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Endo Bag and Tag™ - Why use Endo Bag and Tag
Endo Bag and Tag™ has been developed to primarily help clinical users to conform to three main criteria set in international guidelines:
• Keeping the scope Covered
• Keeping the scope moist.
The below information reproduces the key points from the main clinical guidelines for reprocessing flexible endoscopes.
1) Keeping the scope covered
The European Society of Gastrointestinal Endoscopy (ESGE), and the World Gastroenterology Organisation (WGO) have both published that all scopes must be covered in the procedure room before they are transported to the Cleaning room.
National Endoscopy Programme Decontamination Standards for Flexible Endoscopes 2009
• Endoscopes are transported to the decontamination area in a covered receptacle that is of an appropriate size so as to avoid contaminating the environment
• The scope is either stored immediately in a suitable cabinet or transported individually in a covered receptacle to prevent recontamination or damage.
ESGE & ESGENA
• Contaminated devices must be transported from the endoscopy room to the reprocessing room in closed containers, with attention paid to protective measures regarding staff and environment
• After the endoscope has been detached from the light source and video processor it is transported in a closed container to the reprocessing room to avoid environmental contamination.
Multi-society Guideline on Reprocessing Flexible GI Endoscopes
• During transportation, soiled endoscopes should be contained in a manner that prevents exposure of staff, patients, or the environment to the potentially infectious organisms
• AORN recommends that endoscopes be transported “…in a manner that preserves the disinfection status of the endoscope.”
• CDC guidelines state that, “A protocol should be developed that ensures the user knows whether an endoscope has been appropriately cleaned and disinfected”
CFPP 01 -06
• If the endoscope is to be used directly, it may be laid onto a lined transport tray and covered ready for reuse.
2) Traceability guidelines
Again, all the major endoscope reprocessing guidelines are very clear that a full traceability records be maintained for the reprocessing cycle of each endoscope. The US guidelines go even further stating that scopes should be easily identifiable if the have been reprocessed.
National Endoscopy Programme Decontamination Standards for Flexible Endoscopes 2011
• All endoscopes have a record of their decontamination status such that they are fit for use on patients.
• Tracking of the decontamination cycle, personnel and patient association of each endoscope is undertaken using manual or electronic methods.
• The tracking system is evaluated to assess its effectiveness twice a year.
ESGE & ESGENA
The complete reprocessing cycle of every endoscope should be
• Each reprocessing step is recorded manually or electronically, including the name of the person undertaking each step.
• All endoscopes have a record of their decontamination such that they are ready for use on patients.
US Multi-society Guideline on Reprocessing Flexible GI Endoscopes
• Health care facilities should ensure that users can readily identify whether and when an endoscope has been reprocessed.
• Maintain a log for each procedure indicating the patient’s name and medical record number (if available), the procedure, and the serial number or other identifier of the endoscope (and AER, if used) to assist in an outbreak investigation.
CFPP 01 -06
• The tracker system should allow the User to track and trace the endoscope decontamination process through manual wash, EWD, storage and finally to use on a patient on a single computer system.
3) Keeping the scope moist
In the UK the Choice Framework for local Policy and Procedures (CFPP) 01-06 offers best practice guidance on the management and decontamination of flexible endoscopes (principally gastrointestinal scopes and bronchoscopes). It also aims to support commissioners and providers in implementing appropriate and effective decontamination measures to reduce the risks of person-to-person transmission of human prion diseases.
In the document it states:
DOH Choice Framework for local Policy and Procedures 01-06 – Decontamination of flexible endoscopes: Operational management manual June 2012
Flexible endoscopes should be kept moist after use and before manual cleaning. If endoscopes are allowed to dry during this period, soil will be difficult to remove.
Endoscopes should be transferred from the point of use to the decontamination area as soon as possible. There are several options available to retain endoscope moisture during return
transport to decontamination unit after use. For example:
• A damp endoscope could be placed in a plastic bag and the bag sealed. The bag could then be placed onto a tray to support the body of the endoscope and transported on a purpose-built trolley.
• A used endoscope could be sprayed and injected with a non-drying fluid and then transported in a plastic lined tray designed for the purpose.
• A used endoscope could be put in a tray with a small volume of water and covered.
Endoscopes should not be transported with the lumen full of fluid.