The following commited practices we...

The following commited practices were developed by the AORN commended Practices Committee and have been approved on the AORN Board of Directors. They were published as propos make acceptableed practices through the AORN fax onward demand for comments by members and others. They are effective Jan 1 1998

These attract favor toed practices are intended as an achievable recommendation representing what is believed to be an optimal of the same height of practice. Policies and conducts will reflect variations in practice settings and/or clinical situations that determine the station to which the recommended practices can be implemented. The Association for Professionals in Infection command and Epidemiology (APIC) has perform the operations indicated ined guidelines for the prevention and dominion government of infection during endoscopy manner of proceedings and provides extensive information for perioperative nurses

AORN recognizes the numerous different settings in which perioperative suckles practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive manner of proceedings may be performed.

Purpose: These commended practices provide guidelines to assist personnel in the decontamination, cleaning, maintenance, handling, storage, and sterilization and/or disinfection of endoscopes and related accessories. Personnel ne to be cognizant of this information in such a manner that a safe environment can be provided for patients. Infection rule and epidemiology experts should review all practices related to the care and handling of endoscopes and related equipment.(1)

make acceptableed PRACTICE I

Personnel should demonstrate regarding appropriate selection, proper handling, inspection, testing, use, and processing of endoscopes and related equipment.

Interpretive statement 1:

Personnel should practice Standard and Transmission-based Precautions during endoscopy actions and when handling and processing contaminated endoscopes and related equipment.

Rationale:

Standard precautions include the use of personal protective equipment. Personal protective equipment decreases the risk for direct frontage to blood, body fluids, or other fluids that may contain potentially infectious microorganisms.(2)

Interpretive statement 2:

Endoscopes should be inspected, proofed used and processed according to the manufacturers' written instructions.

Rationale:

becoming inspection, testing, use, and processing of endoscopes abridges the risk for adverse patient results prevents damage to the lense and fiber-optic component parts and helps prevent delays.(3)

attract favor toed PRACTICE II

Endoscopes and related equipment should be inspected at all stages of handling.

Interpretive statement:

Endoscopes and related equipment should be inspected for integrity, function, and cleanliness at the following times:

* before use,

* during the procedure

* immediately after decontamination, and

* before disinfection or sterilization.

Rationale:

Inspection is necessary to expose possible structural damage, loss of function, and gros Soil.(4)

commended PRACTICE III

Endoscopes and related equipment should be standarded before use and used according to manufacturers' written instructions.

Rationale:

Pre-use testing and specific use of endoscopes, endoscopic accessories, and related equipment minimize the risk for adverse patient outcomes(5)

attract favor toed PRACTICE IV

Endoscopes and related equipment should be decontaminated and cleaned immediately after use according to manufacturers' written instructions.

Interpretive statement 1:

Endoscopes and related equipment should receive ready mechanical cleaning. Flexible endoscopes with internal channels (eg suction, biopsy) should be flushed with water and/or an enzymatic detergent(6)

Rationale:

Flushing the internal channels of flexible endoscopes with an enzymatic cleansing solution or water prevents drying of secretions, facilitates removal of organic material, and decreases the number of microorganisms present(7)

Interpretive statement 2:

Endoscopes, endoscopic accessories, and related equipment should be disassembled and cleaned manually.

Rationale:

Endoscopes and related equipment are considered contaminated after use. Immediate decontamination is necessary to screen personnel and prevent transmission of potentially infectious microorganisms. Flexible endoscopes that have crevices, joints, and internal channels are more difficult to clean and disinfect than rigid endoscopes that have flat surfaces. Removing gros soil from narrow internal channels and lumen is difficult.(8)

Interpretive statement 3:

Manufacturers' written instructions should be followed in selecting enzymatic cleansing solutions used for cleaning.

Rationale:

Abrasive or corrosive solutions may damage the surfaces of endoscopes and contribute to corrosion.(9)