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ECRI Top Health Technology Hazards List Includes Poor Sterilization Practices

October 10, 2019Sri Mandava Hospital Management Infection Control Managing Endoscopes Patient Safety

The ECRI Institute, based in Philadelphia, has just released its annual list of health technology hazards for 2020. This year’s list includes an entry at number 3 for poor sterilization practices, echoing prior year concerns about sub-standard disinfection practices for flexible endoscopes.

ECRI’s list is the result of extensive research by its own engineers, scientists and clinicians, as well as investigation into its own problem reporting network. The list considers criteria such as severity, frequency and insidiousness when ranking the hazards. It’s no surprise that sterilization practices came in as number 3 on the list, as reports of safety breaches due to poorly sterilized or disinfected medical equipment continue to occur all around the country. The Executive Brief published by ECRI Institute explains why endoscope reprocessing continues to be such a concern:

“This concern exists in all healthcare settings where patients may come in contact with contaminated items, particularly those intended to enter sterile tissue or the vascular system. However, not all healthcare settings have similar resources for core infection prevention and control (IPC) practices. Settings that may lack the sterilization program resources commonly found in acute care facilities, for example, include medical offices (e.g., OB/GYN, dermatology), dental offices, and similar locations that are not serviced by a central sterile processing department.

During IPC consultations in these settings, ECRI Institute has observed numerous oversights and improper actions associated with sterilization processes. While the prevalence of such failures is unknown, the potential exists for this to be an insidious, widespread patient safety risk.”

Read the entire Executive Brief here: Top 10 Health Technology Hazards for 2020

As the spotlight on reusable medical equipment such as endoscopes and surgical instruments continues to shine, hospitals and ambulatory surgical centers must continue to be vigilant in enforcing the highest standards for sterilization and high-level disinfection. We must make sure that team members are performing the steps of the sterilization or reprocessing cycle consistently and are documenting their findings along the way. If your department wants to automate the workflow and documentation process of the endoscope reprocessing cycle, consider a software system like iRIScope. Systems like these ensure that your staff are performing consistent, repeatable and documented steps during reprocessing. They also minimize manual efforts to document the process by incorporating advanced data collection technologies like RFID directly in to the workflow.

A Scope Tracking Solution That Can Grow With Your Hospital

October 3, 2019Sri Mandava Hospital Management Infection Control Joint Commission Managing Endoscopes Patient Safety Regulatory Compliance

The Joint Commission (TJC), the United States Food & Drug Administration (FDA) and several other regulatory and accreditation agencies have recently put more focus on flexible endoscopes in their guidance to US hospitals and surgery centers. It comes as no surprise, as over the last decade the number of reported outbreaks based on inadequately reprocessed scopes has increased significantly.

To increase their vigilance, many hospitals and surgery centers are evaluating technologies that can help them track their scopes and automate the documentation of key steps along their usage lifecycle. This is being done especially with TJC and other accreditation bureaus in mind, as they have cracked down on lax scope documentation practices in recent years. With several solutions on the market that bring different features to the table, we’ll focus on one particular solution that is unique in its modular design – allowing hospitals to tailor their scope tracking and storage solution to their needs.

There are two primary components of an endoscope documentation system. The first will capture all of the scope transactions that take place at the clean storage area of the scopes. The second will capture the various steps during the high-level disinfection (HLD) process that each hospital would like to track. Combined, these two components give a full picture of the entire endoscope usage lifecycle to ensure high standards of reprocessing compliance, staff accountability and patient safety.

While some smaller hospitals and surgery centers require only limited tracking functionality, other larger hospitals and health systems require a lot more functionality due the complexity of their operations. iRIScope, from Mobile Aspects, approaches the challenge of automating endoscope tracking with a modular system. This modularity allows hospitals and surgery centers to tailor a system that fits their initial requirements, and to also have a system that grows with them as their needs and requirements change.

Smaller hospitals or surgery centers may only desire a scope tracking solution with basic functionality such as tracking scopes to patients and ensuring all scopes go through a standard reprocessing cycle each time. Having this data will be key for when TJC or other inspectors audit the endoscopy practices. With this data in electronic, easily-accessible format, hospitals can provide data in real-time as auditors go through their tracing methodology. iRIScope gathers this data by placing data capturing kiosks at key points along the endoscope usage lifecycle, such as at clean storage and reprocessing areas. Providing a turnkey solution such as this can be a cost-effective way to prepare for electronic data requirements in endoscopy.

A busier environment, such as an academic medical center or a large free-standing endoscopy center, may have different requirements due to the number of scopes under management and round-the-clock operations. With many more scopes to manage and many more employees accessing scopes after hours (when supervision is minimal), centers like these may need more security around their scopes to protect from mismanagement, theft or other unnecessary usage or contact. To solve this unique requirement, iRIScope has optional RFID-enabled scope storage cabinets that can keep an extra eye on scopes in busy centers by automatically associating staff and patients to each endoscope taken. Real-time alerts built into iRIScope also help to prevent scopes from being misplaced or lost during long trips between floors or buildings.

Depending on their infection control requirements, some endoscopy operations may want to enable additional safety features within iRIScope. For example, some centers may want to track their reprocessing protocols beginning in the procedure room by using additional kiosks to capture the time stamp of when the bedside cleaning begins. In situations such as these, iRIScope can be enabled to track this step and any other specific steps during reprocessing that the department considers critical. Some centers may also want to follow high-level disinfection with forced air through endoscope channels as recommended by many agencies. iRIScope allows this module to be added to any or all smart cabinets installed in the department, depending on their specific requirements.

As hospitals and health systems grow, and as endoscope reprocessing and handling standards change, endoscopy managers need a system that will grow with them. With the modular design of iRIScope, endoscopes can now be managed in a way that matches existing workflows and protocols, and can grow and adapt to changing requirements as time passes. This makes sure that any investment in the iRIScope tracking system will be a secure and sound decision.

Why Channel Drying Is So Crucial To Endoscope Infection Control

September 26, 2019Sri Mandava Hospital Management Infection Control Joint Commission Managing Endoscopes Patient Safety Regulatory Compliance

Because endoscopes are reusable medical instruments, one of their biggest risks is the very real possibility of passing diseases to patients through contact with inadequately disinfected scopes. Though the risk of passing diseases through scopes is relatively low, the danger is always there, especially when high-level disinfection (HLD) protocols aren’t closely followed. One area where many healthcare providers fall short is in the drying of endoscopes following HLD.

Several guiding bodies, from the US Food & Drug Administration (FDA) to the Society for Gastroenterology Nurses and Associates (SGNA) have put out guidance stating that endoscopes must be properly dried following HLD before contact with the next patient. While the concept is simple and widely-understood in theory, it is not always adhered to in practice. One of the major reasons is that many busy Endoscopy centers don’t allow enough time from when scopes are unloaded from Automated Endoscope Reprocessors (AERs) to their use in a procedure. In situations like these, not allowing a scope to properly dry internally and externally increases the potential for disease transmission. Additionally, not allowing scopes to hang vertically to allow any moisture to drain properly post-HLD can allow moisture to build up inside the scope.

Though there is some conflicting guidance, many studies have shown that wet or moist endoscopes carry much higher risk of harboring bacteria than dry ones. One such study from Lawrence F. Muscarella, Ph.D. strongly suggests that endoscope drying should take place after every reprocessing cycle due to the threat of transmission of waterborne bacteria in damp endoscopes (Muscarella, L. F. (2006). Inconsistencies in endoscope-reprocessing and infection-control guidelines: The importance of endoscope drying. American Journal of Gastroenterology, 101(9), 2147-2154). Without this crucial step, it has been widely published that moisture build up within an endoscope can lead to extremely higher rates of bacteria growth.

There are systems on the market that can help staff adhere to basic drying procedures such as blowing filtered air through channels and having scopes hang vertically in storage. One such system is iRIScope from Mobile Aspects, which was introduced in the last several years to guide healthcare providers through the proper, society-recommended HLD protocols every single time. With iRIScope, sterile technicians will be guided through the entire HLD process to make sure that any potentially harmful diseases are minimized via proper HLD techniques. The system also includes smart storage cabinets that allow scopes to hang vertically with forced air running through the channels. Built-in technology will even alert your staff if improperly reprocessed scopes are hung in storage, or if it’s time to re-disinfect a scope based on local protocols. With a second pair of eyes on your scopes at all times, you can ensure that patients are kept safe while simultaneously following society and Joint Commission guidelines.

How To Reduce Unnecessary Contact With Endoscopes Using RFID Technology

September 19, 2019Sri Mandava Hospital Management Infection Control Managing Endoscopes Patient Safety Regulatory Compliance

One of the biggest risks of using flexible endoscopes in healthcare stems from the reusable nature of the expensive instruments. Though the risk of passing disease on through endoscopes is relatively low, the danger is always there even when following the instructions for use provided by the manufacturers. The high-level disinfection process for medical endoscopes can still leave some residual bacteria as shown by several recent studies.

Adding to this complication is that there is a lot of time that passes between when endoscopes are high level disinfected and when they are used on patients. During this time, several humans may come into contact with disinfected scopes during normal business operations. Runners transport scopes from sterile processing to the storage areas, techs scan endoscopes in and out of clean storage and nurses pull endoscopes for upcoming procedures and transport them to the lab.

Any human contact with endoscopes increases the possibility of transmission of disease. While many points of contact with endoscopes are unpreventable, healthcare providers must attempt to eliminate physical contact with endoscopes whenever possible to maintain the highest levels of patient safety. One of the easiest places to eliminate human contact with endoscopes relates to the way most hospitals and outpatient centers track scope hang-time limits. Most hospitals approach this challenge by applying paper tags to scopes that list the last date of high-level disinfection for each scope and/or the expiration date for the scope. If endoscopes are checked daily for these expiration dates, each scope may be touched 7 to 30 additional times by an employee (depending on the hang-time limit set by the hospital) before the next use on a patient.

However, there is a way to eliminate these unnecessary touches by using automation technologies. iRIScope from Mobile Aspects was introduced in the last several years to take manual documentation for endoscope management and turn it into electronic records. Using RFID technology, you can now literally have your scopes alert you when they need to be re-washed (and get rid of those pesky paper tags).

The way RFID technology helps automate endoscope management is both simple and highly effective. Attaching medical-grade RFID tags to your endoscopes allows each scope to be tracked electronically as it goes through the HLD process. Because you now have an electronic time stamp of each scope’s most recent wash stored in a database, intelligent analytics built into iRIScope smart cabinets will push endoscope re-wash alerts right to your inbox.

No more log books, no more paper tags – just electronic documentation that makes your department more effective and more efficient. Patient safety and accreditation likelihood will improve because your disinfected scopes are less prone to contamination. All the time staff spends looking at paper tags to see which scopes need to be washed can be turned into time spent on patient care. And all potential for human error in miscalculating the re-wash limits can be eliminated.

How To Use Predictive Analytics In The Hospital Supply Chain

September 12, 2019Sri Mandava Big Data Cost Reduction Hospital Finance Hospital IT Hospital Management Operational Efficiency Supply Chain The Business of Surgery

Many hospitals still rely on manual processes or antiquated technologies for managing their expensive supplies and implants. The concept of predictive analytics and artificial intelligence (AI) in their supply chains may seem like a remote possibility, but this doesn’t necessarily have to be the case.

Advances in hospital supply chain technologies over the last decade have now made it possible for hospitals to realize the benefits of predictive analytics in inventory management. Real-time data gathering technologies, such as RFID-enabled smart cabinets, can help hospitals gather the data needed to harness the incredible power of AI and predictive analytics. As this article by Chris Luoma at Health Data Management explains:

“Properly managing inventory levels is a challenge. In fact, many hospitals still cling to the “more is better” mindset when it comes to supplies. More inventory on hand reduces the risk of running out, ensuring the highest possible care can be delivered to patients at all times. However, excess supply drives up costs and increases waste for those products that expire before use.

Just-in-time (JIT) delivery is one way hospitals combat overstock and waste. Although it requires quite a bit of manpower to execute, JIT delivery is a highly efficient system, well suited for the regular course of business. However, if there is a disruption, such as a natural disaster or flu outbreak, JIT is less efficient and costs can soar.

As more data becomes available through increased levels of automation, supply chain teams can use predictive analytics to better forecast demand. Synthesizing historical and real-time data from multiple systems will enable teams to gain insight into case mixes, anticipate the types of cases that are likely to come through the door, and the supplies required to support those cases.

Moreover, predictive analytics will enable more intelligent, data-informed decisions throughout the entire delivery process. With better planning, a distributor can understand what a provider needs to stock. Manufacturers can use that data to see what needs to be produced, including the raw materials. This will let the industry reduce excess capacity from delivery systems, and ultimately reduce risk.”

Read the entire article here: How predictive analytics will impact the supply chain in the 2020s

In order to better compete in the 2020s, hospitals will have to find ways to reduce waste throughout the system, including within the supply chain. Predictive analytics will bring the promise of increased efficiency and reduced waste to those hospitals and health systems that pursue its benefits. However, a key challenge will be ensuring a reliable, real-time view of all supplies and their usage trends so artificial intelligence can make the proper conclusions. A system like iRISupply marries inventory management software with RFID cabinets to provide a just-in-time system for managing key supplies and implants. This AI-ready software will also arm you with the data you need to make the best re-ordering and stocking decisions possible. iRISupply will not only provide you with the usage data and reports you need, but will take it one step further and provide actionable recommendations about which products are overstocked, understocked or that can even be eliminated altogether. Mobile Aspects supply chain experts will also sit down with you quarterly as part of a best-in-class customer success program to discuss strategies to optimize your inventory mix and review the data behind those suggestions. By closely managing PAR levels and setting up interfaces for automatic re-ordering, the twin problems of stock-outs and bloated inventories can be successfully and sustainably eliminated.

How To Link Patient Outcomes To Medical Devices Using UDI

September 10, 2019Sri Mandava Big Data Clinical Documentation Hospital IT Hospital Management Operational Efficiency Regulatory Compliance Supply Chain The Business of Surgery

The United States Food & Drug Administration (FDA) is touting the benefits of tying unique device identifiers (UDIs) on medical devices to patient outcomes via electronic medical records. UDIs have been a long-term dream for many in healthcare, who view the ability to track and trace medical devices using unique item-level codes as a true game changer for patient safety and documentation quality.

By utilizing UDIs on a wide scale for the first time, the FDA is hoping to not only improve the ease of patient safety recalls but also to study the post-market effects of devices on patient outcomes. This article from Greg Slabodkin at Health Data Management elaborates:

“A medical device may ultimately get approved and—as it is used in a larger population—we understand its benefits but also potential concerns and may need to pull that device from the market,” Amy Abernethy, MD, FDA’s principal deputy commissioner and acting CIO, told last week’s Interoperability Forum, held by the Office of the National Coordinator for Health IT.

“One way to do that is to have the universal device identifier available in the electronic health record and now have the universal device identifier start to be linked to patient outcomes,” said Abernethy.

The Global Unique Device Identification Database, which is publicly available, contains key device identification information submitted to the FDA about medical devices. Currently, the GUDID database contains more than 2 million device records and enables patients and healthcare providers to download information about their devices.

However, the FDA is working with ONC, the Centers for Medicare and Medicaid Services and the National Library of Medicine on improving the accuracy of device-related adverse event reporting and expediting the resolution of device-related problems, according to Abernethy.

“I believe interoperability is key to all types of processes going forward—including the interoperability from the electronic health record—and that this is a place where FDA and ONC can continue to collaborate and work together,” she added.

In the next couple of months, the FDA will release a plan to modernize the agency’s technology infrastructure, including interfaces with stakeholders, Abernethy said.

She made the case that modernized, active surveillance that utilizes real-world data is the future of medical device safety signal detection and is one of the agency’s main priorities.”

Read the entire article here: FDA sees benefits of linking universal device IDs to EHRs

With data accuracy around implants and medical supplies a constant source of frustration for hospitals and the FDA, the roll-out of UDIs will bring a sea change to the healthcare system. To make sure you’re ready for the UDI roll-out, consider a system like iRISupply that targets the procedural areas of a hospital, where hospitals spend and make 50% of their dollars. The system is UDI-ready and gives all the anticipated benefits of UDI today by using RFID technology to track supplies down to the item-level. The software will arm your hospital with the data you need to make inventory optimization and patient safety decisions that will provide a large and sustainable ROI to your hospital. The system also links implants and supplies used in procedures automatically to your EMR via a direct two-way interface.

FDA Presses Industry To Use Duodenoscopes With Disposable Components

September 3, 2019Sri Mandava Hospital Management Infection Control Managing Endoscopes Patient Safety Regulatory Compliance

The United States Food and Drug Administration (FDA) has begun its effort to move the US healthcare industry to use duodenoscopes with disposable components, such as end caps. The effort is being made to reduce the incidences of superbug transmissions through inadequately reprocessed duodenoscopes that have been reported in recent years.

The FDA is urging healthcare facilities to end their use of duodenoscopes with rigid end caps from the major manufacturers Olympus, Pentax and Fujifilm. Their view is that using disposable end caps can remove one variable from reprocessing that has proven difficult to properly disinfect for some facilities. A recent article by Conor Hale at Fierce Biotech continues:

“..the FDA is urging duodenoscopes be designed with single-use caps that eliminate the need for reprocessing and allow improved access to the device’s interior for cleaning. The first duodenoscope with a disposable plastic end cap, Pentax’s ED34-i10T, was cleared in September 2017; Fujifilm has since received clearance for a similar model.

For the future, the agency recommends the industry move toward fully disposable duodenoscopes once they become available.

“We recognize that a full transition away from conventional duodenoscopes to innovative models will take time and immediate transition is not possible for all health care facilities due to cost and market availability,” Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, said in an agency statement.

“This is why we’re communicating with health care facilities now—so they can begin developing a transition plan to replace conventional duodenoscopes—and those facilities that are purchasing duodenoscopes with fixed endcaps can invest in the newer, innovative models,” Shuren said. “We are also encouraging the manufacturers of these duodenoscope models to assist health care facilities with their transition plans.”

Though the overall risk of transmitting infections through reused duodenoscopes is relatively low, continuing reports of contamination have caused the agency to act, he added. Earlier this year, the FDA reported new surveillance data tracking infection rates linked to reprocessed devices from Olympus, Fujifilm and Pentax.

In April, the agency disclosed that 5.4% of samples tested positive for what it describes as “high concern” organisms—such as Escherichia coli or the bacteria related to staph infections—up from 3% detailed in a safety communication in December 2018.

According to the FDA, flexible duodenoscopes are used in more than 500,000 endoscopic procedures a year, including in the diagnosis of the pancreas and bile ducts. Reprocessing procedures can take hundreds of steps to remove bodily tissues and fluids as well as microorganisms.

“Information from postmarket surveillance human factors studies indicate that many steps in the reprocessing instructions cannot be reliably followed by health care facilities,” the agency said, referring to real-world studies required of Olympus, Fujifilm and Pentax, adding that users frequently had difficulty understanding and completing the manufacturers’ instructions.

Going forward, the FDA is ordering new postmarket studies of devices with disposable end caps to ensure the feature makes reprocessing instructions easier to follow and lowers contamination rates. The agency requested that real-world contamination rates be included in product labeling once those studies are completed.

“We are collaborating with the FDA and are supportive of their recommendation of a gradual transition to duodenoscopes with disposable components,” an Olympus representative said in a statement to FierceMedTech. “Accordingly, we are diligently working on development of a disposable endcap duodenoscope and anticipate filing our submission to the FDA as soon as possible.”

The FDA is not making any changes to the approval status of currently cleared devices and said that it believes the continued availability of fixed end cap devices is in the best interest of the public health at this time.”

Read the entire article here: Too tough to clean: FDA urges industry transition to disposable duodenoscopes

While the transition from rigid end caps, to disposable end caps to potentially fully disposable duodenoscopes takes place, hospitals must make sure that their staff is following the proper protocols each and every time a duodenoscope is reprocessed. Systems such as iRIScope can display the proper workflow for reprocessing duodenoscopes and document the process automatically. Any breaches of protocol can be alerted in real-time to protect patients and identify which staff members need additional training on reprocessing techniques. You owe it to your staff and your patients to offer everyone the peace of mind that duodenoscopes and all other flexible endoscopes are being properly reprocessed every single time.

How To Create A Culture Of Safety Across A Growing Health System

September 3, 2019Sri Mandava Hospital IT Hospital Management Infection Control Joint Commission Managing Endoscopes Patient Safety Regulatory Compliance Tissue Management

Hospitals continue to fight the trends of declining reimbursements and increasing expenses with a multi-pronged attack. One of the favorite tools of larger health systems that are staving off shrinking margins is hospital consolidation. The idea goes that as more hospitals are brought into the health system, efficiencies can be gained by sending less profitable procedures to lower cost settings and consolidating the highest margin procedures at the flagship hospital(s). With all of the changes going on in health care, one fact will remain the same – hospital consolidation is here to stay.

One of the operational challenges of growing a health system is making sure that the same standard of care is reached regardless of the setting. This means that the best practices learned from the flagship hospitals need to be carried out at community hospitals and surgery centers that are built or brought into the fold. While simple in theory, this has been a nagging challenge to health systems in practice.

To create a culture of safety, health systems must not only spend the time and money to properly train staff, they must also invest in the right technologies. While staff can be trained in all the safest practices, how can you ensure that staff are following them when no one is watching? One possible solution is to use software for documentation and tracking.

For example, some of the top hospitals in the country use RFID-based tracking and documentation software from Mobile Aspects to ensure Joint Commission standards are consistently met in their tissue, endoscopy and blood operations. Using this software, health systems are able to define their best practices and enforce them using tracking software. Health systems define the workflows that they want their employees to follow, then Mobile Aspects encodes these workflows into the tracking software to ensure a consistent, repeatable process. When protocols are breached, employees are immediately alerted about skipped or incomplete steps for immediate correction. Managers are also sent reports that allow them to identify employees who make repeated errors so that they can be given additional education.

With all of the uncertainty that hospital consolidation brings to both the acquiring health system and the acquired hospital, make it a priority to introduce automation to ensure consistent practices are followed throughout the health system. This will bring you one step closer to a true culture of safety by making sure employees are following best practices every single time.

Mayo Clinic Physician Reiterates Need To Focus On Safe Endoscope Reprocessing

August 15, 2019Sri Mandava Hospital Management Infection Control Managing Endoscopes Patient Safety Regulatory Compliance

Hospitals continue to focus on duodenoscopes and their successful reprocessing in order to reduce the incidence of superbug breakouts related to endoscopes. The primary concern that hospitals have to address regarding duodenoscope reprocessing revolves around some of the manual components of disinfecting these devices.

Bret T. Petersen, MD of the Mayo Clinic in Rochester, Minnesota recently spoke with Healio regarding some of the current updates around duodenoscope reprocessing, and endoscope reprocessing in general. Dr. Petersen pointed out that while endoscope-related outbreaks have declined over the past year, they are still a persistent risk for hospitals and ambulatory centers performing endoscopic procedures. Dr. Petersen also discussed some of the key updates on reprocessing best practices:

“Since 2015, much of our field has been focused on the need to attend to adequate endoscope reprocessing to avoid further outbreaks like those we’ve seen in multiple major centers from duodenoscopes,” Petersen told Healio Gastroenterology and Liver Disease. “The advice at the present time hasn’t changed greatly, in that we’re still emphasizing the importance of attending to pre-cleaning, cleaning, high-level disinfection, adequate drying and appropriate storage.”

Petersen said the manual components remain weak points in the process, as well as adequate drying after high-level disinfection. However, although outbreaks still occur, overall incidence has been in decline.

FDA oversight remains the most active current issue, Petersen said, with a focus on post-market surveillance studies. Two duodenoscope companies have completed their studies and are awaiting a compilation of all their data, and data from the third company should be ready by the end of the year.

“All of them are, unfortunately showing persistent levels of contamination,” Petersen said. “This brings to play the importance of single-use devices, including colonoscopes and duodenoscopes, which are very close to the marketplace.”

Read the entire article and view the accompanying video here: VIDEO: Focus remains on safe endoscope reprocessing

With all the protocols that endoscope techs and sterile processing staff must follow to properly high level disinfect every scope, hospitals and ambulatory centers must put in the proper checks and balances to make sure scopes are reprocessed properly every single time. While supervisors can spot check and catch a certain percentage of these errors, it’s not feasible to keep a pair of eyes on staff 24×7. This is where a scope tracking system, such as iRIScope from Mobile Aspects, can come into play. The system’s built in artificial intelligence analyzes all reprocessing steps in real-time to assess whether critical steps are missed. The system can then send immediate alerts to supervisors, and even display alerts on storage cabinets to warn end-users not to use any potentially poorly reprocessed endoscopes. While staff can be trained ad infinitum, all employees are prone to occasional mistakes. Help mitigate this risk with a smart tracking system like iRIScope and you could potentially save patients’ lives.

How To Increase Endoscope Reprocessing Protocol Adherence With Technology

August 8, 2019Sri Mandava Hospital Management Infection Control Joint Commission Managing Endoscopes Patient Safety Regulatory Compliance

Flexible endoscopes have been the source of many superbug breakouts over the past decade. In order to protect your facility from the patient safety and legal nightmares that superbug breakouts lead to, you need to make sure that your staff is following your standard operating procedures for reprocessing endoscopes every single time.

Even the best trained staff members can make mistakes when they come under high-pressure situations. So how can you make sure that you catch any of these mistakes when they occur and what can you do to prevent them from happening in the first place? As this article from Cynthia Saver at OR Manager discusses:

“Policies and procedures. Policies and procedures should be specific, sufficient, and congruent with current guidelines, [Scott Lucas of ECRI Institute] says. If they aren’t, they should be revised. Lucas adds that it’s best to have separate policies for instruments and endoscopes because each category has unique needs. He advises reviewing and updating policies on a regular basis and whenever any new equipment is added.

Compliance. Sometimes the best policies and procedures aren’t followed because of pressures such as time constraints. To assess for compliance, the team can review reprocessing logs for completeness, check biological indicator and test procedures and results, and conduct audits.

“It’s good to use peers to conduct some of the audits,” Lucas says. For example, staff can check a percentage of trays for proper processing. Supervisors can conduct random audits at various points in the processing cycle. Some instrument tracking systems may make it possible to link trays to the specific patients on whom they were used.

Staffing. Lucas says the team should ask, “Where are the bottlenecks?” because staff may cut corners in these situations. Bottlenecks may occur during a specific shift or in a specific point in the reprocessing cycle, such as the manual cleaning station.

It’s also important to assess staffing levels, what percentage of staff are from agencies, whether staff have had sufficient training, and how long it takes for staff to clean an instrument. (If cleaning takes a long time, it may be necessary to change the technique so that the instrument is still clean, but the time is reduced.) Lucas recommends that organizations commit to having an SPD supervisor on each shift to support staff and manage problems that arise.”

Read the entire article here: ‘Coming clean’ in the SPD requires collaboration and competency–Part 2

With all the protocols that endoscope techs and sterile processing staff must follow to properly high level disinfect every scope, certain steps may be skipped from time to time. While supervisors can spot check and catch a certain percentage of these errors, it’s not feasible to keep a pair of eyes on staff 24×7. This is where a scope tracking system, such as iRIScope from Mobile Aspects, can come into play. The system’s built in artificial intelligence analyzes all reprocessing steps in real-time to assess whether critical steps are missed. The system can then send immediate alerts to supervisors, and even display alerts on storage cabinets to warn end-users not to use any potentially poorly reprocessed endoscopes. While staff can be trained ad infinitum, all employees are prone to occasional mistakes. Help mitigate this risk with a smart tracking system like iRIScope and you could potentially save patients’ lives.

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