Sterilization & Disinfection
Research raises concerns about lubricants used in endoscopes
Current endoscope reprocessing methods are not consistently effective in eliminating organic soil or microbes, and the off-label use of products for defoaming, lubrication, and bleeding control may be contributing to reprocessing failures. Though endoscope manufacturers have cautioned against the use of these products, endoscopists still commonly use them, and many…
Joint Commission issues Quick Safety on disinfection of tonometers, other ophthalmology devices
Editor's Note The Joint Commission on May 21 issued Quick Safety 49: Disinfection of tonometers and other ophthalmology devices. The Joint Commission noted that the American Academy of Ophthalmology has reported that transmission of adenovirus and herpes simplex virus HIV, hepatitis C virus, enterovirus 70, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus,…
What should you do if your sterilizer fails?
A sterilization failure is a significant event. Receiving a positive biological indicator (BI) result from a sterilizer can be devastating and presents a patient safety concern because it could result in infection. This article addresses the proper action to take in the event of a positive BI result and biological…
Off-label use of simethicone, lubricants, and tissue glue contributes to endoscope reprocessing failures
Editor's Note The off-label use of defoaming agents, lubricants, and tissue glue is common, and these insoluable substances are not removed during reprocessing, this study finds. Of 69 fully reprocessed endoscopes examined in four hospitals, microbial cultures were positive for 50% or more. The researchers, led by Cori Ofstead, MSPH,…
FDA considering additional regulatory actions to reduce duodenoscope risks
Editor's Note The Food & Drug Administration on April 16 announced it is considering additional regulatory actions, including consulting with federal health experts for guidance, to reduce the risks of contamination and infections associated with duodenoscopes. The FDA is also working with manufacturers of disposable duodenoscopes that would make reprocessing…
'Coming clean' in the SPD requires collaboration and competency—Part 2
Contaminated surgical instruments pose a danger to patients and to an organization’s bottom line. In Part 1 of this two-part series, we discussed prevention strategies (OR Manager, April 2019, 14-15, 19). In Part 2, the focus is on investigating potential contamination, along with design considerations. Detective work Despite best…
FDA continues efforts to assess duodenoscope contamination risk
Editor's Note The Food & Drug Administration (FDA) on April 12 announced that it is taking steps to implement additional regulatory actions, including consulting with federal health experts, on how to reduce the risks of contamination and infections linked to duodenoscopes. The agency is also collaborating with manufacturers of disposable…
FDA issues statement on trach tube shortages
Editor's Note The Food & Drug Administration on April 12 issued a statement about the agency’s efforts to mitigate the shortage of Smiths Medical’s Bivona tracheostomy tubes, especially the pediatric tubes. The shortage is a result of the closure of a large ethylene oxide sterilization facility in Willowbrook, Illinois, and there…
'Coming clean' in the SPD requires collaboration and competency—Part 1
Contaminated surgical instruments made ECRI Institute’s 2019 annual top 10 list of health technology hazards, coming in at number five: “Mishandling flexible endoscopes after disinfection can lead to patient infections.” Number two on the list in 2018 was “Endoscope reprocessing failures continue to expose patients to infection risk.” It’s not…
Elevating standard of endoscope reprocessing with terminal sterilization of duodenoscopes
Editor's Note Terminal sterilization of duodenoscopes can be achieved with a hydrogen peroxide-ozone sterilizer, this study finds. A sterility assurance level of 10-6 was achieved under laboratory worst-case conditions and under clinical conditions using a hydrogen peroxide-ozone sterilizer with regulatory clearance for terminal sterilization of duodenoscopes (STERIZONE VP4, TSO3 Inc,…
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