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Managing Endoscopes After Prolonged Delays in Cleaning


Delays in the cleaning of endoscopes can create difficulties with cleaning these devices and increased damage to the scopes. Prolonged delays in cleaning generally are considered to be over an hour after pre-cleaning is completed. To help remove dried debris and reduce the opportunity for biofilm formation and adherence, soaking endoscopes for extended periods is recommended.


As always, referring to each scope and each detergent instruction for use (IFU) is mandatory. Temperature, concentration, and dilution vary for each detergent, as well as recommended soak times. A common theme for soaking items to be cleaned varies from one to five minutes. Soak times can extend for up to ten hours, but the determining factor is the endoscope IFU.


In the Olympus instructions for cleaning endoscopes that have undergone a delay, their recommendations state, "When determining how long to soak the endoscope, the state of the external debris is an acceptable indicator. If debris has loosened on external surfaces of the endoscope, then the conditions within the channels should be the same. Therefore, if the debris on the external surface is confirmed to have been loosened by visual inspection, then the appropriate soak time has been achieved. Endoscopes should never be immersed for longer than the maximum presoak time indicated in the endoscope’s reprocessing instructions."


The key to good practice is good communication. Tracking the endoscope cleaning process from the minute the pre-cleaning ends to the minute the cleaning process begins is the determining factor for extended measures. Keeping within the recommended time frames saves time and can save damage to the endoscope while also reducing patient issues.


References


Delays in Endoscope Reprocessing … and the Biofilms Within By Melinda Benedict, MS, CIC, CFER

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