Issue link: https://beckershealthcare.uberflip.com/i/1544360
9 EXECUTIVE BRIEFING 2 EXECUTIVE BRIEFING Borescope benefits While enhanced visual inspection is the standard for inspecting the outside of a scope, the best practice for inspecting the inside of a scope involves using a borescope. Borescopes help identify debris, organic material or damage within an endoscope. Ideally, borescopes are used after an endoscope is manually cleaned, before the endoscope undergoes high-level disinfection. Frequent use of a borescope detects debris or damage earlier, improves an endoscope's performance, decreases repair costs and extends an endoscope's longevity. Borescope use also reduces risks to patients and improves safety. "Doing a borescope inspection every time results in detecting damage earlier," Dr. Drosnock said. "Repair costs go down significantly and scopes can be used longer." The right documentation Another best practice in the endoscopy workflow is rapid documentation of precisely when an endoscope is removed from the patient and the initial cleaning begins. This is referred to as the "point of use treatment" or POUT. It's the first step in the cleaning and reprocessing chain. Accurate, timely notation of the POUT is essential to comply with the "golden hour." This is the critical first 60 minutes from the POUT to when manual cleaning begins in the processing department. If an endoscope sits unprocessed beyond the "golden hour" after a procedure, it must undergo an extended detergent soaking period prior to manual cleaning, a process known as the delayed reprocessing protocol. If cleaning is not performed within this window, organic material can dry and harden on the endoscope, biofilm can begin to form and subsequent cleaning becomes more difficult, time-consuming, and costly. While delayed reprocessing is intended to mitigate these risks, it introduces additional workflow complexity and variability, particularly in busy endoscopy units where tracking time out of use and ensuring proper adherence can be challenging. This makes it difficult to ensure delayed reprocessing compliance and, in turn, can compromise patient safety. Ms. Darga said easy, practical ways to document the POU include using Healthmark's one-hour hang tag, writing the POU on the biohazard label and entering this information into the electronic medical record. Consistently documenting the POU is important even when the same person, typically a technician, is responsible for both the POU and processing. While it may be tempting to assume documentation isn't necessary because the technician knows when the golden hour ends, unpredictability and distractions can intervene. Establishing a disciplined documentation process, which can take just seconds per case, helps reduce risk and improve safety. The right standard Decreasing the risks in endoscopy reprocessing through enhanced visual inspection, use of borescopes, effective documentation and other best practices requires establishing organizational competencies and implementing standard operating procedures. Embedding the right competencies in the endoscopy team starts with hiring qualified technicians, continuously educating them through ongoing training and conducting frequent monitoring and audits. Beyond instilling the necessary competencies, nothing replaces having consistent, repeatable processes, which ensures that reprocessing is done the same way after every procedure. "Every scope should be inspected with enhanced visual inspection every time after it's cleaned," Dr. Drosnock said. "That's the requirement and the standard." Dr. Mary Ann Drosnock DrHSc, CIC, CFER, RM (NRCM), AAMIF, FAPIC Head of Clinical Affairs at Healthmark and nationally recognized expert in flexible endoscope reprocessing and infection prevention. Dyan Darga RN, MSN, CGRN, NE-BC A Healthmark Clinical Education Specialist with decades of hands-on experience in endoscopy, gastroenterology, and endoscope reprocessing.