing cycle is for
personnel to manually clean the endoscope.5 Some flexible
endoscopes contain several ports and channels that can
acquire high levels of microbial contamination.4 Effective
cleaning helps to reduce the bioburden to a level that does
not pose a sterilization or high-level disinfection challenge in
the subsequent processing steps.4 Personnel should follow
these manual cleaning steps:
Clean the endoscope as soon as possible after leak
testing and in accordance with the endoscope manufacturer’s IFU.4
Use the type of water and cleaning solution recommended
by the endoscope manufacturer.4
Use a freshly prepared cleaning solution, and use a clean
solution for every new cleaning process to help prevent crosscontamination.4
Do not add additional products to the cleaning solution
unless recommended by the manufacturer.4
Follow the cleaning solution manufacturer’s IFU for
o water quality, hardness, and pH;
o solution concentration and dilution;
o water temperature;
o contact time;
o conditions of storage;
o the defined period for the safe use of a cleaning product
after opening the container (ie, use life); and
o the period of time during which a stored cleaning product
remains effective, useful, or suitable for use (ie, shelf life).4
An automated titration unit may be used to concentrate
cleaning chemicals at a consistent ratio. Personnel should
change cleaning solutions when the temperature of the
solution does not meet the temperature specified in the
manufacturer’s IFU.4 Personnel should completely
submerge the endoscope in the cleaning solution during
the cleaning process and clean all exterior surfaces of the
endoscope (Figure 2) with a soft, lint-free sponge or cloth
saturated with the cleaning solution.4 This helps to
remove any material left after precleaning. In addition,
personnel should
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May 2016, Vol. 103, No. 5
brush all accessible channels and the distal end of the endoscope with a cleaning brush of the width, length, and material
recommended by the endoscope manufacturer (Figure 3);4
manually actuate the endoscope’s valves while cleaning;4
clean and brush the elevator mechanism and the recesses
surrounding it with a cleaning brush of the width, length,
and material recommended by the manufacturer;4
raise and lower the moveable elevator at the distal end of the
endoscope, if present (Figure 4), throughout the manual
cleaning process to help ensure no organic debris is lodged
in the moving part and to allow for more effective cleaning;4
use a clean brush for each endoscope cleaning;4
visually inspect the brush and do not use it if the integrity of
the brush is in question;4
brush the accessible channels of the endoscope several times
until there is no debris present on the brush;4
use new lumen cleaning technologies, if compatible with
the endoscope, because they may be less damaging to the
internal lumens;4
flush the endoscope channels with the cleaning solution;4
flush and rinse the external surfaces and internal channels
with utility water (ie, tap water) until all cleaning solution
and residual debris are removed;4
dry the exterior surface of the endoscope with a lint-free
cloth and purge all channels with instrument air4 (ie, a
medical gas that is not respired, is filtered to 0.01 micron,
is free of liquids and hydrocarbon vapors, and is dry to a
dew point of e40 F [e40 C]);6
clean, brush, rinse, and process reusable parts such as water
bottles, tubing, port covers, and accessories such as forceps
and cleaning brushes;4
sterilize or high-level disinfect water bottles at least daily,
using sterile water to fill the bottle;4 and
use single-use components and accessories if compatible with
the scope and discard all single-use components after use.4
Inspecting
An inspection of the scope helps to identify any residual
organic residue that may remain on the endoscope or any
damage that may need to be repaired.4 Personnel should
visually inspect all new, used, refurbished, repaired, and
loaned endoscopes, accessories, and other equipment
according to the manufacturer’s IFU and evaluate them for
cleanliness,
clarity of lenses,
missing parts,
moisture,
integrity of seals and gaskets,
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May 2016, Vol. 103, No. 5
Back to Basics: Flexible Endoscope Processing
Figure 2. All exterior surfaces of the endoscope should be cleaned with a soft, lint-free sponge or cloth saturated
with the cleaning solution. Reprinted with permission from Guideline for processing flexible endoscopes. In:
Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2016.
correct functioning, and
defects.4
High-Level Disinfection or Liquid
Chemical Sterilization
Personnel should use lighted magnification for the inspection
and inspect internal channels using an endoscopic camera or
borescope (ie, a device used to inspect the inside of an instrument through a small opening or lumen of the instrument).4 Personnel should replace or repair any defective
scopes, equipment, or accessories.4
Following the manufacturer’s IFU for manual cleaning,
personnel should either mechanically clean and mechanically
process endoscopes by exposure to a high-level disinfectant or
liquid chemical sterilant, or mechanically clean and sterilize
endoscopes and accessories.5 Mechanical processing should be
performed in accordance with the endoscope and mechanical
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AORN Journal j 493
Spruce
May 2016, Vol. 103, No. 5
Figure 3. All accessible channels and the distal end of the endoscope should be brushed with a cleaning
brush of the width, length, and material recommended by the endoscope manufacturer. Reprinted with permission
from Guideline for processing flexible endoscopes. In: Guidelines for Perioperative Practice. Denver, CO:
AORN, Inc; 2016.
processor manufacturers’ IFU.4 Processing personnel should
verify that the endoscope and the processor are compatible
before use and position the endoscope and its accessories in
the mechanical processor so that the processing solutions
come into contact with all surfaces of the endoscope.4 In
addition, all connectors between the endoscope and the
processor should be connected correctly.4
Processing personnel should monitor mechanical processing
cycles to verify that they are completed as programmed.4
When using mechanical processing, it should be performed
using water that is extensively treated to remove
microorganisms and other materials (ie, critical water).4
Cleaning, sterilant, and disinfectant solutions and chemicals
recommended by the endoscope manufacturer and the
mechanical processor manufacturer should be used.4 Do not
use the following for processing endoscopes:
skin antiseptics,
hypochlorites,
phenolics, or
quaternary ammonium compounds.4
494 j AORN Journal
Solutions and chemicals should be used at the volume, concentration, temperature, and contact time recommended by
the mechanical processor manufacturer.4
After high-level disinfection or liquid chemical sterilization,
personnel should mechanically rinse and flush the endoscope
and its channels with sterile or critical water; they should rinse
and dry all removable parts and may mechanically or manually
flush lumens with 70% to 90% ethyl or isopropyl alcohol.4
Alcohol facilitates drying by binding the residual water and
enhancing its evaporation. It also prevents the colonization
and transmission of waterborne bacteria.4 However, flushing
endoscope lumens with alcohol may not be necessary if
the endoscope is effectively dried. This practice is not
recommended in some countries because of the fixative
properties of alcohol.4
The exterior surfaces of the scope should be dried with a soft,
lint-free sponge or cloth, and the channels should be dried by
purging with instrument air or mechanically dried with a
mechanical processor drying system.4
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May 2016, Vol. 103, No. 5
Back to Basics: Flexible Endoscope Processing
available, personnel should store the endoscope in a closed
cabinet with high-efficiency particulate arrestanceefiltered air
that provides positive pressure and allows air circulation.4
Endoscopes should not be stored in the original shipment
case.4 They should either be stored in a cabinet that is of
sufficient height, depth, and width to allow the endoscope to
hang vertically without coiling or touching the bottom of the
cabinet or be stored in a cabinet designed and intended for
the horizontal storage of flexible endoscopes.4
Flexible endoscopes should be stored with all valves open and
removable parts detached and stored with the endoscope.4 The
endoscope should be clearly identifiable as processed and ready
for use with a distinct visual cue.4 Personnel should
wear clean gloves when transporting scopes to and from the
cabinet and
visually inspect endoscopes and storage cabinets for cleanliness before endoscopes are placed into or removed from
storage.4
Figure 4. Some duodenoscopes have a moveable
elevator channel at the distal end that allows accessory
instruments to access the biliary and pancreatic ducts.
Reprinted with permission from Guideline for processing flexible endoscopes. In: Guidelines for
Perioperative Practice. Denver, CO: AORN, Inc; 2016.
A multidisciplinary team should establish a policy to determine
the maximum storage time that endoscopes are considered safe
to use without reprocessing.4 The evidence regarding the
maximum safe storage time for processed flexible endoscopes
is inconclusive.4 Professional organizations’ recommended
storage times range from three hours to 30 days.4 More
detailed information on the evidence regarding the maximum
safe storage times for processed endoscopes can be found in
the AORN “Guideline for processing flexible endoscopes.”4
Packaging and Sterilization
BENEFIT
Endoscope accessories that enter sterile tissue or the vascular
system should be packaged and sterilized.4 Sterilization
procedures for flexible endoscopes should be performed in
accordance with AORN’s “Guideline for selection and use
of packaging systems for sterilization”7 and “Guideline for
sterilization.”8
Endoscopes are used in identifying and treating diseases and
are highly beneficial to patients. Meticulous adherence to
evidence-based clinical practice guidelines benefits patients by
helping to decrease the risk of exposure to potentially
dangerous pathogenic microorganisms transmitted via flexible
endoscopes. Understanding the complexity of these instruments and how to clean, process, and store flexible endoscopes in compliance with manufacturers’ IFU and
guidelines from professional organizations benefits patients
and perioperative, endoscopy, and sterile processing team
members by providing clean, safe endoscopes for use.
Storage
Flexible endoscopes should be stored in a manner that minimizes their contamination and protects them from damage.4
Personnel should store endoscopes in accordance with
endoscope and cabinet manufacturers’ IFU. Storage cabinets
should have doors and be located at least three feet from any
sink.4 Personnel should store flexible endoscopes in a drying
cabinet.4 Drying cabinets include a drying system that
circulates high-efficiency particulate arrestanceefiltered air
through the cabinet while filtered air under pressure is forced
through the endoscope channels.4 If no drying cabinet is
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STRATEGIES FOR SUCCESS
To help ensure that patients are receiving care in a clean, safe,
environment, it is critical that professionals follow evidencebased practices consistently every time they use, clean, or
process flexible endoscopes. To do this, AORN’s “Guideline
for processing flexible endoscopes”4 recommends the
following practices.
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Spruce
Personnel should process flexible endoscopes in an area
constructed and designed for that purpose.4
After precleaning at the point of use, cleaning and processing
should occur in a room that is not used for any other purpose and is physically separated from locations where patient
care is being performed.4
Endoscope reprocessing may occur in a single room or two
separate rooms.4
o In a one-room design, a minimum of three feet should
separate the decontamination area and clean work area.4
There should be a door that provides access to and from the
decontamination area and a separate door that provides access to and from the clean area.4
There should be a unidirectional workflow from the
decontamination area to the clean area and to clean storage
in a separate location.4
Heating, ventilation, and air conditioning systems for
endoscopy suites should be designed according to state and
local building codes and guidelines set forth by the Facility
Guidelines Institute9 and the American Society of Heating,
Refrigerating, and Air-Conditioning Engineers.10
Hand hygiene stations should be provided, and a minimum of two
decontamination sinks (or one sink with two divisions) should be
provided in the decontamination area of the endoscopy processing
room.4 Sinks should be deep enough to allow the complete
submersion of the endoscope and large enough to allow the
endoscope to be positioned in the sink without tight coiling.4
Instrument air should be provided in the endoscopy processing
room.4 Team members who are processing flexible endoscopes
should receive initial and ongoing education and complete
competency verification activities that address protocols for
controlling and maintaining a safe environment,
precleaning at the point of use,
transporting,
leak testing,
manual cleaning,
inspecting,
high-level disinfection or liquid chemical sterilization,
packaging and sterilization,
maintaining records of processing and procedures for traceability, and
quality assurance measures.4
WRAP-UP
The FDA has issued a safety communication and alert to
all health care providers regarding endoscopes and their potential
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May 2016, Vol. 103, No. 5
to infect patients with pathogenic, drug-resistant organisms.11 It
is a call to action to all health care providers to follow
manufacturers’ IFU and evidence-based guidelines to help
decrease risk to patients and protect them from potential harm.
References
1. Healthcare-associated infections (HAIs): CDC Statement Los Angeles
County/UCLA investigation of CRE transmission and duodenoscopes. Centers for Disease Control and Prevention. http://
www.cdc.gov/hai/outbreaks/cdcstatement-LA-CRE.html. Updated
November 16, 2015. Accessed December 21, 2015.
2. Infections associated with reprocessed flexible bronchoscopes:
FDA safety communication. US Food and Drug Administration.
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm
462949.htm. Accessed December 9, 2015.
3. Design of endoscopic retrograde cholangiopancreatography
(ERCP) duodenoscopes may impede effective cleaning: FDA safety
communication. US Food and Drug Administration. http://www.fda
.gov/MedicalDevices/Safety/AlertsandNotices/ucm434871.htm.
Published February 19, 2015. Updated March 4, 2015. Accessed
December 21, 2015.
4. Guideline for processing flexible endoscopes. In: Guidelines for
Perioperative Practice. Denver, CO: AORN, Inc; 2016:675-758.
5. 29 CFR x1910.1030: bloodborne pathogens. Occupational Safety
and Health Administration. http://www.osha.gov/pls/oshaweb/
owadisp.show_document?p_table¼STANDARDS&p_id¼10051.
Accessed December 9, 2015.
6. NFPA 99: Health Care Facilities Code Handbook. Quincy, MA:
National Fire Protection Association; 2015.
7. Guideline for selection and use of packaging systems for sterilization. In: Guidelines for Perioperative Practice. Denver, CO:
AORN, Inc; 2016:809-822.
8. Guideline for sterilization. In: Guidelines for Perioperative Practice.
Denver, CO: AORN, Inc; 2016:823-850.
9. Guidelines for Design and Construction of Hospitals and Outpatient
Facilities. Chicago, IL: Facility Guidelines Institute; 2014.
10. Overview of health care HVAC systems. In: HVAC Design Manual
for Hospitals and Clinics. 2nd ed. Atlanta, GA: American Society of
Heating, Refrigerating and Air-Conditioning Engineers; 2013.
11. Medical devices: factors affecting quality of reprocessing. US Food
and Drug Administration. http://www.fda.gov/MedicalDevices/
ProductsandMedicalProcedures/ReprocessingofReusableMedical
Devices/ucm454622.htm. Updated August 4, 2015. Accessed
December 21, 2015.
Lisa Spruce, DNP, RN, CNS-CP, CNOR, ACNS, ACNP,
FAAN, is the director, Evidence-based Perioperative
Practice, at AORN, Inc, Denver, CO. Dr Spruce has no
declared affiliation that could be perceived as posing a
potential conflict of interest in the publication of this
article.
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EXAMINATION
Continuing Education:
Back to Basics: Flexible Endoscope
Processing 1.6
www.aornjournal.org/content/cme
PURPOSE/GOAL
To provide the learner with knowledge of best practices related to flexible endoscope processing.
OBJECTIVES
1.
2.
3.
Discuss common areas of concern that relate to perioperative best practices.
Discuss best practices that could enhance safety in the perioperative area.
Describe implementation of evidence-based practice in relation to perioperative nursing care.
The Examination and Learner Evaluation are printed here for your convenience. To receive
continuing education credit, you must complete the online Examination and Learner Evaluation
at http://www.aornjournal.org/content/cme.
QUESTIONS
1.
2.
3.
2.
3.
Undergoing flexible endoscopic procedures decreases the
risk that patients may become infected with antibioticresistant organisms.
a. true
b. false
The issues that have been identified as contributing
to endoscope-related health careeassociated infections
include
1. critical lapses in endoscope reprocessing.
2. failure to follow manufacturer’s written instructions
for use (IFU).
3. endoscope design that prevents adequate cleaning of
some parts of the device.
4. lack of processing equipment.
5. lack of adequate time for processing.
a. 4 and 5
b. 1, 2, and 3
c. 1, 2, 3, and 4
d. 1, 2, 3, 4, and 5
To improve endoscope processing, perioperative
personnel can
1. follow the manufacturer’s IFU for cleaning and
processing.
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4.
clean the endoscope at the point of use.
follow guidelines for transporting, leak testing,
cleaning, and inspecting endoscopes.
appropriately store clean endoscopes.
a. 1 and 3
b. 2 and 4
c. 1, 2, and 4
d. 1, 2, 3, and 4
4.
The most important part of endoscope processing is
a. visual inspection.
b. mechanical decontamination.
c. manual cleaning.
d. sterilization.
5.
Some of the recommended ways to clean an endoscope
include
1. cleaning the exterior surfaces of the endoscope with a
soft, lint-free sponge or cloth saturated with the
cleaning solution.
2. moving the valves while cleaning.
3. cleaning and brushing the elevator mechanism and
the recesses surrounding it with a cleaning brush of
the width, length, and material recommended by the
manufacturer.
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Spruce
May 2016, Vol. 103, No. 5
4. raising and lowering the elevator, which helps to
ensure there is no organic debris lodged in the
moving part.
5. using a clean brush for each endoscope cleaning.
498 j AORN Journal
6. using a cleaning solution of sodium
hypochlorite.
a. 2, 4, and 6
b. 2, 3, 5, and 6
c. 1, 2, 3, 4, and 5
d. 1, 2, 3, 4, 5, and 6
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LEARNER EVALUATION
Continuing Education:
Back to Basics: Flexible Endoscope
Processing 1.6
www.aornjournal.org/content/cme
T
his evaluation is used to determine the extent to
which this continuing education program met
your learning needs. The evaluation is printed here
for your convenience. To receive continuing education credit,
you must complete the online Examination and Learner
Evaluation at http://www.aornjournal.org/content/cme. Rate the
items as described below.
6.
Will you be able to use the information from this article
in your work setting?
1.
Yes
2.
No
7.
Will you change your practice as a result of reading this
article? (If yes, answer question #7A. If no, answer
question #7B.)
7A.
How will you change your practice? (Select all that
apply)
1. I will provide education to my team regarding why
change is needed.
2. I will work with management to change/implement
a policy and procedure.
3. I will plan an informational meeting with physicians
to seek their input and acceptance of the need for
change.
4. I will implement change and evaluate the effect of
the change at regular intervals until the change is
incorporated as best practice.
5. Other: __________________________________
7B.
If you will not change your practice as a result of
reading this article, why? (Select all that apply)
1. The content of the article is not relevant to my
practice.
2. I do not have enough time to teach others about the
purpose of the needed change.
3. I do not have management support to make a
change.
4. Other: __________________________________
8.
Our accrediting body requires that we verify the time
you needed to complete the 1.6 continuing education
contact hour (96-minute) program: ______________
PURPOSE/GOAL
To provide the learner with knowledge of best practices related
to flexible endoscope processing.
OBJECTIVES
To what extent were the following objectives of this
continuing education program achieved?
1. Discuss common areas of concern that relate to perioperative best practices.
Low
1.
2.
3.
4.
5.
High
2.
3.
Discuss best practices that could enhance safety in the
perioperative area.
Low
1.
2.
3.
4.
5.
High
Describe implementation of evidence-based practice in
relation to perioperative nursing care.
Low
1.
2.
3.
4.
5.
High
CONTENT
4.
5.
To what extent did this article increase your knowledge
of the subject matter?
Low
1.
2.
3.
4.
5.
High
To what extent were your individual objectives met?
Low
1.
2.
3.
4.
5.
High
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AORN Journal j 499