Endoscopic Processing Safety and Cost Considerations: Longer Disinfection for Complicated Procedures

Grant Application

Mohamed H. Yassin, MD, PhD, Rahman Hariri, PhD, MBA, Juliet Ferrelli, MS, CIC, and Leanna McKibben, RN, MSN, ofUPMC Mercy

 

Proposed Innovation

Endoscopic procedures are one of the most commonly performed procedures for inpatients and outpatients. They are essential to patient care for both diagnosis and therapy. Despite established cleaning, disinfection, and sterilization processes for medical devices, multiple infection outbreaks across the country have led to questions concerning safety.

The search is ongoing for safe and cost-effective endoscope processing technology. One of the biggest challenges is removing and cleaning the biofilm buildup in the long, narrow lumen, or tubing, in the endoscope — especially following lengthier, more complicated procedures. This project, which proposes longer soaking of equipment to remove biofilm, will test and compare the effectiveness of ethylene oxide gas (ETO) sterilization and high-level disinfection (HLD) practices after longer vs. standard soaking in enzymatic detergents. There currently are no specific national standards regarding this issue.

 

Improvements in Action

Through this project conducted jointly by the UPMC Mercy Microbiology Department, Infection Control, and Hospital Administration, investigators will review cases over a 12-month period of patients who developed a fever or bacteremia within 72 hours following an endoscopic procedure lasting longer than 40 minutes. They will also conduct experiments to gather data on the presence of bacterial biofilm within endoscopes after various cleaning, disinfection, and sterilization processes.

 

Results — In Progress

By cutting open the scopes and culturing the inside, investigators will gather valuable information about the effectiveness of current cleaning processes and the importance of routine cultures. It will also establish the benefit of longer enzymatic soaking, which would be an inexpensive, effective, and easily reproducible intervention.