Endoscopic decontamination: an audit and practical review.
A comprehensive audit of endoscopic decontamination practices throughout a 1200-bedded teaching hospital trust was undertaken, prior to a review of the current policy and consideration of alternative disinfectants. Pharmacy records of glutaraldehyde usage, occupational health staff survey data of glutaraldehyde exposure, discussions with all departments where endoscopy might be conducted and information from all companies supplying endoscopes and allied equipment were reviewed. In total, 56 endoscopes were found to be in use in 16 areas of the Trust. In the main designated endoscopy units, compliance with the established policy was generally good, but in other areas, equipment which could tolerate autoclaving was being disinfected with chemical sterilants; some units were still using endoscopes which were not fully immersible and there was widespread use of disinfectant troughs, rather than automated washer-disinfectors. In most cases, this was because staff were concerned about endoscopy equipment passing to a central processing department with potential delays and losses. An updated Trust-wide endoscopy policy, using glutaraldehyde and incorporating the current British Thoracic Society, British Gastroenterological Society and British Urological Society guidelines, has now been implemented. The issues around this and alternative disinfectants are discussed.
Ruddy
M
M
Department of Medical Microbiology, Royal Free and University College Medical School, Pond Street, London, UK.
Kibbler
C C
CC
D003428:Cross Infection / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods*; D004202:Disinfectants / Q000627:therapeutic use*; D019723:Endoscopes; D004866:Equipment Contamination / Q000517:prevention & control*; D005976:Glutaral / Q000627:therapeutic use*; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D008131:London; D017410:Practice Guidelines as Topic
D004202:Disinfectants; D005976:Glutaral