The following approveed practices ...

The following approveed practices were developed by the AORN make acceptableed Practices Committee and have been approved according to the AORN Board of Directors. They were at handed as proposed recommended practices for illustrations by members and others. They are effective Jan 1 2003

These commended practices are intended as achievable recommendations representing what is believed to be an optimal flush of practice. Policies and courses will reflect variations in practice settings and/or clinical situations that determine the step to which the recommended practices can be implemented.

AORN recognizes the numerous different settings in which perioperative nourishs 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 proceedings may be performed.

Purpose: These praiseed practices provide guidelines to assist personnel in the care, cleaning, decontamination, maintenance, handling, storage, and sterilization and/or disinfection of flexible and rigid endoscopes and related accessories. Use of these approveed practices will assist personnel in providing a safe environment for patients and health care workers. These attract favor toed practices are based on the mostly current literature and thinking at the time of their disclosure They should be used to exhibit policies and procedures for care of endoscopes and accessories in the practice setting. As of the present day information becomes available, perioperative supply with nourishments should consult with infection command professionals and epidemiologists to review and revise operations as appropriate.

make acceptableed PRACTICE I

Personnel should demonstrate in the use, care, and processing of endoscopes and related equipment.

1 Each facility should unfold a system for measuring and documenting personnel (1) Personnel working with endoscopes and endoscopic accessories should demonstrate commensurate with their responsibilities. Education programs should be specific to the token and design of endoscopes used and the proceedings performed in the facility. Manufacturers' specific instructions for endoscope care and use will be an important constituent of the education program. Personnel should be required to demonstrate periodically and when new endoscopic equipment and/or accessories are introduced into the practice setting. Educational activities should be documented and maintained forward file in the facility. (2)

2 Personnel should practice standard and transmission-based/expanded precautions during endoscopy proceedings and when handling and processing contaminated endoscopes and related equipment. (3) Standard precautions include the use of personal protective equipment. Personal protective equipment moulds the risk of direct outlook to blood, body fluids, or other fluids that may contain potentially infectious microorganisms. (4)

commited PRACTICE II

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

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

* before use,

* during the procedure

* after the procedure

* immediately after decontamination, and

* before disinfection or sterilization.

Visual inspection helps personnel discover structural damage, loss of function, and/or gros soil that may impact further processing and/or patient issue (5)

2. Damaged and/or soiled endoscopes and/or accessories should be remov from service. A damaged instrument that has been used should be considered contaminated and treated accordingly, using the appropriate flat of precaution to protect personnel from exposing to potentially harmful microorganisms. (6)

commited PRACTICE III

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

1 urgency (ie, leak) tests should be performed in succession used flexible fiber-optic endoscopes with leak testing capabilities before they are immersed in cleaning solutions or water. Leaks in either the covering or united or more of the inside channels can be determined by dint of the presence of air small matters when air pressure is applied to the inside of the insertion tube. If using a leak exhibition system not requiring water, pursue manufacturers' instructions. Unless otherwise specified in manufacturers' instructions, a damaged endoscope should not be submerg If damage is descryed the endoscope should be remov from service before it is cleaned, and the manufacturer should be confered for directions regarding further action to be taken. If the crushing test identifies interstitial space damage to a fiber-optic endoscope, the endoscope requires repair. An endoscope being reverted to the manufacturer for repair is considered a contaminated medical device and should be labeled accordingly for shipping. The endoscope must be packaged in impervious material and labeled with a biohazard token for transport. The biohazard label will act as a warning of potentially infectious material. relate to Occupational Safety and Health Administration regulations for preventing outlook to bloodborne pathogens for specific information in succession labeling contaminated equipment being shipped for repair. (7)