What is the efficacy of sterile sheath use to prevent cross-contamination when using a fiberoptic nasopharyngolaryngoscope (FNPL) in an otolaryngology clinic?
Background: After each use of FNPL, the endoscope must be disinfected before it is used in another patient to prevent cross-contamination. Previous reports suggest that methods for disinfection vary among facilities, and medical assistants who disinfect the devices do not necessarily adhere to standard methods. Additionally, the use of liquid germicidal agents does not prevent contamination with bacterial spores. An individually packaged disposable sterile sheath (IPDSS) has been designed to fit over the FNPL and has been marketed as a means of preventing cross-contamination
Study design: Prospective controlled trial
Setting: Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine
Synopsis: The study was designed to evaluate the microbes on FNPLs used in patients after placing an IPDSS over the scope during insertion in a patient, compared with the microbes cultured from FNPLs when no sheath was used. All scopes were disinfected between patients.
Analysis of the samples was performed by Cambridge Biomedical Research Group, Inc., a CLIA-certified and CAP-accredited laboratory. The microbial results for the IPDSS group were similar to results from the traditional group. Total disinfection time for the sheath method averaged 89 seconds, while time spent using the germicidal liquid averaged 14 minutes. The team observed that FNPLs have a baseline contamination level that may result from storage or contamination during transportation.
Bottom line: The microbial study results demonstrate that the IPDSS system is as effective as using a liquid germicidal system for preventing cross-contamination, and medical assistants were able to adhere to rigorous guidelines.
Citation: Elackattu A, Zoccoli M, Spiegel JH, et al. A comparison of two methods for preventing cross-contamination when using flexible fiberoptic endoscopes in an otolaryngology clinic: disposable sterile sheaths versus immersion in germicidal liquid. Laryngoscope. 2010;120(12):2410-2416.
—Reviewed by Sue Pondrom