What is the durability of endoscopes to continued use and automated high-level disinfection, and how many duty cycles can a flexible endoscope withstand before repairs should be anticipated?
Background: High-level disinfection (HLD) for semi-critical instruments such as flexible endoscopes is recommended by the Association of Operating Room Nurses and the Association for Professionals in Infection Control and Epidemiology. It is not easy, however, to find repair data or the number of duty cycles (individual patient endoscopic examinations and HLD processing) for flexible endoscopes utilized in pediatric patients.
Study design: Retrospective review
Setting: Cincinnati Children’s Hospital Medical Center
Synopsis: The authors examined 4,336 endoscopic exams and subsequent disinfection cycles for 60 flexible endoscopes in an outpatient tertiary pediatric otolaryngology practice from 2005 to 2009. Of the 77 repairs performed, on average, the 2.2 mm flexible endoscopes were utilized for 61.9 examinations before major repair was needed, whereas the 3.6 mm endoscopes did not need major repair and were utilized for 154.5 exams before needing minor repairs.
Although the need for repair may in part be due to the automated endoscope reprocessor use itself, the authors said the current study did not allow for determination of a causal role. The most common reason for major repair of nonchanneled fiberoptic endoscopes was a substantial number of broken fiberoptic fibers, which prohibited effective use.
Bottom line: Even when utilizing standardized, automated HLD and limiting the number of personnel processing the endoscopes, smaller fiberoptic endoscopes demonstrate a shortened time interval between repairs than that seen with the larger endoscopes.
Citation: Statham MM, Willging JP. Automated high-level disinfection of nonchanneled flexible endoscopes: duty cycles and endoscope repair. Laryngoscope. 2010;120(10):1946-1948.
—Reviewed by Sue Pondrom