large number and variety of GI endoscopic procedures performed, documented instances of infectious complications remain rare, with an estimated frequency of 1 in 1.8 million procedures," said Bret T. Petersen, MD, FASGE, chairman, ASGE Quality Assurance in Endoscopy Committee. "Since the 2003 guideline was published, additional outbreaks of infection related to suboptimal infection prevention practices during endoscopy or lapses in endoscope reprocessing have been well publicized. Given the ongoing, but rare, occurrences of endoscopy-associated infections attributed to lapses in infection prevention, an update of the multisociety guideline was warranted."
Flexible GI endoscopes should first be completely cleaned and then subjected to at least high-level disinfection. This standard has been recommended by federal agencies such as the FDA and CDC; professional organizations such as ASGE, SHEA, the American College of Gastroenterology, the American Gastroenterology Association, the Society of Gastroenterology Nurses and Associates (SGNA), the Association of periOperative Registered Nurses (AORN), and the Association for Professionals in Infection Control and Epidemiology. These organizations have developed guidance documents that detail the sequence and specifics of each element of appropriate endoscope reprocessing. There are no published studies of confirmed transmission of infection when these guidelines have been followed.
"These guidelines ensure that all clinicians are following the most up to date evidence-based methods to help keep patients safe," said Keith Woeltje, MD, PhD, FSHEA, chair of SHEA's Guidelines Committee. "The rare occurrence of transmission via endoscope speaks to the efficacy of reprocessing methods and shows the impact this guidance has in practice."
Specific additions or changes published in the "Multisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2011" include:
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