title: Infection control practices in gastrointestinal endoscopy in the United States: a national survey.
abstract: OBJECTIVE
  To ascertain current infection control practices, endoscope cleaning procedures, perceived risks of infection, and implementation of universal precautions in gastrointestinal endoscopy units in the United States.
  
  
  METHODS
  National mailed survey of gastroenterology nurses and associates conducted anonymously in March 1988.
  
  
  METHODS
  Completed surveys were received from all 50 states and Puerto Rico and from all practice settings. The most common practice setting was private/community hospitals (66%).
  
  
  METHODS
  Of the 4,952 survey forms mailed to all members and to interested nonmembers of the Society of Gastrointestinal Nurses and Associates, 2,158 (44%) were returned and 2,030 (41%) were completed and evaluable. Of the respondents, 1,487 (73%) were registered nurses.
  
  
  RESULTS
  Sixty-seven percent (n = 1,358) of the respondents routinely used an enzymatic cleaner as a step in the instrument decontamination process; 93% (n = 1,879) chemically disinfected instruments after each case; and 88% (n = 1,779) disinfected endoscopes with an aqueous glutaraldehyde product. Respondents reported that they and a significantly smaller proportion of physicians (p less than .001) employed barrier precautions for all endoscopic cases involving possible contact with blood/body fluids of patients known (66% versus 57%, respectively) and not known (12% versus 8%, respectively) to have a bloodborne infection. Endoscopy-related infections, usually bacterial, were reported to have occurred at their institutions by 6% (n = 116) of respondents.
  
  
  CONCLUSIONS
  We conclude that cleaning, disinfection, and sterilization procedures for gastrointestinal endoscopic instruments vary, that appropriate protective apparel is not always worn, and that some practices may lead to preventable endoscopy-related infection in patients.
authors.affiliation: Division of Infectious Diseases, St. Louis University School of Medicine, MO 63104.
authors.forename: G J
authors.initials: GJ
authors.lastname: Gorse
authors.forename: R L
authors.initials: RL
authors.lastname: Messner
mesh_terms: D001424:Bacterial Infections / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods* / Q000592:standards; D019723:Endoscopes; D005762:Gastroenterology / Q000295:instrumentation*; D005932:Gloves, Surgical / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009726:Nurses; D011481:Protective Clothing / Q000706:statistics & numerical data; D012307:Risk Factors; D013242:Sterilization / Q000379:methods* / Q000592:standards; D011795:Surveys and Questionnaires; D014481:United States