• Majority of experienced workers “disliked” some of the manual reprocessing tasks;

• 70% felt pressure to work quickly;

• More than half experienced discomfort associated with reprocessing;

• Employees indicated that using more automated systems provided increased consistency and better compliance-related documentation than manual processing.

According to Cori L. Ofstead, MSPH, lead researcher, “This study shows that institutions have adopted written GI endoscope reprocessing guidelines, yet there are clearly suboptimal practices and wide variations in adherence within and between institutions. Our findings indicate the majority of employees experience occupational health problems attributed to reprocessing, and many of them dislike tasks associated with manual cleaning. We found that automation improves consistency and employee satisfaction. In accordance with CDC guidelines, every facility should reexamine their practices, and seek ways to improve occupational health and reduce infection risks for patients.”

The CLEANR Study was conducted from October 2008 through April 2009 at six US sites (only five provided data in the required time frame) including two gastroenterology centers, three multi-specialty hospitals, and one outpatient surgery center. Participating sites used a variety of reprocessing methodologies ranging from manual cleaning with brushes to automated channel irrigators and other automated systems including the ASP EVOTECH Endoscope Cleaner and Reprocessor. The EVOTECH System is the first commercially available system in the US that both cleans and high-level disinfects endoscopes. It does not eliminate bedside precleaning in procedure room and no manual cleaning is required when selecting a cycle that has a wash stage.

Managers were interviewed and individuals tasked with the responsibility of cleaning endoscopes after a GI procedure were surveyed and their actions documented by an observer. Managers at every site stated that written reprocessing policies were in place. Study results indicated that GI endoscope reprocessing time varied by the individual, and its variability resulted in:

• Majority of endoscopes using traditional reprocessing techniques were not reprocessed in accordance with existing reprocessing guidelines.

• Inconsistency in brushing, detergent flush, rinsing, alcohol flushes and forced-air drying times:

• Brush times ranged from 10 seconds to 2:30 minutes.

• Detergent flush times ranged from 18 seconds to 2:45 minutes.

• Sites with consistent flush times were using an automated channel irrigator.

• Rinsing times ranged from 76 seconds to 3:20 minutes.

• Alcohol flushes were only documented in 39.5% of instances.

• Forced air was used in 81.5% of instances.

“ASP realizes that ensuring proper GI endoscope reprocessing is a complex and challenging task, and not all facilities have these issues,” said Barbara Trattler, Director, Clinical Education at ASP. “ASP will continue to partner with our customers and industry to increase awareness of best practices in reprocessing. We are also dedicated to developing new technology solutions such as the EVOTECH Endoscope Cleaner and Reprocessor the first commercially available system to eliminate the labor-intensive manual cleaning of endoscopes—to help improve compliance and increase employee satisfaction.”