From the May 2022 issue of HealthCare Business News magazine
Cleaning verification testing intervals have changed. ST91 now requires cleaning verification on all high-risk endoscopes with each processing cycle and a statistically significant portion of non-high-risk endoscopes. The document provides guidance on how to determine that portion in an annex. There are also strengthened guidelines around enhanced visual inspection using lighted magnification to evaluate the condition of the endoscope after manual cleaning but before disinfection or sterilization. Borescope inspection continues to be recommended at a periodic interval determined by the facility.
Another important point is that manual disinfection (i.e., soaking in a basin of high-level disinfectant) is no longer recommended due to the variability/inconsistency of personnel responsible for the process. This could have wide implications in non-hospital-based settings where manual disinfection is still performed regularly. Take an inventory of all the places within your facility where endoscopes are being processed. Likely, some or many of them still perform manual soaking in high-level disinfectant (HLD).
Additionally, ST91 strengthened the wording around sterilization processes and reemphasizes the original Spaulding Classification System. It states that all endoscopes should be sterilized, but if not possible, then we resort to high-level disinfection. If sterilization is available at the facility and the scope is compatible with that method, it should be sterilized. Everyone should be striving for sterilization for all endoscopes. Remember that endoscopes used in a critical application, (i.e., those used in a sterile area of the body) must be sterilized.
All endoscopes are now required to be completely dried both externally and internally before reuse, even post-AER processing. And it does not matter whether the endoscope is going into the storage cabinet or back to immediate reuse, all scopes should be subjected to a compressed air-drying cycle of 10 minutes or placed into an active drying cabinet to dry internally. This will add time to the processing cycle.
These highlights are only a few changes worth mentioning in the new ST91. It is recommended that each facility obtain a copy of the new standard and begin a thorough review. Assemble a multi-disciplinary team to review the guidance and create a crosswalk of noncompliance topics based on the current practices at the facility. Create an implementation strategy with assigned due dates. That way facilities can prioritize issues and begin the implementation of the changes. This is an important update to the standard that will increase quality in endoscope processing and therefore patient safety.
The new standard is
available at this link.
About the author: Mary Ann Drosnock is the director of clinical affairs at Healthmark Industries.
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