INSURANCE INSIGHTS C. Implementing Endoscope Reprocessing Guidelines Hard-to-clean medical scopes used to diagnose a variety of internal conditions have been linked to the spread of deadly microbes, including carbapenemresistant Enterobacteriaceae. Considered a healthcare-associated infection by the CDC, this and other “superbugs” endanger patients and staff, while exacting a financial toll on healthcare settings in the form of unreimbursed care, sanctions and liability. In response to rising infection rates associated with certain scoping devices,1 the CDC released its “Interim Duodenoscope Surveillance Protocol” http://www.cdc.gov/hai/organisms/cre/creduodenoscope surveillance-protocol.html, which addresses proper cleaning, inspection and culturing of duodenoscopes and other flexible endoscopic devices after reprocessing (i.e., sterilizing non-disposable devices prior to use on other patients). The protocol also recommends a series of actions designed to minimize patient risk following potential scope contamination. A written response plan should include the following measures: Œ Remove the scoping device from clinical use until it has been demonstrated to be free of dangerous micro-organisms. Œ Notify patients of positive culture results and initiate appropriate medical treatment. Œ Provide remedial training for personnel on reprocessing procedures, followed by documented evaluation of competency in this area. The CDC emphasizes that surveillance of bacterial cultures does not obviate the need for documented training and supervision of staff members engaged in endoscopic reprocessing. Furthermore, while the interim protocol provides general guidance on enhancing endoscope safety, medical practices also must adhere to manufacturers’ instructions for the cleaning and disinfecting of any scoping apparatus. Medical practices are in the front lines of the fight against contagious disease, whether due to widespread vaccine avoidance or the emergence of highly resistant microbes. The guidelines and references presented in this article can help remind colleagues and staff of their obligation to protect not only their patients, but also the community as a whole. For additional information on CNA risk management solutions, please contact CNA at (800) 341-3684. 1. Eisler, P. “Timeline: Tracking the Deadly Superbug Cases Tied to Medical Scopes.” USA Today, May 21, 2015. Peter Eisler w ww.TheOMA.org Fall 2015 27
OMA Medicine in Oregon Fall 2015
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